Unreliable data will impede the NHS's planned improvements in patient care. Howard Davis looks at how enhancing clinical data quality in community care and mental health can support better decision making and care delivery.
The NHS is moving to a more collaborative, integrated approach in designing, planning, and delivering health services across local areas. This means that the data used across different types of NHS organisations needs to be consistent and reliable across all settings: inpatient, outpatient, community – and across all provider types, from specialist hospitals to mental health providers. Unfortunately, it's clear that these standards are currently not in place.
Traditionally, mental health and community data has received less scrutiny than acute hospital data. As a result, the data for these two sectors is less well developed. This will make it harder for health systems to progress with the integration of services and deliver improvements in care.
Working with the HFMA to improve community and mental health data
We have been collaborating with the Healthcare Financial Management Association (HFMA) to look at the challenges that NHS clinical data quality presents to accurate cost information, and the relevance of decisions based on this data.
The HFMA is a professional association for finance staff working in healthcare. It's a charitable organisation that uses its local and national networks to promote the highest professional standards and innovation in financial management and governance across the UK health economy. It's provided independent support and guidance to its members and the wider healthcare community for over 70 years.
The first stage of our work with the HFMA was published earlier in the year, identifying that improvements were required in community and mental health data. We also described the steps that executive staff and clinical leaders can take to put processes in place to deliver accurate clinical and cost information.
Since then, we've worked with both the HFMA and NHS colleagues from community and mental health organisations to understand their concerns and explore practical solutions to improve the accuracy and usability of their clinical data. We published these fresh findings in our second briefing: improving data quality for costing community and mental health services.
Why is clinical data quality so important?
One reason community and mental health services struggle to demonstrate their value within health systems because they don't have enough reliable and relevant data. Accurate data is necessary to drive the necessary innovation and changes to care outlined in recent NHS policy documents, including its Long Term Plan:
Improving patient pathways - good-quality data helps the NHS to provide the right care for the right patient in the right place
Delivering better value - robust cost data helps the NHS understand how resources are used, and supports the reduction in unwarranted clinical variation
Tackling health inequalities - community and mental health services have a key role to play in reducing the impact that inequalities have on a patient’s health; accurate data helps the NHS identify those inequalities and plan to address them
Effective financial management - reliable information will be key to helping the NHS understand the underlying financial positions of systems when financial baselines are reset after COVID-19
Yet, understanding the benefits of improving clinical data quality does not make the solutions for delivering it obvious.
Identifying practical solutions to help the NHS improve its data
The lower scrutiny of mental health and community data has ingrained problems with accuracy. When the HFMA's Costing for Value Institute recently surveyed its members on mental health and community health data, many members responded that it was often of poor quality or even incomplete.
We collaborated with Institute members to identify potential solutions that would help them realise their ambitions for improving patient care, including chairing a workshop at the Institute’s Costing Conference in April 2021.
Area of business to impact
Governance and leadership
Ensure you have the basic governance in place: nominate a Board member with specific responsibility for scrutiny and oversight of clinical data quality
Establish a data quality panel chaired by a clinician: identify areas to improve and optimal resource allocation to achieve this
Using the data
Ensure that cost information is used to support decision making: improvements will happen as clinicians review their activity and identify service improvements
Make data readily available and easily understood: interactive reporting, trend analysis, or dashboard reporting
Clinical relevance and ownership
Align data entry into clinical systems with how care is delivered so that it generates meaningful, clinically relevant information
Build in checks to improve clinical data quality: monthly activity sign-off with operational managers
Informatics, operational service, and finance teams should spend time understanding each other's activities to ensure that data is more joined up and consistent
Establish a single-version-of-the-truth for activity data to align national and local reporting, and internal and external views of services are the same
Good data quality is not only necessary for financial management. The primary use of the data is clinical. The same data underpins service redesign and the monitoring of clinical quality, as well as the Model Health System and Getting it Right First Time [ 1316 kb ].