Dear Dr Dixon,

Health Foundation analysis of the impact of the Optimised Patient Tracking and Intelligent Choices Application.

Thank you for your letter of 22 July 2026, in which you formally shared with the Office for Statistics Regulation (OSR) the Health Foundation’s analysis of the impact of the Optimised Patient Tracking and Intelligent Choices Application (OPTICA).

Thank you for clearly setting out the main findings of the analysis, most notably that the Health Foundation found no evidence of measurable improvements in discharge performance among the trusts using OPTICA. We have noted your comment that the findings contrast sharply with the claims about the benefits of the OPTICA cited on the NHS England website at the time of writing.

As you are aware, we considered the Health Foundation’s findings as part of our wider casework investigation into the communication and presentation of the impact of the Federated Data Platform (FDP) on NHS performance metrics. We understand that the Health Foundation’s analysis had not been commissioned by NHS England, but that it had been shared with NHS England at a senior level and that NHS analysts had subsequently reviewed its key findings.

In our engagement with NHS England, the FDP team has referred to a positive and constructive relationship with the Health Foundation. They told us that key differences between the methods used in the Health Foundation analysis and the methods used by the NHS had been discussed by the relevant analysts from both parties. This included a difference in the cohort analysed; we understand the Health Foundation analysis looked at all patients, including those staying fewer than 7 days in hospital, whereas NHS England analysis was restricted to patients staying more than 7 days (in line with their intended use of OPTICA).

Having received your letter, we noted the high probability that the Health Foundation’s report will be compared directly to NHS England’s published information on OPTICA benefits. We expressed to NHS England our concern that the contrasting information about the impact of OPTICA is leading to a confused picture for patients and the public. We also reiterated that it is important that the information published by NHS England on OPTICA’s impact is communicated to users and the public with integrity, clarity and accuracy.

The FDP team recognised that further work should be undertaken to improve the communication of the impact of OPTICA and to follow up on some of the findings from the Health Foundation’s analysis.

As a result of our casework, NHS England committed to four actions regarding its OPTICA reporting and its engagement with the Health Foundation. NHS England told OSR it would:

• (i) Reengage with the Health Foundation to get their input into the national evaluation methodology.
• (ii) Ensure evaluating the impact of OPTICA [discharge planning] is a top priority for the national evaluation contract work.
• (iii) Apply the same caveats around causality (as stated in our response to the previous issue [FDP uptake and benefits]) to our comms and on the website around OPTICA’s impact on discharge delays.
• (iv) Clarify on the website that the case studies are written by organisations using FDP themselves and are not authored by NHS England.

We understand from NHS England that it has since carried out actions against all four commitments. This has included: contacting the Health Foundation to invite your analysts to comment on Imperial College’s evaluation methodology plan for the national evaluation methodology; including an evaluation of OPTICA as a priority area for the national evaluation; updating the FDP website on 22 July with caveats on causality around OPTICA’s impact on discharge delays; and updating the FDP website to clarify the content presented in the OPTICA case studies is authored by individual trusts, not by NHS England. We understand that analysts from the Health Foundation are due to meet statisticians from NHS England to discuss some of these areas in September 2026.

In further discussions with the FDP team on 31 July, we have also recommended that NHS England should consider publishing a public reference to the upcoming Imperial College evaluation on the FDP website, with clear information on the project’s scope and timeline. Information about the evaluation is also available on the government’s Evaluation Registry. Given its importance to patients and stakeholders, NHS England should communicate the evaluation and its findings transparently from the outset.

I agree with you that the transparent use of robust evidence is vital for maintaining public trust and supporting effective decision-making. OSR will continue to monitor NHS England’s work to strengthen the quality and communication of the FDP benefits data, including OPTICA, and its onward interpretation by users. Where necessary, we will make further recommendations to NHS England for improvements and highlight any practice which does not align with our expectations under the Code of Practice for Statistics.

I would welcome the opportunity to meet to discuss this matter with you further. If you are happy to do so, I will contact your office to find a convenient time in the near future.

For completeness, I have copied this letter to the Chair of the Health and Social Care Committee, Layla Moran MP, and to the Chief Executive of NHS England, Sir Jim Mackey.

Yours sincerely,

Ed Humpherson
Director General for OSR