Assessment Report: Statistics on Prescription Cost Analysis: England

In 2020, we fully assessed the NHS Business Service Authority’s (NHSBSA) Prescription Cost Analysis (PCA): England statistics against the Code of Practice for Statistics. NHSBSA are a new official statistics producer and this assessment was prompted due to a change in publication ownership from NHS Digital to NHSBSA.

Key Findings

The PCA is a valued, long-standing and trusted source of information used by government departments, the pharmaceutical industry, academics and professional bodies. The statistics enable users to understand the cost and demand for prescription items (drugs, appliances or dressings) in England.

The main focus of our requirements is around improving the public value of the statistics to meet the needs of users through a number of ways. Encouragingly, the team at NHSBSA has a number of user engagement activities planned to enhance and develop its understanding of the uses and users of the PCA. As part of this, we expect to see collaboration with pharmaceutical experts and clinicians to improve the level of insight, liaison with statisticians in the devolved administrations to improve the comparability and coherence of PCA across the UK and improve explanation and signposting between existing PCA data sources at NHSBSA.

The statistics are robust, with an enhanced level of quality assurance. NHSBSA have plans to revise and consult on the methods used to produce the PCA. We recommend that they collaborate with other experts in the UK to enhance the comparability and coherence of the statistics.

Finally, as a new official statistics producer, the NHSBSA has to improve some elements of trustworthiness to demonstrate full compliance with the Code. More regular contact with the Head of Profession at the Department of Health and Social Care (DHSC) will ensure that the Lead Official at NHSBSA is appropriately supported in their role. There were also wider concerns raised by users around the clarity of the process to request data held by NHSBSA. The NHSBSA should ensure that the process is clearly defined and understood by users. FoI requests should also be reviewed periodically with a view of publishing more routine data.

Recommendations

The PCA statistics can maintain National Statistics designation once we have confirmed that the improvements outlined in the six requirements set out in the report have been made. NHSBSA have committed to publish an action plan in November 2020, setting out how they plan to meet each of our requirements. They will report back to us by the end of February 2021.

Related Links:

Ed Humpherson to Michael Cole: Assessment of Prescription Cost Analysis: England statistics

Nina Monckton to Ed Humperson: Requesting assessment of the prescription cost analysis

Ed Humperson to Nina Monckton: Assessment of Prescription Cost Analysis

Mental Health Statistics in England

Attitudes towards mental health have changed in recent years. Mental health, which was often stigmatised and not discussed openly, is receiving increasing public, media and government attention as an important public health issue. There is a greater awareness that mental health is something we all have and, just like physical health, it can sometimes be good and sometimes be poor.

Our review of mental health statistics in England, carried out before the Covid-19 pandemic, explores why good statistics in this area are important, but is not intended to provide specific guidance on statistics directly related to the effects of the pandemic. We hope however, that sharing our findings on the strengths and weaknesses of mental health statistics, along with highlighting specific recommendations for improvements, will help inform decisions in the statistical sector both in the immediate term and going forward.

Our research for this review focused on answering the following two questions:

  • is the mental health statistical system publishing the information required to provide individuals, service providers and policy makers with a comprehensive picture on mental health?
  • do the existing statistics help answer the key questions about mental health in society today?

We spoke to a wide range of statistics users across different areas of society. They told us of their need for high quality statistics which are able to answer a broad range of questions. Users told us that the existing statistics did not paint a full enough picture of individuals and their conditions, and that producers should be taking greater steps to maximise the insight from existing statistics. In some areas they wanted to know more than the current statistics were able to tell them.

We heard that there is a need for improved quality across the datasets underlying many mental health statistics. Users told us that mental health statistics should be more accessible, both in terms of finding relevant publications and in relation to producers making publications easy to read and explaining clearly the limitations of the statistics. In addition to this, they spoke of their frustrations that some surveys were not carried out as often as they would like, as well as challenges around obtaining data for secondary analysis purposes.

Our research identified that, although the existing mental health statistics go some way to meeting user’s needs, there is much more that can be done.

Our recommendations:

  1. Statistics producers and organisations should exploit the value of the statistics through better data, greater analysis and linking data.
  2. We want to see continued activity to improve the quality of underlying statistics datasets, as well as clear communication with users about quality issues.
  3. We want to see clearer leadership and greater collaboration across producers of mental health statistics.
  4. Access to NHS Digital data needs to improve.

We understand that addressing these issues may not currently be a priority for statistics producers due to the COVID-19 situation, however we expect statistics producers to work collaboratively towards delivering these recommendations when they are able to do so.

Report on Adult Social Care statistics in England

Today, the Office for Statistics Regulation (OSR) has published its findings from an in-depth review of Adult Social Care statistics in England.

The need for good data to support delivery of adult social care should not be underestimated. While there is rightly a focus on delivery, a scarcity of funding has led to under investment in data and analysis, making it harder for individuals and organisations to make informed decisions.

This needs to be addressed. The need for information is increasing as society evolves and the demands on social care services over coming years look set to increase. Improved data matters in solving problems, supporting efficiency and maximising outcomes. It is also important to inform decisions made by individuals about the care they receive or provide for themselves and their families.

Our review highlighted three main areas for attention:

  • Better leadership and collaboration across the many different organisations involved in the process of publishing official statistics on social care, that enables working across boundaries to join-up government departments, local authorities and between public and private sector providers;
  • Gaps in available data as most information available comes from local authorities with responsibilities for adult social services and does not cover private household expenditure, privately funded care or the value of unpaid care causing limited knowledge of individuals care journeys and outcomes; and
  • Improving existing official statistics through accessibility, coherence, quality, timeliness and granularity of the data to provide insight and allow existing data to better meet user needs.

 

Related Links

Mary to Sandra Tudor, MHCLG (January 2020)

Mary Gregory to Chris Roebuck, NHS Digital (January 2020)

Mary Gregory to Mark Svenson, NHS England (January 2020)

Mary Gregory to Iain Bell, ONS (January 2020)

Systemic Review Outline: Adult Social Care

Response from NHS Digital on Adult Social Care in England (February 2020)

 

NHS Digital data access review update – May 2019

Executive Summary

This report sets out the initial conclusions from the Office for Statistics Regulation’s (OSR) Review of NHS Digital’s data sharing and access processes, and the areas that will now be subject to further review.

Enabling users to access data is one of the key ways that statistics producers can meet the Code of Practice for Statistics’ expectations to fulfil the potential of the data they hold.

The areas we will be focusing on have been identified following conversations with users of English health data about their experiences of accessing data from NHS Digital.

We have identified some actions that OSR and NHS Digital can take now to address user concerns without needing further exploration.

The main objective of the next stage of the Review is to identify ways to ensure that the full potential of NHS Digital’s data can be realised. It will address two areas:

  • How can users with innovative or complicated proposals be supported to access health data in England?
  • How can data users and NHS Digital work together to improve data quality and documentation?

 

Related Links:

Ed Humpherson to Sarah Wilkinson (NHS Digital), May 2019

Joining Up Data for Better Statistics, September 2018

Exploring the public value of statistics about post-16 education and skills in England

The Office for Statistics Regulation (OSR) is exploring the value of data and statistics in relation to post-16 education and skills in England.

Good quality and accessible information in this area is important to support the most fair, efficient and effective provision of education and training to meet the needs of both individuals and employers. This report explores the extent to which data and statistics in England meet this need and focusses on three main areas: further education and apprenticeships, higher education, and skills and lifelong learning. It does not aim to present a definitive picture but aims to start a conversation about priority areas for improvements.

We have now completed the next phase of our review where we have engaged with users and producers with a specific interest in statistics on post-16 education and skills in Wales, Scotland and Northern Ireland, and we have produced a UK report. 

NHS Performance Measures

Over the last two years the Office of Statistics Regulation has investigated different concerns over accident and emergency (A&E) statistics in England, Scotland and Wales.

We have worked closely with statisticians producing these statistics on A&E attendance and waiting times to make timely and informed interventions.

This report summarises our interventions and serves as a vehicle to develop and innovate the presentation of performance measures more widely.


Related links:

Ed Humpherson to Mark Svenson

Ed Humpherson to Glyn Jones

Ed Humpherson to Roger Halliday

 

Improving the Public Value of Health and Care Statistics in England

In 2015, we became concerned that there were issues within the statistical system that needed to be addressed to enhance the public value of health and social care statistics. We discovered from a series of Patient Experience assessments published in 2014 that areas for improvement were replicated across a suite of statistics published by different producers, indicating a systemic problem. These concerns led to a suite of co-ordinated activity undertaken by the Office for Statistics Regulation (OSR) to improve the coherence and accessibility of health and social care statistics in England.

As part of this systemic review the Office for Statistics Regulation took the lead on:

  • identifying key issues of coordination and leadership within the statistical system;
  • obtaining acknowledgement of the issues by the organisations involved in producing these statistics;
  • asking producers to take ownership of the issues and commit to improvement; and
  • facilitating discussions to develop actions for the statistical system.

The report summarises the key findings, action taken and recommendations from this suite of activity.

Following the publication of the report we stepped back from convening producers and setting the agenda, allowing those producing the statistics in England to take leadership in setting the strategic direction for health and care statistics. During this time, we retained regulatory oversight to assist improvements with health and care statistics.

In April 2019, we took the decision to close the formal part of this systemic review. We felt that this was an appropriate decision given the progress we had seen over the previous 12 months, and our increasing confidence that producers of health statistics across the UK are looking to collaborate and support each other better. At this point we continue to keep in touch with the EHSSG to ensure that progress continues at a satisfactory rate and the EHSSG continues to deliver against its action plan.

 

Related links

Letter to producers, setting out the recommendations which they needed to act on to maintain momentum (March 2018)

Health and Social Care Statistics in England: update on Systemic Review

In 2015, following a series of assessments, we identified a range of systemic issues affecting health and care statistics in England. Fundamentally, there was no single individual or organisation with clear leadership responsibility and this had led to problems with the coherence and accessibility of these statistics. To bring about change, we have engaged with the system intensively over the past two years, with staff from the Office for Statistics Regulation convening and leading three Round Table meetings and two conferences seeking buy in to improvements and practical steps to bring about change.

We held the first Round Table meeting on 22 February 2016 involving senior decision makers in the health sector, then published a discussion paper ‘Health Statistics – Direction of Travel’ in March 2016 reflecting broad recognition of the issues we had identified. To kick-start engagement with the statistics user community, we ran a successful ‘Health and Care Statistics Summit’ in July 2016. To keep momentum going, we convened a second Round Table in December 2016 and the third Round Table in May 2017. Participants agreed that the short term focus would be on strengthening the system through the collaborative work plan set out by the English Health and Social Care Statistics Steering Group (EHSSG). This cross-producer group was set up in response to our intervention and is a key player in implementing operational change. It has published a vision and action plan and works through a set of theme groups.

In November 2017 we hosted a conference ‘Putting users’ needs at the heart of improving health and social care statistics’. This brought together eight EHSSG theme leads with users interested in statistics in their area and was judged by participants to be a useful model that could be replicated in future. However, many users are unaware of the positive work that statisticians are doing to improve health and social care statistics. This affects the confidence users have in the system and we can see that they are still frustrated with the pace of change.

As we stand back from our intensive convening role, we are pleased at the foundations that have been laid through the work of the EHSSG and are keen to see that the full potential of the group is realised. We have published a report on progress made and sent a letter to producers, setting out a series of recommendations which they need to act on to maintain momentum. Progress against these recommendations will be reviewed as part of our 2018/19 Regulatory Portfolio and we will intervene if progress is not sufficient. Considering the scale of the task, we expect to monitor progress for at least two years. We will also use compliance checks and assessments to look at statistical outputs and how they are developing.