Equitable Commissioning for a Diverse Society: are we using the right intelligence?
Written by admin on Wednesday, October 10, 2007 09:32
Key points from Kings' Fund Seminar
The King’s Fund, jointly with the London Health Observatory (LHO), held a half-day seminar on 22 June 2007 to discuss the challenge of equitable commissioning for ethnically diverse populations and explore what data and intelligence is needed by commissioners in order to commission well.
The focus of the day was on ethnicity data in the NHS in England, although it was recognised that similar, if not greater, challenges lie ahead in relation to data collection and use relating to disability and sexual orientation.
Key points to emerge from the seminar
- NHS reforms have created new opportunities for data-driven, intelligent commissioning, by both primary care trusts (PCTs) and primary care clinicians, which should help to deliver efficient and equitable services in the future.
- However, there are substantial gaps in the data on service use available to commissioners. These include: no routine, national data on the ethnicity of patients registered with and using GP services, no ethnicity data on outpatient attendances or A&E attendances and patchy data on the use of community-based services. Better data exists on the ethnicity of inpatients and users of mental health services.
- There are also gaps in mortality and morbidity data, including no ethnicity on birth and death certificates.
- These gaps are hampering the ability of commissioners to assess need and commission services equitably. The gaps are compounded by very limited use of the available data, which can potentially be analysed much more fruitfully than at present.
- Notwithstanding the national data gaps, there are examples of very good practice locally of data collection and data use in primary care, which should be disseminated more widely. It was felt to be important to move the focus of the debate on from the practicalities of data collection to the uses to which the data can be put, particularly to convince clinicians of the utility of collecting such data.
- The Department of Health is aware of the data collection gaps and is promising action. This was welcomed by many of those attending the seminar, who called for clear and effective leadership from the centre. Many of those attending felt that collection of ethnicity data should be made mandatory in primary care and secondary care and that the results of the data collection should be accessible to commissioners.
- Many felt that Connecting for Health should reconsider its position on its classification of ethnicity as a 'sensitive' data item under the Data Protection Act, which affects both the collection and sharing of ethnicity data with commissioners. Many of those attending argued that failing to make this ethnicity data collection mandatory and accessible now and in the future as part of the Electronic Patient Care record was potentially illegal under the Race Relations Amendment Act and put the NHS out of step with other public services where such data collection is both routine and uncontroversial.
For more information, seminar presentations and to download a detailed summary of equitable commissioning seminar click here.
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