How and why we process health data

NHS Digital require us to further detail how we access, and use, ONS births and deaths (mortality) data and Hospital Episode Statistics (HES) data. 

• ONS death files hold personally identifiable data about people who have died in our area, as provided at the time of registration of the death, along with additional GP details, geographical information, details about the cause of death and associated administrative details. 
• ONS birth files hold personally identifiable data about births in our area, collected at birth registration along with details relating to mothers and fathers, stillbirths, birthweight and geographical information. 
• Hospital Episode Statistics hold pseudonymised data collected when someone attends accident and emergency, is admitted to a hospital bed, attends as an outpatient, or attends an urgent care centre

Our access to these data is by application to NHS Digital for use by public health analysts in local authorities for statistical purposes to support our functions. Data supply and management is covered by a Data Access Agreement (DAA) with NHS Digital.

The terms of the DAA stipulate that data are supplied to us under specific legislation and for specific purposes. ONS births and deaths data access is permitted under section 42 (4) of the Statistics and Registration Service Act 2007, as amended by section 287 of the Health and Social Care Act 2012, for the purpose of statistical analysis for Local Authority Public Health purposes. Hospital Episode Statistics data are supplied in accordance with section 261 of the Health and Social Care Act 2012. Data is released under regulation 3 of the Health Service (Control of Patient Information) Regulations 2002 and can only be used for Public Health purposes.

This ONS births, deaths files and Hospital Episode Statistics are of significant value to the local authority as it enables our analysts to:

• respond to, identify and monitor patterns and trends in birth rates, low birth weight and stillbirths, highlighting differences between geographic areas, age, sex and other characteristics. It is also used to identify differences between areas and inform the planning and targeting of health, care and public health services
• respond to and identify patterns and trends in death rates, life expectancy and premature death, highlighting differences between geographic areas, age, sex and other characteristics. It is also used to identify differences between areas and inform the planning and targeting of health, care and public health services
• measure the health, mortality or care needs of the population, for a specific geographical area or population group
• plan, evaluate and monitor health and social care policies, services or interventions; and,
• protect and/or improve the public’s health, including such subjects as the incidence of disease, the characteristics (e.g. age, gender, occupation) of persons with disease, the risk factors about sections of the population, or the effectiveness of medical treatments

Identifiers included in data relating to ONS birth files

The term person identifiable data relates to any data that could potentially identify a specific individual. The following fields in the Birth Record are classified as person identifiable:

• address of usual residence of mother
• place of birth
• postcode of usual residence of mother and postcode of birth of child
• NHS number of child
• date of birth of child
• mothers age
• still birth indicators
• birth weight of the baby

These identifiable data are processed by Lambeth Council for specific purposes, including determining catchment areas, distances and drive times for providers of fertility and maternity services, and monitoring trends in monthly births to identify patterns in birth rate across the year.

Identifiers included in data relating to ONS death files

The term person identifiable data relates to any data that could potentially identify a specific individual. The following fields in the Primary Care Mortality Dataset are classified as person identifiable:

• deceased’s address
• postcode of usual residence of the deceased
• postcode of place of death
• NHS number
• date of birth
• date of death
• maiden name
• name of certifier
• name of coroner
• cause of death

These identifiable data are processed by Lambeth Council for specific purposes including the suicide audit (which gathers information on suicide to identify local hotspots and risk factors to inform work on the prevention of suicide and directing at-risk individuals into preventative and treatment services), the investigation of child deaths to identify if they were preventable, the investigation of deaths in public places for accident prevention, and the seasonal monitoring of death rates.

Information included in data relating to Hospital Episode Statistics (HES)

Data provided is pseudonymisation, this is a process where information within a data record that may identify an individual are replaced by artificial identifiers, or pseudonyms, and can no longer be attributed to a specific person without the use of additional information.

Information held includes:

• age
• method of admission
• source of admission
• diagnosis codes
• procedure and investigation codes
• area of residence
• hospital attended
• date of attendance
• GP practice of patient