Andrew Mason

Data Warehouse and BI Manager Information Services, NHS Business Services Authority

Supernova Award Category: 

Data to Decisions

The Organization: 

The NHS Business Services Authority (NHSBSA) is an Arm's-Length Body of the Department of Health and Social Care, which delivers a range of national services to help the NHS run efficiently. NHSBSA manages healthcare information at scale and has a reputation for driving cost savings and efficiencies across the NHS. The NHSBSA manages approximately £36 billion of NHS spend annually - over 25% of the NHS’ annual budget. The purpose of the NHSBSA is to be a catalyst for better health and it uses its data and insight to add value to the wider healthcare system.

The Problem: 

In 2014, the NHSBSA was given the challenge of identifying £1 billion of annual savings as well as aligning the use of its data assets to the NHS Long Term Plan and starting to improve patient outcomes; for example, reducing polypharmacy rates and identifying individuals who are on potentially harmful combinations of drugs. It was time to stop being a provider of raw data and to start being a provider of world class analytics and insight. In 2020, this became even more important when the COVID-19 pandemic hit the UK, and the NHSBSA and its partners needed to find a way to support and protect individuals who were ill and high risk, and to minimize risk to the rest of the population. 

The Solution: 

The NHSBSA assembled a team of data scientists, data engineers and data visualizers to identify savings and ways to improve patient outcomes, which were productionised in enterprise data warehouse and a suite of business intelligence products that support the wider NHS in monitoring and improving prescribing habits as well as improving the Dental and Optometry services within the NHS. In response to the COVID-19 pandemic, the Chief Medical Officer (CMO) for England, working with the CMOs of the devolved administrations and other senior clinicians, commissioned NHS Digital to produce a list of vulnerable people at high risk of complications from COVID-19, who should be shielded for at least 12 weeks. The NHSBSA utilized its prescribing/dispensing data to support NHS Digital in the creation of the shielded patients list (SPL), which enables partner organizations across the government to support and protect those who needed shielding at this time. 

The Results: 

The NHSBSA Insight directorate transformed transactional systems into a key management information tool, putting data at the heart of decisions that can impact patients’ lives as well as identifying savings which can be put back into front line services. The Data Science team identified £100m of potential savings within the first 6 months with £1bn+ of savings identified by 2019. Business Intelligence products have been released to provide the NHS with actionable insight that informs decision makers and improves patient outcomes. Currently 4,000+ registered users can access dashboards that address: improving prescribing habits; improving patient outcomes; identifying savings; and reducing fraud, error and waste.
This data warehouse and data set allowed NHSBSA to respond to COVID-19 by: (1) Identifying groups for the Shielded Patient List: “At risk”- 19 million people at risk from influenza, who should practice strict social distancing; and “At high risk”- 1.5 million people who should practice complete “shielding”; (2) Reducing foot traffic to doctors’ surgeries by identifying patients who would benefit from electronic dispensing of medications; (3) Relieving pressures on pharmacies that deliver medications, depending on their customer base; (4) Providing reports about prescribing trends, drug prices and dental visits; (5) Providing data on dental workforce and urgent/non-urgent treatments. 

  • 59% of practices have decreased the percentage of patients prescribed two or more medicines likely to cause kidney injury -- to 58,300 fewer patients.
  • 9,400 fewer patients prescribed 10 or more unique medicines.
  • 7.6% fewer patients receiving antibiotics, prescribed in GP practices in England (13.1 million compared to 14.2 million).
  • Over 4,000 registered users of their BI products
  • Data used to support Public Health England to understand Cancer Care Pathways
  • In response to COVID-19, supported the identification of circa 19 million individuals that would make up the shielded patient list
  • 3,000 GPs contacted to identify patients who would benefit from electronic repeat dispensing to reduce footfall in GP practices 
The Technology: 

Oracle Exadata and Oracle Analytics Cloud plus the use of Oracle Data Miner and R to support the data scientists.
The NHSBSA Open Data Portal is powered by cKAN.

Disruptive Factor: 

The NHSBSA is, at heart, a high volume transaction business, reimbursing pharmacists for the drugs they dispense as a perfect example. As a result, the NHSBSA had a wealth of data which was being underutilized. The Insight directorate has taken the byproduct of a transactional process and transformed it into first class actionable insight, which has had a huge impact on the NHS and patients who rely on the NHS. Not only are the NHSBSA creating BI products to inform the wider NHS and improve decision making, they are also committed to ensuring their data sets are open so that other organizations can harness that data and create social value from it.  

Shining Moment: 

In Jan 2014, NHSBSA was asked to deliver £1 billion of annual savings. They set up a data science team that identified £100 million of savings within 6 months. Then, they began producing clinical dashboards. By 2019, NHSBSA had identified a potential saving of £1.6 billion. With their data set and data warehouse, they responded to COVID-19 by creating the shielded patient list, and sharing data with Public Health England, which uses it to benefit society. 

About NHS Business Services Authority

A Catalyst for Better Health: The NHS Business Services Authority is a Special Health Authority and an Arm's-Length Body of the Department of Health, which provides a range of critical central services to NHS organisations, NHS contractors, patients and the public.