Title: Unlocking data to inform public health policy and practice: Exploring barriers and creating solutions for public health intelligence using integrated datasets across Kent, Sussex and Surrey (KSS)
Funder: Department of Health and Social Care

Abstract: Aim of the research_x000D_ This project aims to support using data for planning public health services by:_x000D_ • Improving data analysis skills in Kent, Sussex and Surrey (KSS) public health teams_x000D_ • Solving current problems around linking existing data_x000D_ • Understanding how we can involve the public in deciding how different health and administrative data can be linked and stored safely, and who has access to them for improving services and research._x000D_ Background_x000D_ Local authorities (LAs) in England are responsible for improving the health of their local population. This work is led by public health (PH) teams. _x000D_ In KSS, the LAs want to improve services for communities and find ways to improve health. They want to do this by joining up (or linking) data from health, social care, housing and education services. Linked datasets have been started, but LAs have some barriers which stop them using the data fully. _x000D_ Firstly, PH teams do not have analysts with advanced data analysis skills to answer complex data questions. Secondly, there are difficulties in linking different types of non-health data (housing, education) with health and social care data (social services, GP records). Thirdly, local Integrated Care Systems (ICS), who plan and fund local health and care services and manage datasets, do not currently know how the public feel about their data being linked together and used to improve services and public health._x000D_ Better ways of involving the public, that are informed by public views, need to be put in place._x000D_ Design and methods used_x000D_ • We will bring together data scientists at universities with members of PH teams, database teams, and public representatives. This new group will gather to discuss challenges, barriers and create solutions to using available data in the best way to improve the public’s health._x000D_ • We will train two PH analysts to solve problems of local public needs through the use of existing data. They will be trained by university data scientists. The analyst in Kent will focus on the use of different sources of data to understand what things affect the public’s health e.g. the types of environment people live in. The analyst in Sussex will look at using available data to spot earlier opportunities to keep people well and independent for longer._x000D_ • We will hold public discussion groups to find out what people think about the use of health and other data to improve services. This will advise the ICS on how to be clear and trustworthy about data use. It will also suggest ways the public can be included in decision-making around using data._x000D_ Patient and public involvement_x000D_ The project was designed with and reviewed by multiple members of the public. A member of the public will be a study team member and will contribute to decision-making and support the running of the public focused work. We will consult with the public throughout the project and we will include the public in our working community. The public will be asked to review documents and help us interpret results from our discussion groups._x000D_ Dissemination_x000D_ The results of this project will be made available online in: _x000D_ • A project report_x000D_ • A publication in a scientific journal_x000D_ • A lay summary_x000D_ We will share our findings through events for the public, researchers, service providers and analysts. The working community will continue beyond the project and will continue the development of analytical and research skills to help the public stay well and prevent ill health.

Lay abstract: The triangulation of population level health needs, data, and health service use is done by public health teams in local authorities (LAs). In the region of Kent, Surrey and Sussex (KSS), LAs, together with NHS partners, have launched programmes to create integrated datasets of citizens’ NHS, social care and administrative records. While the infrastructure for hosting and linking data is proceeding, to unlock the potential for these datasets to improve health and quality of life for the local population, several barriers must be tackled. Currently, analytics capacity and capability in KSS public health teams is not at a level to deal with the complexity of the integrated data, and due to the pandemic, LAs have not had the capacity to develop those skills through training or recruitment. Second, legal and technical solutions for linkage of data to enable cross sector working (e.g. between health and housing or education) are needed. Third, public involvement and engagement in various aspects of the use of routinely collected data to support decision making in local authorities and across health and care systems has been largely neglected. _x000D_ _x000D_ In this project we will tackle each of these three barriers. We will create and foster a partnership network between academic researchers, data-intensive scientists, and public health practitioners with a focus on sharing expertise in the technical linkage and analysis of multi-dimensional integrated datasets, kickstarted by two data-sprint events. Through this network, and by funding two 6-month analyst fellowships, we will support knowledge exchange, training and capacity in the public health teams, and tackle important public health case studies identified by our local authority partners (‘learning by doing’). _x000D_ _x000D_ In Sussex, the fellow will explore how to use integrated data to identify patterns of service use or clusters of factors which are robust proxies for being at high risk of decline in health status, multimorbidity, or increase in care needs. This would inform better targeted early intervention, and improvement in provision of more holistic and less duplicated care across services. _x000D_ _x000D_ In Kent, the fellow will explore technical solutions within current legal frameworks for linking non-NHS, non-social care data, such as from housing, education and employment, with health and care datasets, to explore of socio-economic and wider determinants of health. These approaches will maximise the use of different sources of data to facilitate cross-sector working across service providers, to gain a greater understanding of health needs and health inequalities, particularly focussing on the local needs of promoting early & preventive service use. In addition, they will reduce inefficient provision or duplication for people using multiple services, both of which are key public health and LA focus. _x000D_ _x000D_ Finally, we will conduct a series of deliberative focus groups to understand public perception of the use of routinely collected data to support decision making in local authorities and ensure public involvement is embedded in dataset governance structures. _x000D_ _x000D_ We will disseminate results from projects through bespoke stakeholder and public-facing events, reports, journal articles, and regional and national conferences. This work will enable a step-change in productivity in terms of analysing citizens’ data for local and regional public health intelligence to improve health for the local population.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE