Background
The Investment and Impact Fund (IIF) forms part of the Network Contract Directed Enhanced Service (DES). It supports Primary Care Networks (PCNs) to deliver high quality care to their population, as well as supporting the delivery of priority objectives articulated in the NHS Long Term Plan and in Investment and Evolution.
IIF includes a number of indicators which require a change to the GPES Data Model to deliver improved GP contract indicators as detailed below.
Index of Multiple Deprivation
Tackling neighbourhood health inequalities, informed by the Core20Plus5 approach, is a major focus of the Network Contract DES. The Core20Plus5 is focused on the 20% of most deprived neighbourhoods, as well as on five clinical areas particularly important for health inequalities. The Indices of Deprivation are used to define the level of deprivation of neighbourhoods across England and hence enable comparison of care provision across deprived and non-deprived areas.
Currently, the GPES Data Model does not allow data collection of least deprived quintile and most deprived quintile for health inequalities. In order to resolve this, three mandatory fields have been added in the Patients Table Attribute List:
‘Lower Layer Super Output Area (LSOA)’ - (mapped from Patient postcode)
‘Index of Multiple Deprivation Rank’ – (mapped from LSOA)
‘Index of Multiple Deprivation Decile’ – (mapped from LSOA)
To determine the deprivation of the area in which a Patient lives, their postcode is mapped up to LSOA level. These LSOAs are ranked from most to least deprived (IMD Rank) and are also allocated a decile (a value 1 to 10). In indicator construction, the Patients within the 20% most deprived areas would be identified as those with an IMD Decile of 1 or 2. IMD Rank can be used to identify percentages, not a factor of 10, e.g. 15% most deprived.
Mapping files:
LSOA to IMD - English indices of deprivation 2019
Patient postcode to LSOA - Office for National Statistics data
Outline Plan
Suppliers to be compliant after 3 months of the Roadmap Item Publication date. Suppliers are to create indicators (as specified by the GP Specification and Extraction Service) based on the new fields:
Build functionality using new fields T1A30, T1A31 and T1A32 to create a Patient cohort based on the deprivation level of the area in which they live (e.g. Patients living in the 20% least deprived areas)
Summary of Change
GPES Data Extraction: GPES Interoperability requirements updated |
The GPES-I requirements |
GPES Interoperability Standard document: Requirements T1A30, T1A31 and T1A32 added to the Patients Table |
Ref | Item - PATIENTS | User view | Technical notes | Data type | M/O |
T1A30 | LSOA | Lower Layer Super Output Area of residence | Return LSOA mapped from T1A6 patient postcode using Office for National Statistics data | CV | M |
T1A31 | IMD_RANK | Index of Multiple Deprivation Rank of LSOA of residence | Return Index of Multiple Deprivation Rank mapped from T1A30 LSOA using English indices of deprivation 2019 | CV | M |
T1A32 | IMD_DECILE | Index of Multiple Deprivation Decile of LSOA of residence | Return Index of Multiple Deprivation Decile (a value 1 to 10) mapped from T1A30 LSOA English indices of deprivation 2019 | CV | M |
Full Specification
The updated GPES Data Extraction Standard will be added at a later date. Proposed changes can be viewed in the Summary of Change above.
Assurance Approach
Suppliers will be asked to demonstrate their mitigations against the pre-identified risks through completion of the NHS England Solution Assurance Risk log submission, supported with the requested messaging based test evidence and online demonstration by the Supplier to a group of NHS England representatives.
The successful conclusion of the NHS England assurance for the risk mitigations implemented by the Supplier in relation to these requirements will be required before the changes can be deployed in the production environment.