Risk stratification

Risk stratification tools can help to:-

• Assess how likely a person is to require emergency or urgent care
• Prevent ill health
• Prevent unexpected hospital visits and
• Identify the need for preventative measures

Your data is used in two ways by GPs and by Kent and Medway Integrated Care Board directly.

Risk Stratification for case finding

The data available through the risk stratification helps your GP focus on preventing health issues and can use them to spot and support patients with long-term conditions. It can help to prevent unexpected hospital visits or lower the chance of getting other diseases.

Your GP will use computer-based algorithms or calculations to find registered patients who are at most risk. Your GP will do this on a routine basis. It will be done electronically without human intervention and will produce a report that will be reviewed by a multidisciplinary team of staff at your practice. You might then be contacted if changes to your care are identified. If needed, your GP might offer you additional healthcare services.

Risk Stratification for commissioning

Health care commissioners need information about the treatment of patients to review and plan current and future health care services. To do this they need to be able to see information about the health care provided to patients which can include patient level data.

Data is sent directly to a risk stratification tool by NHS England and/or GP practices. Once the data is in the tool, ICB staff only have access to anonymised, pseudonymised or aggregated data. You will not be personally identifiable nor will any ICB staff have access to your personal or confidential data.

An example of the benefit to patients includes using risk stratification to reduce unplanned emergency admissions.

Using primary and secondary care data, as well as real-time information on admissions, risk stratification enable GPs to build registers of high-risk patients and drill down to view individual care pathways.  This informs practices if any at-risk patients have attended A&E or been admitted as an emergency within the last 24 hours.

In this way, primary care healthcare professionals can gain essential insight into how they might consider modifying care plans and pathways to improve self-care, reduce, GP appointments and hospital admissions, and support patients' needs in the most cost effective way.

Our latest report for Kent and Medway shows that for the year to date, up to 31 July we have had 4,295 Critical Admission Avoidance patients identified and 10,261 Significant Admission Avoidance patients identified.

NHS Kent and Medway rely on the following lawful basis under UK GDPR for processing your personal data for the purposes of risk stratification:

Article 6(1)(e) 'processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller..'.

Article 9(2)(h) 'processing is necessary for the purposes of preventive or occupational medicine, for the assessment of the working capacity of the employee, medical diagnosis, the provision of health or social care or treatment or the management of health or social care systems and services..'.

We will also recognise your rights established under UK case law collectively known as the “Common Law Duty of Confidentiality”.  

NHS Kent and Medway ICB has Section 251 approval from the Secretary of State for Health and Social Care, through the Confidentiality Advisory Group (CAG) of the Health Research Authority, to allow it to receive this data, in line with specific technical and security measures in place, for the purposes of risk stratification.

This approval allows your GP or staff within your GP Practice who are responsible for providing your care, to see information that identifies you, but the ICB staff will only be able to see information in a format that does not reveal your identity.

If you are happy for your data to be used in this way, you don't need to do anything.

However, if you don't want your data included in the risk stratification service you can choose to opt-out. There are three types of UK GDPR objection codes that can be applied should you decide to opt out with each having a different impact as illustrated.

GDPR objection codes

Type/Code	Data shared to Local Share Care Record	Data shared with other NHS providers of care	Data shared  for research and planning
Type 1 opt out 9NuO	Data will still be shared for direct care purposes	Data will still be Shared for direct care purposes	Your GP will not share your data outside of the practice except for direct care purposes. However, NHS England will still be able to collect and share data from other healthcare providers, such as hospitals.
National Op Out	Data will still be shared for direct care purposes	Data will still be shared for direct care purposes	NHS England and other health and care organisations will not be able to share any of your personal data with other organisations for research and planning, except in certain situations. For example, when required by law.
GDPR objection code 93c1 for Risk Stratification	This code applies to GP data being extracted for risk stratification purposes only	This code applies to GP data being extracted for risk stratification purposes only	This code applies to GP data being extracted for risk stratification purposes only

You can choose to opt out by contacting your NHS Kent and Medway ICB, who will let your GP know and they will then apply a code which will ensure that your information is not used in the programme.

Please be advised however, opting out of data sharing for risk stratification purposes can potentially affect the proactive provision of care and the identification of individuals at high risk. It might limit the ability of healthcare providers to use data-driven insights for targeted interventions, potentially impacting preventative measures and access to timely care. 

You can contact the ICB by email, phone or post: kmicb.ig@nhs.net

Telephone: 01634 335095

NHS Kent and Medway
2nd floor
Gail House
Lower Stone Street
Maidstone 
ME15 6NB

• National Data Opt-Out: Opting out of sharing confidential patient information
• Myth busting
• National Data Opt-Out Operational Policy Guidance