Consultation Hub

Welcome

This site provides access to a number of consultations run by NHS Digital.

You can view our open and recently closed consultations below, or you can search for a consultation by keyword.

Open Consultations

  • 2021-22 Survey of Adult Carers in England - Oldham

    Survey of Adult Carers in England 2021-22. More

    Closes 31 December 2021

  • Implementation of electronic fit notes in secondary care

    The Statement of Fitness for Work (“fit note or Med 3 form”) was introduced in April 2010 across England, Wales and Scotland by the Department for Work and Pensions (DWP). In 2012 the DWP worked with the national General Practice Systems of Choice (GPSoC)... More

    Closes 24 January 2022

  • CIPG Clinical Systems Proficiency Survey

    The CIPG has a requirement to understand the skillset of its clinicians and therefore the responses to this survey will be added to a larger database of information about the clinical skills and expertise in CIPG. More

    Closes 7 April 2022

  • SCR in Community Pharmacy – Acceptable Use Agreement

    Completion of the agreement confirms the pharmacy contractor and relevant members of their team at the pharmacy (site) have undertaken the actions required prior to accessing SCR (detailed below) and agree to comply with the ongoing requirements (detailed below) for access to the SCR application.... More

    Closes 30 September 2022

  • NHS Data Model and Dictionary Service Query Resolution Survey

    The NHS Data Model and Dictionary Service is committed to delivering high quality products and services to all our users and customers by operating to a set of robust and well defined editorial principles, standards and work procedures. The values that underpin the processes and procedures of... More

    Closes 31 March 2023

Closed Consultations

We Asked, You Said, We Did

Here are some of the issues we have consulted on and their outcomes. See all outcomes

We asked

We consulted on the continued implementation of Patient Level Costing Information Systems (PLICS) Mandatory Collections and the changes planned for the collections due to commence in autumn 2021.      

You said

40 responses were received to the consultation. 

Respondents were asked to select the option which best described the services their Trust had provided during the financial year 2020-2021.

The table below provides a summary of the responses provided:

Services provided

Number of responses

Acute

18

Mental Health

3

IAPT

0

Ambulance

5

Acute and Mental Health

0

Mental Health and IAPT

10

Acute and IAPT

0

3 or more services out of (Acute, Mental Health, IAPT, Ambulance)

4

 

The overwhelming majority of respondents to the consultation provided information on how their PLICS data collection would be undertaken, including aspects such as the staff, processes, IT systems and data flows involved. 

The responses received highlighted in the main, that the collection would be a significant exercise for Trusts with a number of surrounding processes, dependencies on IT systems and staff involved. 

A significant minority of the responses highlighted the impact of the COVID-19 pandemic as an issue with the collection, with the main concerns summarised as:

  • Challenges with allocation of COVID-19 costs/costing requirements.
  • The impact on data quality.
  • Reduced availability of/re-deployment of staff.
  • Concerns regarding inconsistencies in recording of data/costs, as a result of running services differently or changes in operational arrangements.
  • Difficulties in getting input from other teams and/or lack of access to/impact on informatics teams.

Some respondents raised other concerns, (where COVID was not cited) including:

Trusts undergoing a system migration/upgrade

Lack of face to face support

Informatics team availability

Availability and quality of patient data/data feeds

Keeping up to date with the guidance

Limited time between collections

Reconciliation of PLICS and activity data

Timeliness of documentation/data requirements from NHSI

Concerns over data quality of submissions

Timely availability of Trusts getting their data outputs

Difference in costing requirements vs existing Adult Critical Care data flows

A significant majority of respondents highlighted expected benefits of PLICS.  However, there were concerns from a number of respondents, that the benefits of FY20/21 data would be limited or of no benefit, due to the impacts of the COVID-19 pandemic and extent of its comparability to other year’s data.

Some respondents highlighted that the collection may provide some insight into/provide an indication of costs associated with the pandemic.

The vast majority of respondents provided information on the time involved in preparing for the collection, which demonstrated a range of timings for these processes across Trusts.  The responses highlighted that the overall process may take a number of months, and in some cases 6 months or more.

Respondents also provided information on the additional training requirements and expected additional costs associated with the collection.

Some respondents raised other concerns or suggestions, including:

Clearer process for benchmarking

Simplifying ledger mapping

Any move to more frequent cost collection needs to be consulted on and considered

The need for clear guidance and support which is relevant for the services concerned

The local cost implications of PLICS software

The need for tangible benefits to be fed back to practitioners

The need for timely publication of guidance, schemas and tools, along with sufficient lead time for changes

A clear future vision of information requirements

Availability of resource

The need for a period of stability to incorporate the changes over the last 3 years

Bring National Cost Collection closer to the Trust BAU

In addition, a number of responses were received relating to process clarifications or discrete queries by a particular Trust.

We did

We would like to thank everyone who responded.  Your feedback is valuable and important information which will be used to inform and support future work by NHS Digital on PLICS.  Responses relating to process clarifications or discrete queries will be raised with the relevant Trust.  This summary of the feedback is also being communicated to NHS England and NHS Improvement.

For further updates on PLICS at NHS Digital, please see the relevant section of the NHS Digital website.

We asked

Recording, managing and resolving complaints is an important part of modern service delivery and provides important feedback for service improvement. The data that is collected nationally serves multiple purposes, for example, it enables national bodies discharge their respective legal duties and responsibilities in listening and responding to public voice on the NHS. It also helps with focusing improvement and support to the NHS including providers of NHS funded services.

Practices must compile the K041b return - a mandatory data collection – to capture data and information regarding written complaints received by GP and Dental Practices.

To help reduce the administrative burden associated with this data collection, we consulted on a package of simplifying changes. Specifically, we sought feedback on the usefulness and relevance of each of the 6 separate components which make up the existing return:

  1. Organisation Details and Summary Data
  2. Age of patient
  3. Status of Complainant
  4. Service area
  5. Subject area
  6. Staff group
  7. We also asked for free text responses on all the above points and in an additional feedback section. 

    Our proposals were to streamline the current collection to ensure it delivers maximum benefit whilst reducing the burden of the data submission.

    The vast majority of respondents showed support for this approach and the chance to remove some of the burden which is associated with the completion of the return.

    There were 91 responses in total from several types of organisation, ranging from GP practices to central government bodies, summarised below:

    National organisation         4

    Primary Care provider        80

    Regional organisation        5

    Other/unknown                  2

    Completion rate of all questions in the consultation was good, though a small number of respondents did not answer all questions.

    As a result of the complexity of some of the issues raised as part of the responses we received, we will form a Task and Finish (T&F) group to help us work on the best way to implement some changes. Where possible changes will be implemented for the 2020-21 collection year, though some matters will be carried over for the 2021-22 collection.

    Once the T&F work is complete, we will issue a further update to this response along with final details of the collection systems (covering General Practice and Dentistry) and changes we will make to the data items being collected.

    To further help practices at this time, we have extended the collection window from the usual 6 weeks to 12 weeks. Improvements have also been made to the portal to address technical issues that previously occurred and to make the experience of uploading the return easier.

    The remainder of this document summarises the findings for each of the 6 components of the return – headered and numbered through each of the We asked, You said, We did sections of the response. There is a summary of our proposals, the responses, and the resulting actions, including issues to be considered by the T&F group. If you would like to be involved in this process, please contact us at nhs.comp@nhs.net, quoting ‘Involvement in Complaints Consultation’. Our intention is to encompass views from a range of stakeholders involved.

    Please refer to ‘Next Steps’ in the ‘We did’ section for details of the collection window for the 2020/21 year.

    We would like to thank everyone who made the time to respond to the consultation.

Our Proposals: 

   1. Organisation Details and Summary Data

We did not propose any changes to this section to allow the high-level overview of complaint volumes and resolution status to remain in its current format.

  1. Age of Patient

We proposed ceasing collecting this data item on the basis that it was not consistent with other statistical returns, not collected by individual age to allow bespoke analysis, and cannot be linked to the types of complaints that are submitted.

  1. Status of Complainant

As with Age of Patient, we questioned if this data item was able to offer any insight into complaints, with approximately 80% of complainants being attributed to the Patient. The status also cannot be linked to types of complaints. We proposed whether there is value in still collecting this item or amending and simplifying the categories.

  1. Service Area

We proposed removing Service Area from the collection. This is because data shows 97% of GP practice submitted complaints have been for GP Surgery and 99% of Dental practice submitted complaints have been for Dental Surgery and there is therefore little value in retaining these items when this data would still be available via the 2 separate mechanisms used for collecting data from each.

  1. Subject Area

We did not propose removing this field from the collection, but instead asked users for ways in which the current list of 40 different Subject Areas could be improved or streamlined.

  1. Staff Group

Recognising that Staff Group is also a key component of the return, we did not ask for feedback on the potential for dropping this field but suggested a replacement list to the one currently in use. We asked users to comment on the list in terms of its accuracy, potential groupings, or further inclusions/exclusions.

 

You said

  1. Organisation Details and Summary Data

81 respondents agreed with our proposal to keep collecting the data items in this section of the return.

  1. Age of Patient

60 respondents said that collecting age was not a useful factor in assessing and resolving complaints, and 64 said they felt the current bandings were not useful. 72 respondents (79%) said it would not be detrimental if age band were no longer included in future collections.

There were also a number of contextual responses which referred to both the burden that this data item causes.

However, some respondents did say that age was a useful metric, for example, in relation to monitoring health inequalities, and that a pragmatic solution is to bring the age bandings in line with other existing statistical collections.

  1. Status of Complainant

59 respondents stated that the current Complainant Statuses were not useful, with 72 also stating that it would not be detrimental to stop collecting the item. However, 76 responses showed support for simplifying the categories and there were a number of comments related to the importance of capturing Carers.

  1. Service Area

59 respondents stated the current Service Areas are not useful in their current guise with 71 of the 91 responses advocating its removal.

  1. Subject Area

56 respondents answered at least one of the 4 questions posed.

There was a broad selection of contextual responses in this area, which ranged from suggestions for grouping the categories, right through to acknowledgement that all the categories could be legitimate cause for complaint. A cross-section of comments on the 4 questions asked are as follows.

Are there any subject areas that could be removed and why? (45 responses)

“I would sub-select the categories to the 5 or 6 most commonly reported.”

“These categories are all possible causes for complaints.”

“There are some which are very open to interpretation in relation to which to use therefore the resulting analysis will be flawed.”

What new subject areas could be added/included and why? (26 responses)

“Streamlining the categories is necessary although I would question that whether Pandemic or COVID should be listed as an option going forward.”

“We suggest including ‘Remote Dental appointment’, ‘Remote GP appointment”

Do you have suggestions on how this list could be grouped into categories and sub-categories? (30 responses)

“There are too many, just go back to the six”

“Clinical - attitude, knowledge, error

Management - attitude, infection control, safety

Staff - attitude, skill, knowledge

Prescriptions - error, reaction to”

 

“Better Headings for categories would be more simplistic for instance

Appointments can be grouped as one

Refusals can all be grouped

Clinical can be grouped, to include all aspects from care planning to misdiagnosis and prescribing”

Please use the box below to expand on any of your selections above or provide any further comments on this proposal (5 responses)

“Agree [that] proposed groupings improves ease of reporting and reduces repetition.”

  1. Staff Group

Slightly over half of respondents (46) supplied answers to at least one of the questions posed in this section. The remaining 45 did not respond to any of the questions.

Of those who did respond, a range of comments were provided on this topic with the most recurring themes centring on agreement with streamlining the current list of 10 down to the 7 provided, with strong support for merging the Practitioner / Locum category.

Other emerging themes were the need for clarity over the proposed Care Professional / Other Care Professional groups and repeated comments that this entire section could be further simplified into only 2 categories Clinical and Non-Clinical groups. A number of comments were also made asking for Practice Manager to not be a standalone category as this could be usefully grouped within other categories.

  1. Additional feedback

21 users provided further comments in this free-text section.

The main theme emerging from this were broad support for the intention to streamline the return and reduce the burden involved in submission. We welcome these comments which are in line with our proposals in the consultation. Some examples of the comments received can be seen below:

“Overall I think it is important to streamline the information and group things better to be able to see more clearly where complaints are made and the reasons for them.”

“Keen to see the collection process simplified.”

“I am pleased to see the changes you are proposing.”

“Too much information is requested which simply isn’t needed.”

We did

  1. Organisation Details and Summary Data

This data item will be retained within the collection.

  1. Age of Patient

If possible for the 2020-21 collection year, we would like to reference the age categories used in the General Practice Extraction Service (GPES) at the same time as reducing the number of categories in the current list. GPES categories are in 10 yr bands (0-9, 10-19 up to 90+0) and we propose to merge some of these bands to be 4 groups, down from the current 8 options, as below;

Existing Age Categories

Proposed categories

Age 0-5

Age 0-19

Age 6-17

Age 20-59

Age 18-25

Age 60 and above

Age 26-55

Age Unknown

Age 56-64

 

Age 65-74

 

Age 75 and over

 

Age Unknown

 

 

 

The T&F group will explore implementation barriers with implementing these changes for the 2020-21 collection, for example, if they have been categorising patients to the existing categories during the year.

  1. Status of Complainant

The number of options will be reduced, seeing some merged and Carers split out to represent the continued importance of Carer Identification, as below;

Existing Status categories

Proposed Status categories

Patient

Patient/Parent/Guardian

Parent

Carer

Guardian

Other

Carer

 

Other

 

As above, the T&F group will explore implementation barriers with implementing these changes for the 2020-21 collection. If these changes can be implemented for the 2020-21 collection clear annotation on the collection tool will reference the merged categories.

  1. Service Area

This data item will be removed, starting from the 2020/21 collection.

  1. Subject Area

Part of the feedback we received indicated that making significant changes to this category for the 2020/21 collection year would cause operational difficulties for some submitting organisations. We will therefore continue to collect the existing Subjects in the 2020-21 collection.

Ahead of the 2021/22 collection the T&F group will find the best way to improve this category and communicate the results to data submitters as soon as possible.  To allow maximum time for changes to be implemented ahead of the 2021/22 return. Given the broad range of responses and some of the complexities involved in sensibly re-shaping some of these categories we will invite contributors to this consultation to help improve the list of options ahead of the 2021/22 collection.

  1. Staff Group

Similar to the issue surrounding Subject Area, the T&F group will find the best way to improve this category with a view to simplification of the existing options for the 2021/22 collection year. Any re-classification of options within this category will reference the Expanding Our Workforce workstream led by NHS England.

We will therefore continue to collect the existing Staff Groups in the 2020-21 collection.

Next Steps

Any actions identified under the ‘We did’ sections will be built into an amended collection tool being developed in-house by NHS Digital for the 2020/21 data collection. Once these developments have been made, a short testing period will commence before the collection tool is made live.

 

We will then continue to work with stakeholders to identify the best way to simplify the Subject Area and Staff Group categories and provide updates as soon as the work is completed.

The collection window for the 2020-21 year KO41b will open on 9th August this year and remain open for 12 weeks.

Please contact us at nhs.comp@nhs.net, quoting Involvement in Complaints Consultation, if you wish to be involved in the T&F group.

 

We asked

We consulted on the future of the Guardianship under the Mental Health Act data collection and publication. Our proposal was that we would cease this publication due to very low numbers nationally and limited use of the publication.  We sought to establish who uses the data, how it is used and what would be the impact if the publication was discontinued.

You said

62 responses were received. 53 of these were from local authorities, and 9 were from other organisations, including national bodies such as the Approved Mental Heath Professionals (AMHP) Leads Network.

The support for the proposal was split as follows:

 

Support proposal to cease

Do not support proposal to cease

Local Authority

32

21

Other

2

7

All

34

28

 

Reasons given for supporting the proposal were:

  • Guardianship orders are not widely used in practice
  • The published data is not used.

However it was acknowledged by a couple of respondents that some monitoring and oversight would still be valuable. 

Reasons given for not supporting the proposal are summarised as:

  • It is important to know how Guardianship orders are being used, despite the small numbers, as it remains a statutory provision.
  • People under Guardianship are subjected to the restrictions under the Mental Health Act and this should not be taken lightly. It is vital that we keep a record of who is under these sections of the legislation.
  • The data provides national oversight. It is not being collected or published anywhere else.
  • It has an important use in questioning why some areas are not using Guardianships.
  • Accurate statistics should be provided regarding use of all aspects of the Mental Health Act.
  • This is not the right time to discontinue the data collection and publication, given the Government’s Mental Health Act white paper and ongoing consultation of its proposals. This includes the aim to reduce the number of people detained in hospital and to reduce the restrictions placed upon patients. As Guardianship is arguably the least restrictive of all the sections of the MHA, it is important to continue the data collection to know how much it is being used and who is using it.

Of the respondents who said they currently use the data, all aspects of the data collection are important, this includes:

  • Number of new and continuing cases
  • Duration
  • Legal basis
  • Relationship to Guardian
  • Organisation and geographical area

We did

Firstly we would like to sincerely thank everyone who responded. You have provided valuable and important information to us which we were not previously aware of.

We have weighed up the responses, and whilst the majority supported the proposal to cease, we acknowledge the counter-view that it remains important to continue the data collection and publication. This is in order to provide an accurate national position, which would not be otherwise available, and it was pointed out that it is especially important at this time when a review of the Mental Health Act is ongoing.

Therefore we will be going ahead with the next data collection from 01 April 2021 and we expect to publish the data in September 2021. This will collect data for the periods 01 April 2018–31 March 2019, 01 April 2019–31 March 2020, 01 April 2020–31 March 2021.

Following this consultation it has since become clear that there are further factors to consider in terms of the longer term future of the Guardianship data collection and publication, such as the NHS Digital data strategy currently in development and Mental Health Act reforms. We will be open and transparent about any future decisions that are made.

In previous years we have produced an in-depth report to set out the findings. This year we will present the data in Excel tables and reduce our written commentary on the findings. However, as with all our data collections, users are encouraged to approach us directly with any requests for additional analysis and we can work with you to understand your requirements and provide the data.