This is my first time of sending a message on this Forum as I’m hoping someone might be able to help with a specific API problem that needs a solution.
For context: our University research group has been funded to set up and pilot a new National Audit for patients with musculoskeletal conditions (e.g. back, knee and shoulder pain) in community and primary care. All the existing national audits are collecting/reporting data from secondary care, and whilst individual MSK services are collecting data, there is an urgent need for consistent, benchmarked, and reported health data in this sector. The Community Services Data Set is not currently focussed on MSK conditions or reporting against MSK Standards of Care.
Most musculoskeletal (MSK) patients are now being treated by either GPs or community-led physiotherapy teams who are either seeing patients via direct self-referral or going into GP practices as First Contact Practitioners.
Many physiotherapy clinical teams are willing to be part of our National MSK Audit and we already have over 40 NHS organisations from all around the UK who are currently being onboarded (e.g. organising data sharing agreements, aligning data collection to our data dictionary, adding our consent and data privacy information into their routine data collection methods). We also have HRA ethics approval for 5 years to collect the data, which will sit within the West Midlands Secure Data Environment (so not leave the NHS for analysis). We are using patient consent as the legal basis for medical record data linkage across the system. The CSUs are able to get the secondary care data we want for patients into the national audit repository. Patients will complete a survey (online) to collect the PROMs and consent needed.
The problem is that we need to find the right API and mechanism to extract relevant primary care data at scale for these MSK patients. We have a primary care informatics expert who has built a bespoke extraction search needed for EMIS and SystmOne. We initially thought the NIHR Clinical Research Network teams would help - but as National Research Databases are not adopted onto the NIHR research portfolio, they are unable to do this for us.
I have identified the following options that I’m currently exploring:
- to get individual ICS/ICBs to approve the project and use the agreements they already have with GP practices - so that regional CSUs can extract the primary care data.
- to explore whether the CQC and QOF teams could do this (does anyone know if these teams would be willing to help as MSK is currently not part of QOF?).
- NHS England’s GP Connect team in theory should be able to do this - however, the request seems to need to come from the NHS and be primarily for routine patient care - rather than research with a quality improvement focus.
- There might be commercial partners e.g. Primary Care IT Ltd that have the APIs and could do it - but for a fee - and our National Audit team funding is already very stretched!
The aim for the new National MSK Audit is to not only analyse, case-mix adjust and benchmark the data, but also to allow clinical teams access to their own linked data - which they currently don’t have available. To help them, we are also building a set of QI dashboards for example, we have one that shows MSK “need” at a local level (using OHID data), as well as local MSK “provision” - using Shapeatlas-type maps; we also have one that shows provider performance against a set of KPIs.
Anyway - apologies for the long email… but someone on this network might be well-placed to help us - or know who we could approach for some help to solve this problem.
Professor of Physiotherapy
Keele University School of Medicine