Emergency Care Data Set (ECDS)
ECDS - An introduction
CDS Type 011 - Emergency Care Data Set (ECDS) is a new national data set for urgent and emergency care which will replace the current data set used to collect information from Emergency Departments across England
Commissioners, clinicians, managers and patients require high quality information in order to design, contract for, improve and assure the care provided in Emergency Departments (EDs) and (for patients) to make informed choices about when and where to access emergency care services. However, the information currently available to stakeholders is limited and doesn't contain many of the data items that are required to understand capacity and demand or improve patient care.
The new data set will be implemented from October 2017 across all Emergency Department types, including A&E, Minor Injury Units, Urgent Care Centers and Walk in Centres .
The ECDS replaces the current Accident & Emergency Commissioning Data Set (CDS type 010). The ECDS will be implemented via a new version of the A&E CDS - CDS 6.2 Type 011.
By implementing ECDS across all emergency departments, we'll be able to compare data to provide a more accurate, detailed and comprehensive picture of all emergency attendances.
Support and guidance will be provided to emergency department information systems (EDIS) suppliers to ensure systems are updated to facilitate the collection of data via the ECDS and providers will be supported through implementation following the issue of a formal Information Standards Notice (ISN).
Why is a new data set for emergency care required?
The Accident and Emergency Commissioning Data Set (CDS type 010) was developed in the early 1980s. At that time the work of the ED was largely minor injuries with occasional major trauma, and CDS Type 010 was developed to capture these types of attendances. Since then there has been a sustained and rapid increase in the volume, scope and complexity of emergency care. This is due to changes in the health needs of the population (e.g. an increasingly ageing population), the system's ability to respond to these changing needs and also how the population makes decisions on where to access the care that they need.
The Accident and Emergency Commissioning Data Set (CDS Type 010) hasn't kept up with these changes in health care practice and it's recognised that this has resulted in an 'information gap' in the data collected from Emergency Departments.
This information gap creates issues such as :
- Poor quality data undermining the integrity of secondary uses information (published as Hospital Episode Statistics on a monthly and annual basis ) that relies on data collected currently via CDS.
- System capacity and demand management are impossible to determine accurately locally or centrally.
- Current metrics of healthcare do not consistently measure inputs or outputs, making comparisons of 'value added' or different modes of healthcare delivery (Minor Injury Unit, Walk-in Centre, etc.) impossible.
- Use of multiple current coding systems with inconsistent implementation means data are not valid nor reliable. This makes the information insufficient for either clinical use or policy-making.
- NHS Digital data has shown that a valid, coded diagnosis exists for less than half of all ED attendances.
- Commissioners of healthcare, who rely on data obtained through the Secondary Uses Service (SUS), can't accurately plan or monitor emergency care.
While the primary purpose of any clinical data collected in emergency departments must always be to improve the quality and safety of patient care, there is a clear responsibility to the wider NHS and to the public to demonstrate that money spent on emergency healthcare is well spent. Better quality data is key to this and there is recognition that there is a cost to collect this data. We believe that the cost is vastly outweighed by the benefits to the patient and to the wider NHS by communicating accurate clinical information, and being able to commissioning the right services for population healthcare needs.
Benefits of a new data set for emergency care
The ECDS project team, NHS Digital and colleagues from across the emergency care system have identified the benefits of implementing a new data set. By 2021/2022 we expect to save around £28 million by making efficiencies based on the new data. This will enable other care and services to be reconfigured, ensuring that resources are used more effectively.
We expect that the implementation of the ECDS will support an improvement in emergency department data quality and provide more consistency. Outcomes that we expect to see once the ECDS goes live include:
- Improved quality of data collected in Emergency Departments relating to patient presentation, diagnosis, discharge and follow up will support a better understanding of the value added by the introduction of new models of care and ensure that patients are receiving care in the most appropriate care setting.
- The information generated will allow commissioners to accurately fund demand, and implement strategic changes, e.g. through payment and Commissioning For Quality and Innovation (CQUIN) mechanisms
- Support for future healthcare policy and strategy to ensure an improved quality of patient care, such as that articulated in the "Keogh Review" of Urgent and Emergency Care, and the NHS England "Five Year Forward View".
- Improved data access, research and audit in emergency healthcare to support service improvement initiatives.
For more information on the ECDS anticipated benefits, the expected business change and ECDS capabilities please request a copy of the Benefits matrix by emailing: firstname.lastname@example.org.
- January 2017 - Draft technical specification published as an Advanced Notification
- March 2017 -approval for the data set as an Information Standard
- April 2017 - Information Standards Notice(ISN) publication
- October 2017 - start of implementation of ECDS in type 1 and type 2 emergency departments
- In 2018 - start of implementation of ECDS in type 3 and 4 emergency departments
ECDS data items
The ECDS consists of a number of 'new' data items and data items which originate from the current A&E CDS. The majority of the 'new' data items are already collected in departments, so this change will ensure that all the items can be viewed centrally and used to inform planning.
We're also taking the opportunity to introduce the use of SNOMED CT codes for Emergency Departments to capture relevant information, specifically the clinical data items. This is being introduced in line with Nation Information Board policy objectives found in Personalised Health and Care 2020.
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