Sources of Information

1. Sources of Information Susan Hamilton Information Development Officer, Avon IM&T Consortium

2. Aims • What types of data are available • Where the data is held • How to access the data • Issues for using and interpreting the data • What to do when there is no data.

3. Types of Data 1. Examples of NHS Data • In-patient hospital activity - cause, age, sex, address, treatment, type of admissions • A&E – attendances, treatment, age, sex • Ambulance – cause, seriousness, location • Prevention - vaccination rates, quit smoking • Morbidity – asthma & diabetes prevalence, communicable diseases • Child Health Surveillance – breastfeeding, behaviour, immunisations, ethnicity. • Prescribing – by GP practice • Workforce – numbers, qualifications, skills • Patient and Staff Surveys • Population – GP Practice

4. 2. Examples of Non-NHS Data • Deaths - cause, age, sex, address • Births - location, weight, stillbirths, multiple births • Deprivation – indicators of deprivation • Employment - % unemployed, benefits • Education – exam results, truancy, exclusions, • Housing – house ownership, benefits, quality • Pollution – air, water and noise • Demography – current and future population, ethnicity • Vulnerable groups – children in care, disabled, homeless, asylum seekers • Transport – access to facilities, accidents • Crime – numbers and types, fear of crime.

5. Organisations Hold Data • Trusts, GP Practices & Universities– often hold unique datasets for service and research e.g chronic diseases such as cystic fibrosis, ALSPAC • Cancer Intelligence Unit – cancer incidence, prevalence and survival • Voluntary Organisations – e.g. refugees • Ambulance – all call outs are recorded. • Unitary Authorities - vulnerable groups e.g. homeless, asylum seekers, children in care, disability and local profiles. • Police - accidents, crime • Drugs Misuse Database – types of drugs

6. Formats of Data Individual Person Data • Every person has a unique record mostly with postcodes • Postcodes can be used to provide data at any geographical area • Flexible, but access, confidentiality and time may be a problem. Aggregated • Data at various geographical areas (e.g. wards, beats, GP Practices) • Can be in databases, reports, journals • Analysed e.g. converted into rates, standardised • Readily available but often not at area required.

7. Accessing Data – Individual Person or GP Practice • Need to ask for data to be extracted • Information analysis is provided by the Avon IM&T Consortium. Each PCT has a dedicated analysts • GP practice data • Data collected at practice level is expanding • Including information on diabetes, heart disease, elderly • BUT not freely available • Need to ask the PCT for access to the data. • In general, ask Susan Hamilton (0117 900 2595) or your PCT analyst or the organisation holding the data

8. Aggregated / Analysed Data Wide range of resources of data that has been aggregated to certain geographical area in internet sites, databases, and reports Internet • Local and national data typically at ward, Unitary Authority, Health Authority and Regional level. Useful websites: • Public Health Network http://avon.nhs.uk/phnet • Compendium of Clinical Indicators http://nww.nchod.nhs.uk/ • Department of Health http://193.32.28.83/public/stats3.htm • South West Public Health Observatory http://www.swpho.org.uk/ • ONS http://www.statistics.gov.uk/

9. Neighbourhood Statisticshttp://www.neighbourhood.statistics.gov.uk/ • Unitary Authority B&NES http://www.bathnes.gov.uk/ Bristol http://www.bristol-city.gov.uk/ North Somerset http://www.n-somerset.gov.uk/ South Glos. http://www.southglos.gov.uk/

10. Reports • Many reports are available on the internet • Also see library resource for statistics, books, journals, and reports RUH and King Square House library can be accessed by anyone working in a health related filed. Qualitative Studies – ask locally for studies undertaken in the area including user surveys, Citizen’s Panel, attitudes, behaviour, decisions making etc.

11. Accessing Aggregated Data For all types of data, ask people working in the area to list all potential databases and reports. If needed, ask for help in selecting and interpreting the most appropriate data. Internet • Most NHS organisations should connected • Free internet access is available in public libraries • Ask the librarian Databases • Ask IM&T analysts or Public Health staff for access or extract the data

12. Considerations – Choosing Data • Define the question with regard to area, population, time period, and outcomes. • Quality of data – assess how accurate of each data set. • Generalising data – the smaller the area, the shorter the time period studied, or the older the data is, the less reliable it is likely to be. • Definitions – data from different organisations are often use different geographical areas and definitions.

13. Considerations – Practical Issues • Time implications for gathering, analysing and writing up data. • Confidentiality – restricted access to data and to some small area analysis. • Analysis – for comparative work, often need to convert numbers into rates, assess degree of confidence. • IT facilities – identify access to the internet, packages for drawing tables and graphs.

14. No Data Unlikely to be comprehensive or up to date data on mental health, lifestyle, non-acute hospital activity, up to date data on ethnicity etc. • Use the expertise of the librarian / colleagues working in the field to look for local and national studies on the same topic. • Decide if the population and circumstance used in the study applies to your population • If so, apply the rates the study to your population. • If not, decide if a local survey is needed.

15. Training Opportunities Using a Computer • Avon IM&T Consortium offer a series of training courses for PCT staff at all levels. This includes Microsoft Word, Microsoft Excel, and internet training.   Finding the Evidence • Training opportunities on online database which allows the user to search for published articles are available.    Public Health & Critical Appraisal • Short courses, modules, degree and masters courses in public health are offered at the Bristol University & at some RDSUs