Table 2

Description of care pathways included for evaluation, by region

CHC regionTitle of care pathwayObjectives of care pathwayDescription of care pathway
Connected YorkshireSupporting community care and reducing demand on A&E services
  • To link de-identified routine NHS data to describe a detailed profile of patient demand across both prehospital, primary care and hospital emergency and urgent care settings in Yorkshire.

To collect routine NHS data from a number of EUC providers and link the data to provide a coherent picture of EUC demand.
Safer prescribing for frailty
  • To reduce inappropriate polypharmacy for people with frailty.

To work with GPs to change behaviours related to deprescribing for older people with moderate or severe frailty as identified by electronic Frailty Index scores. This includes developing interventions using which apply evidenced tools to support deprescribing.
Greater ManchesterBRIT—Using data to tackle antibiotic resistance
  • To provide the NHS and clinical care teams with better information on what is happening and who is getting antibiotics.

  • To assist in determining whether the use of antibiotics is reasonable given local resistance patterns to antibiotics.

Analysis of patient records from GPs for effectiveness of antibiotic prescribing in general practices. This includes the development of a DataLab feeding back advanced analytics to clinical staff and policy makers and the evaluation of interventions to optimise prescribing.
Using technology and data to improve the diagnosis and treatment of stroke
  • Improve the recognition of stroke by paramedics to maximise the proportion of acute stroke patients taken directly to a specialist stroke centre for timely expert care and minimising the number of non-stroke patients entering the stroke pathway.

  • Provide timely and focused referral to neurosurgery for patients in Greater Manchester with stroke caused by a brain haemorrhage.

  • Ensure that all patients get all the right treatments that they need to reduce the risk of another stroke when they are discharged from hospital.

To improve stroke recognition by paramedics by linking ambulance data to data at Salford Royal; using primary and secondary care data to create a large cohort of stroke and TIA patients for creating a predictive model of patients who are at high risk of stroke; and using acute trust data to identify predictive factors of early deterioration and death.
North East North CumbriaPredictive modelling for unplanned care
  • To develop predictive modelling tools for unplanned care forecasting to support demand management and service planning in relevant health and social care services.

To produce statistical models that can be used by health/local authority/other analytics teams to produce daily forecasts up to 6 months in advance with the pertinent associated uncertainties and variations in urgent and emergency care.
SILVER: Smart Interventions for Local Vulnerable Families
  • To develop data sharing agreements to allow the linking of existing health data across multiple health agencies via one platform that provides recommendations to key workers.

To link data across multiple agencies including health (physical and mental), social care, criminal justice, housing and education to develop a more complete Learning Health System.
North West CoastDevelopment of a learning system for alcohol
  • To be able to inform health professionals about local clinical care.

  • To define best care or treatments, implement and demonstrate benefits.

Improving the way information is collected, analysed and shared between agencies and service users to bring opportunities for news was to respond collectively.
Development of a learning system for unplanned care
  • To improve how data are used to enhance patient care admitted to hospital for emergency care.

Linking NHS data with social services data to improve the care pathway for patients with COPD and epilepsy.