Industry voice: How the intelligence team in the county council is using the unique property reference number in its efforts to build a clear picture of residents’ health and wellbeing
Data is playing a central role in efforts to improve public health in Kent. The county council and the clinical commissioning groups for Kent and Medway are seeking insights and strengthening their understanding of how different issues are linked through the Kent Integrated Dataset (KID), which brings together pseudonymised data from hundreds of local health and care providers.
It is a unique data partnership that is expanding its scope, and making increasing use of unique property reference numbers (UPRNs) as an effective link between the different datasets at household level, alongside NHS Numbers to link data at person level, both pseudonymised.
The KID programme had its origins in 2013 as a result of Kent’s participation in national pilot programmes such as Long Term Conditions Year of Care and Integration Pioneer site, to explore the use of pseudonymised linked datasets in designing new funding models for integrated care.
Over the years the programme gradually expanded to include other datasets such as Home Safety Check data from Kent Fire & Rescue Service (KFRS). A practical solution was required to link household level data with health and care person level data.
The UPRN is a unique identifier for every addressable location in Great Britain, created by local authorities, held in their local land and property street gazetteers, and managed nationally by GeoPlace, a joint venture between Ordnance Survey and the Local Government Association.
Along with the NHS number, it provides a linkage point for the patient population data within KID. This makes it possible to identify where data from different sources relates to an address, and thereby begin to identify any patterns, without revealing the identities of the relevant individuals. This is especially important given the data protection considerations when accessing and analysing person level datasets to assess population health risks and inequalities in health and care provision.
This demographic data combines with the structured activity and cost data from local service providers, and the segmentation tools within KID to make it a highly valuable tool for the NHS and the council.
Dr Abraham George, consultant in public health for Kent County Council, says that since last year the council’s public health intelligence team has been using the dataset for an increasing number of purposes, and sees opportunities for plenty more.
He points out potential benefits for the dual use of patient and household level identifiers in linked datasets for population health planning purposes such as quantifying specific at-risk cohorts without the direct risk of re-identification. A good example is Toxic Trio – children and young people at increased risk of harm caused by domestic violence and abuse, parental mental ill health and parental substance misuse – individually or in any combination.
The UPRN gives them a route to spot if they are at an address where someone else is receiving support, and help to build up a risk profile. In turn, this can be related to data on other factors in the local environment that could affect mental health.
“The whole agenda is about prevention,” Dr George says. “We need to be risk profiling our population to identify the factors that predispose children using very resource-intensive community services. UPRN is a key enabler to help us start to quantify that risk profile.
“Another example is around social isolation. If we look at just one person living at an address identified by a UPRN it starts to give us a proxy for social isolation, and it helps us to quantify the extent of the problem using local data rather than relying on high level national estimates which may not reflect local variation and context. “
Another project has involved using UPRN to link the datasets around 'safe and well' visits by Kent Fire & Rescue Service with hospital data in KID. There has also been an effort to use the reference number in a profile of a cohort of 820 people who had been sectioned or referred by police to a place of safety for mental health assessments. The UPRN helped to the team to establish how many of these people lived alone – a significant factor in mental health – without referring to data that identified them.
Dr George says that even in projects where the team has not been able to find clear answers, the UPRN has helped to provide a clearer view of what further steps might help.
“UPRN does not always give you the precise right answer, but it does stimulate a new conversation about how we can start to improve data quality,” he says.
He also sees the work as having laid the ground for stronger analysis on behalf of the CCGs. They are currently migrating data to a new data warehouse supplier – a process expected to take 12-18 months – and he expects the new supplier to utilise UPRNs as matter of routine for the KID development going forward.
“When the new supplier takes over it will have little work to do because most of the hard work has been done in the past four years; they just have to copy the methodologies we have used,” he says.
“This is important to us because of the wider determinants on public health. We want to create a rich mosaic of how money and resources are flowing across the Kent and Medway economy, looking at it from a health and wellbeing perspective.”
Overall, he says the UPRN is a great asset in linking data from NHS, local authority and other sources to explore public health; and can provide the scope for innovation around the linkages. This use of the UPRN can be replicated by other public authorities as they all have access to it from AddressBase, which is available from Ordnance Survey under the Public Sector Mapping Agreement.
Visit the GeoPlace online library to download more information on the Kent Integrated Dataset.