When the COVID-19 pandemic first emerged across the UK in early 2020, policy-makers in the East of England turned to Dennis Gillings Professor of Health Management Stefan Scholtes at the University of Cambridge Judge Business School for help. Drawing on 25 years’ experience at the University of Cambridge and with six years as Chair of the Board of the 60,000-patient Granta Medical Practices in Cambridgeshire under his belt, Professor Scholtes convened a multi-disciplinary team of statisticians and public health experts who could help to analyse regional data to inform crucial policy decisions on a local level.
With a health crisis emerging before their eyes, NHS colleagues in the East of England needed rapid advice to help plan their regional response. One of the key questions they needed to answer was how many COVID-19 admissions there might be in each of the hospitals across the East of England. That was the “exam question” that Professor Scholtes and his team took as a starting point.
They combined data from daily situational reports produced by each of the hospitals across the region with national Intensive Care Unit (ICU) data that provided granular patient-by-patient information to build an innovative model that helped to predict the regional timing and size of the pandemic’s peak. They also investigated how to use new data sources, such as mobility data based on mobile usage, to help predict the spread of the COVID-19 virus.
Throughout the first 12 months of the pandemic, Professor Scholtes and his team held weekly Zoom meetings with policymakers from NHS East of England and Public Health England who were making key decisions to help plan everything from the number of ventilators needed to the projected number of hospital beds. Based on this crucial regional analysis, policymakers decided not to open emergency Nightingale Hospitals in the East of England, which helped to save the NHS many millions of pounds.
“I think we did make a different decision because we did have different data,” says Professor Scholtes. “It’s all about making better informed judgements.”
Although the data wasn’t shared publicly, for confidentiality reasons, papers were published about the innovative model developed by the team.29 The partnership between policymakers and academia played a pivotal role in the region’s pandemic response, earning Professor Scholtes and his team a Collaboration Award in the University of Cambridge’s Vice Chancellor’s Awards for Research Impact and Engagement in 2022.
Overcoming barriers
Most of the data Professor Scholtes and his team relied on for their analysis was owned and managed by the NHS. Because it was a health emergency, access to the information they needed was a lot faster than usual, although Professor Scholtes is quick to point out that the data was still hosted securely on a University server, and standard protocols were followed at all times.
“The COVID project was an example of where pragmatism overruled barriers that are sometimes constraining,” says Professor Scholtes. “Normally you have to go through lots of hoops to get to the data that you need. In this case there were shortcuts; they were not dangerous shortcuts because we were very aware of the sensitivity of the data, but they just made our lives a lot easier and a lot faster.”
During non-pandemic times, getting access to healthcare data can be a slow and painstaking progress – taking anything from six to 18 months, according to Professor Scholtes.
“One of the challenges in the NHS is that the data is very siloed,” he explains. Take the example of primary healthcare records held by the 6,000 primary care practices across England: “They have their own data in three different systems,” he says. “And these three systems don’t talk to each other, and they don’t talk to the NHS systems.”
To overcome these data challenges, Professor Scholtes believes that interoperability is vital, while ensuring that safeguards are in place to respect patient confidentiality and privacy. He suggests the planned NHS Federated Data Platform is a useful step in the right direction.
This is software currently being built that will enable NHS organisations to bring together operational data – currently stored in separate systems – to help staff access the information they need in one secure environment.
“If this works as planned, it will make a big difference,” says Professor Scholtes, and this kind of national data pool might also feed into a National Data Library in future, he suggests.
“[A data library] could bring incredible value,” he says, as long as it has the correct guardrails in place to protect patient confidentiality. “At the moment, everything is fragmented. Every researcher has their own way of accessing data and dealing with the red tape that’s necessary. A National Data Library would allow us to do things at scale. Standardisation and scalability would be the key for a data platform like this.”
Demonstrating value
Before building the library, Professor Scholtes suggests taking a step back and asking what questions need to be answered to create public value: “Think of this as a library with empty shelves and then filling the shelves one by one,” he says. “So you break it up, challenge by challenge, and think about how do I fill these shelves, driven by big policy questions. It’s got to be about creating value for society.”
For Professor Scholtes, the onus also falls on academics to demonstrate the value of their research more forcefully than they currently do.
“We tend to stop when our paper is published and that’s only half the story,” he says. “Often you have to carry on and continue your involvement with the policy development and policy implementation piece to close the loop and evaluate what you’ve done. You can tell a bigger story, but it takes five to six years before the story emerges.”
Here again he believes a National Data Library could play a key role.
“I think we as academics have more of a responsibility than just publishing papers,” Professor Scholtes says. “It’s not just about information and knowledge creation. It’s about making a difference.”
Written by Vicky Anning
