FAQ & Solutions

Introduction

There has been consistent opposition to the use of the iBID from individuals in NHS management and a small number of burn services, who have called into question the utility of the iBID. None have provided any reliable evidence of poor performance by the iBID or the BCIG, nor produced constructive or detailed suggestions for alternative ways of fulfilling the same objectives.

Oft-repeated issues are listed here with actions undertaken or remedial actions that are underway:

Dataset too big

The dataset was developed by clinicians, for clinicians, without the benefit of a detailed specification from the NBCG, NNBC or NHSE. The original dataset has been added to in order to comply with the provision of the NHS QD measures as well as specific requests from burn services to develop data collection tools they require.

Minimum dataset not defined

Definition of the essential and required data items was made explicit in the software release in 2012 so as to provide on screen clarification of those fields that were necessary to constitute a complete record. In addition, automatic error reporting was provided to check key fields for completeness. This methodology is
being further developed and extended and is for release in the autumn of 2017.

A document was developed and circulated in July 2016 which listed all the fields which contribute to the QD and the calculations necessary to derive the dashboard items. It would appear to have not been widely read. It has been further developed to provide greater levels of detail and was circulated in February 2017.

Dataset definitions not clear

Additionally, part of the system used to design the iBID software has been released on a website which allows users to inspect detailed information about each field in the software package as well the
calculations involved in the analysis process.

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Multiple admissions poorly handled

No detail has been provided by users concerning this issue. It is unclear what is meant by this.

Unreliable data

The accuracy of the information provided by the iBID system, in common with every other clinical registry or indeed NHS health data systems, remains an issue. Reports concerning data completeness and accuracy have been provided to burn services for many years but in the absence of a system for NHSE to react to consistently poor data it is beyond the roles and responsibilities of the iBID team to issue sanctions.

Reports are too rigid

It has long been acknowledged that the range of reports provided cannot give a comprehensive understanding of what data is available to both commissioners and burn services or indeed the public.

Efforts to engage commissioners, networks or burn services in helping to design reports have been without success as few individuals wish to invest the time necessary to understand data system in sufficient detail so as to meaningfully contribute to the design of new or existing reports.

In an effort to circumvent this problem part of the BCIG work programme in recent years has included the need to develop a web-based system to allow user designed reports to be generated directly from the central database. This has now been released for comment and feedback.

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Access to data not possible

The feedback from users suggests they want access to the raw data. The lack of understanding concerning the detail of the NHS regulations concerning data management is concerning but is widespread problem in all areas and levels of the NHS.

The actions undertaken include:

  1.  Create a document that describes the differing levels of data access that are available and the criteria that must be fulfilled and offer guidance as to the steps that need to be dealt with before getting access to identifiable and non-identifiable data extracts.
  2. Continue to develop with MDSAS a means of allowing real-time access to user-defined reports via a website within N3 under password protected control.
  3. Similarly continue to develop a system that would allow public access to appropriately filtered data.
  4. Reviewing the 2016 report structures to focus on what people need to see.

Coordinator support lacking

There is a general lack of understanding about the variety of coordinators in place across the country. There is significant variation in the skills and funding which introduces wide variation in the support burn services have. A document has been produced which explains this along with a generic person specification
and job description to guide burn services in appointing the correct person for their needs.

There is agreement the face-to-face training is inadequate as lessons need to be repeated and this is being helped by providing the following:

  1. Creating a geographically based mentor system for coordinators with skilled individuals supporting new staff.
  2. To review and enhance the iBID software help file system to explain what each field is for and how it is to be used.
  3. Communicate the ability to access to the design database website with the details of the calculations undertaken in the analysis phase as these will be of use and interest to expert users.
  4. Creating a competition for the best use of iBID data by a coordinator or trainee.
  5. Creating a coordinator standard JD and guidance of ‘how to do it’.

Coordinator training lacking

  1. Establishment a Moodle education resource that would allow 24-hour access.
  2. Explore the experiences of TARN in supporting trainers and trainees and look at the resources they
    use.
  3. Set up tiered coordinator study days to cover advanced issues following the software release in the autumn of 2017

No specification

There is no detail specification for the database as it was developed by clinicians for their own purposes, acknowledging that the clinical information could be used to provide information important to commissioners and service monitoring and design. The development of a detailed specification is intended to take place in 2017 but requires input from NHSE.

However it is recognised that BCIG members and industry partners cannot help with a specification if there is any risk of re-procurement by NHS IT Procurement as this would exclude them from being part of any bid.

No meaningful contract

The initial contract in 2007 was only minimally altered in 2013 following the formal NHS IT procurement exercise. This was the last time any contractual consideration was given by NHS England.

No monitoring

There has been no annual review of the database and its contract and no conditions applied since its inception.

Too costly

This issue is being dealt with by the NHS England review of clinical registries but this process has already demonstrated that the iBID is not the most expensive registry by far.

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