CIPHA Case Study

As one of NHS England’s biggest ever data projects, the award-winning CIPHA programme not only helped to save lives and livelihoods during the pandemic but also set national policy. max20 provided subject matter experts including Lisa A’Hearne who helped to design the programme and went on to become its director.

The value of population health data in saving lives and improving services is now widely recognised, however before the pandemic most data was in standalone systems, such as GP practices, hospitals or local authorities.

CIPHA (Combined Intelligence for Population Health Action) pioneered a new approach to data sharing. Starting out as a platform to help Cheshire and Merseyside respond to the pandemic, it went on to become a £23m programme that encompassed data from over 17 million patients and played a key role in
shaping government and NHS policy.

Local decision makers had already recognised the need for a shared data platform and in 2019 Mersey Care NHS Foundation Trust had contacted max20 to help it assess the options. Lisa A’Hearne, a transformation programme manager, started work in August that year. However with the onset of the pandemic in early 2020, her work took on a new impetus.

The Covid response teams wanted a data platform for Cheshire and Merseyside that could be rolled out rapidly to inform decision making. Jim Hughes, the Trust’s strategic adviser for digital programmes, asked Lisa to adapt the appraisal she had written to provide a suitable framework. After funding was secured from NHSX, work began apace, with Lisa as part of the CIPHA implementation team.

JUNE 2020: The initial roll-out

Within just 12 weeks, the CIPHA system – based on Graphnet’s shared care platform – went live providing real-time rich data on 2.5 million residents from all parts of the care system including 359 GP practices, 26 NHS trusts, nine local authorities and emergency services. The data was combined with information from national sources such as Covid cases and tests, hospital admissions and deaths.

Reference dashboards were produced and the system quickly grew to around 1,000 users. An information governance system was put in place to ensure the integrity of data and maintain trust.

Jim Hughes says: “What was most notable and pleasing was that we now had a consistent way for people in Cheshire and Merseyside to view the data – a single source of truth.”

NOVEMBER 2020: Mass testing trials begin

In the pre-vaccination period, testing was key to managing the spread of the disease and a system of tiered lockdowns was in place. When the government decided to run mass testing pilots, Liverpool was selected as a location because of the access to data the CIPHA programme could offer.

The Army was called in to set up mass testing sites and CIPHA, which by now included 30-minute Covid test feeds from NHS Digital, was used to inform where they would be placed. The team were able to view data at a local authority ward level, see the number of tests being completed in each ward and the results.

“In the wards where people were not actively testing, we would put test centres at the bottom of the streets,” says Lisa. “It was like a game of chess, making sure everybody was in the right place at the right time.”

The exercise was the world’s first mass testing pilot and informed government policy about asymptomatic testing and the subsequent roll-out of lateral flow devices.

MAY 2021: Mask-free events

As the country started to open up, Liverpool was once again selected for a pilot, this time to trial small-scale events without masks. Around 5,000 people were allowed to attend a gig in Sefton Park but were asked to provide proof of a negative Covid test from a local testing centre before entry.

Jim says: “With the data we had, we could guarantee that if someone had a test in the morning, we would know if they were negative by the time they got there. We also collected a huge amount of data, such as Covid traces in wastewater or in the air within the arena.”

The event, the first of its type in the Northern hemisphere, proved that mask-free events could be held safely in the right circumstances.

CIPHA was named Healthcare Project of the Year at the Bionow Awards 2021 and was highly commended in the HSJ Awards 2022 for the use of data to inform services.

April 2022: CIPHA expands

Based on the initial success of the system, NHSX provided additional funding to expand it to cover 11 Integrated Care Boards and a total of 17 million people. Lisa, whose initial contract was due to end, was re-engaged via max20 and became programme director, in charge of managing collaboration with the new users and setting them up on the dashboard.

“We took a ‘sweet shop’ approach,” recalls Lisa. “With each ICB I worked with, I showed them a blueprint of what we had done in the past and allowed them to pick and mix the reports they wanted.”

MARCH 2023 onwards: Looking to the future

While the official CIPHA programme closed in March 2023, the individual ICBs continue to use the platform and populate it with further data. Cheshire and Merseyside ICB, for example, have now added data about fuel poverty to identify those most in need of support and plan to add in information on factors such as education levels and housing in the future.

Meanwhile the success of the programme and the lessons learned have helped to influence NHS England’s plans for the new federated data platform. The Hewitt Review published in the same month emphasised the importance of ICBs using population health data to help deliver their objectives.

Lisa, who wrote the closure report, says: “We take pride in what we have done. It was an honour to work on such a game-changing project and, in such a terrible situation, it was good to be able to give people reassurance that we would be able to come through it.”

“Data is like gold dust. The CIPHA project proved itself multiple times over and demonstrated the value of having the right data at the right time.”

Jim Hughes adds: “CIPHA set the basis for how large Integrated Care Systems need to operate and manage shared data. As we bring in other types of data and use AI to analyse it, we can build up a really rich picture about individuals and understand how to optimise their health, care and general wellbeing. It will enable us to deliver targeted care almost at an individual level.”