Why do organisation identifiers matter? Lessons from the healthcare sector

Over the coming months, 360Giving is working with an expert group looking at the issue of organisation identifiers and how they can be improved. We want to maximise the usefulness of 360Giving data and being able to identify which organisations received what funding. This guest blog post by Giuseppe Sollazzo explains what identifiers are and why they’re important, using the UK healthcare sector as an example.

Giuseppe Sollazzo, Data & Technology specialist

Organisation identifiers sound like an abstract concept with no implications on everyday life, outside the bubble of geeks and bureaucrats; but they are the foundation layer of services. Processes with a huge impact on citizens and businesses depend on them. This blog post explains why identifiers are more important than they might initially seem.

NHS Digital has done a lot of work in this context. It runs an Organisation Data Service (ODS) that produces and releases data about organisations in the NHS, including their unique identifiers. Why is this important to healthcare? Put simply: all patient interactions with health services depend on them being identifiable.

Take GP practices: we all need to use a GP at some point. Today, we can easily find where our closest practice is, what services it provides, how to join its patient’s list, read about quality inspections, and find out what other patients think about it. ODS currently has no responsibility over the GP data, which comes from another part of the NHS, the Business Services Authority (BSA). How can we be sure that the BSA is talking about the same GP Surgery as the ODS, as NHS Choices, as our local hospital? The answer is: thanks to identifiers.

When we use these services as patients, the information layer is transparent. We take for granted the amount of information that needs to be brought together. GP practices mean different things to different groups. Is a GP practice a place, like a supermarket? Is it a group of people working together, like legal chambers? Is it an entity with its own legal standing, like a company? What happens during the lifecycle of a practice, when it forms and transforms, when GPs move away or join? How do we identify the GPs themselves? When asked, most patients say they think of surgeries as physical places.

The ODS addresses the issue of place vs services using the concept of “site” and “organisation”, so that a hospital site can have its own code, while the organisations that operate from that site have another. However, some of these relationships can be hard to define. Each GP has a unique registration number with the General Medical Council; if they run their own practice, they may be linked to other identifying data. The interlinking of these different datasets produces the ability to develop and run health services.

Consider a simple use case: finding the closest GP practice. An address is ok to understand where to go. Some surgeries, however, share premises. Some group surgeries split and reform. What if we sought the patients’ reviews for that practice, and the practice had moved recently? What if a GP practice moved into premises previously occupied by another GP practice? Attributing the reviews correctly is vital for performance monitoring. The use of appropriate identifiers makes sure we have a way to disambiguate.

There are many systems operating without identifiers in many sectors. However, they can only function to a certain point before they break. Having clear identifiers is important for patient safety. The Care Quality Commission is tasked with making inspections that assess the quality and safety of health services. How could they reliably identify GP practices, hospitals and A&E departments without identifiers?

And what about the expectation that organisations publish data about themselves, their processes and outcomes, in order to engage with their users? Without the ability to link through identifiers, the democratising power of data is vastly reduced. Without identifiers, the healthcare system could not provide patients with good data about itself, which reduces their ability to understand who offers a good service and who doesn’t, and whether they are safe in certain medical environments. Identifiers enable data to be used effectively: to argue for better services, exposing risks that need to be managed, in a transparent and democratic way.

Over the coming months, 360Giving will be looking at organisation identifiers and how we can use them more consistently in grants data. If you would like to find out more about this work then please email our Labs Manager, Mor Rubinstein: labs@threesixtygiving.org