The study, led by the University of Sheffield and published in the British Medical Journal Open, was made possible through applying a ‘federated’ approach to data analysis, working with another eight regional sites, from across England managing data from 26 participating acute hospitals. It examined more than 1.5 million emergency department attendances and 660 000 emergency admissions from 21 acute hospitals across England.
The ‘federated’ approach allows researchers working within SDEs to securely analyse data across multiple environments without moving or duplicating the data. While this approach can unlock richer insights across a population that is more representative of the whole and support large-scale studies, it also introduces complex challenges around governance, technical compatibility, and public trust.
It has revealed that up to one-third of A&E attendances and two-fifths of acute admissions could potentially be managed through same-day emergency care (SDEC) and community settings – keeping patients safe and receiving treatment without an overnight hospital stay. Using a single agreed approach to data collection, researchers were able to produce two papers on their findings.
The data was extracted and curated in the same way in each site, then analysed within each region using an agreed analysis plan. Each site then shared its results with South Yorkshire, where all the data was aggregated into a singe result. This federated approach ensures sensitive data is secure as it is not moved around. Each site extracts and codes data in the same way and then analyses the data in the same way. Instead of moving sensitive patient-level data to a central database, the data remained in SDE’s regional data environments and only the anonymous, aggregated results were shared.
This secure collaboration was made possible using a Trusted Research Environment – a highly secure cloud platform at the University of Sheffield – where only approved researchers can analyse complex, pseudonymised data. By safely unlocking NHS data, this research provides healthcare leaders with vital insights needed to reduce A&E wait times and acute admissions, improve local services, and ensure patients get the right care, faster.
Read the full paper: bmjopen.bmj.com/content/16/6/e115446.