Health Risk Screening / Risk Stratification

Health Risk Screening or Risk stratification is a process GPs use to help them to identify and support patients with long-term conditions and to help prevent un-planned hospital admissions or reduce the risk of certain diseases developing such as type 2 diabetes. This is called risk stratification for case-finding.

Risk stratification tools use historic information about patients, such as age, gender, diagnoses and patterns of hospital attendance and admission collected by NHS England from NHS hospitals and community care services. This is linked to data collected in GP practices and analysed to produce a risk score.

Your GP will routinely conduct the risk stratification process outside of your GP appointment. This process is conducted electronically and without human intervention. The resulting report is then reviewed by a multidisciplinary team of staff within the Practice. This may result in contact being made with you if alterations to the provision of your care are identified.

The ICB has agreed with NHS England s251 support for the NHS Number, as an identifier from both NHS England and GP Practice data, to be used to enable this work to take place. The Data is sent directly into a risk stratification tool called Eclipse from NHS England /GP Practices to enable the data to be linked and processed as described above. GPs can identify individual patients from the risk stratified data when it is necessary to discuss the outcome and consider preventative care. Your GP will use computer-based algorithms or calculations to identify their registered patients who are at most risk. Once the data is within the tool ICB staff only have access to anonymised or aggregated data.

Suffolk and North East Essex Integrated Care Board (SNEEICB) also uses risk stratified data with pseudonymised (non-identifiable) data to understand the health needs of the local population to plan and commission the right services. This is called risk stratification for commissioning.

Type of Information Used

Different types of commissioning data are legally allowed to be used by different organisations within, or contracted to, the NHS. Information put into the risk stratification tools used by the ICB:

  • Age
  • Gender
  • GP Practice and Hospital attendances and admissions
  • Medications prescribed
  • Medical conditions (in code form) and other things that affect your health

Legal Basis Statutory requirement for NHS England to collect identifiable information

A Section 251 support approval (CAG 2-03(a)/2013) from the Secretary of State, through the Confidentiality Advisory Group of the Health Research Authority, enables the use of identifiable information about patients included in the datasets.

Data Processing Activities

The practice processes this data internally. Data is also processed by Prescribing Services Ltd (Eclipse) on behalf of the practice. Data is processed by the North of England Commissioning Support Unit on behalf of the ICB.

Opt-out / object details

You have a choice about whether you want your confidential patient information to be used in this way. If you are happy with this use of information you do not need to do anything. If you do not wish your data to be included in the risk stratification service you can choose to opt-out through the National Data Opt-Out process.

Where pseudonymised (non-identifiable) data is being used by the ICB, the National Data Opt-Out does not apply. The data is used in a format which does not directly identify you. You have the right to object to your information being used in this way; however, you should be aware that your objection may have a negative impact on the timely and proactive provision of your direct care. Should you choose to opt-out, please inform your GP practice who will apply an opt-out code to your record to ensure that your information is not included in the programme.

Please contact the Practice Manager to discuss how disclosure of your personal data can be limited.

Date published: 7th June, 2024
Date last updated: 7th June, 2024