Organising Organisations: Data completeness

Our previous blog highlighted how Trusts are reported in the SCMD and how data for related Trusts can be aggregated. This blog takes a deeper look at whether all of the Trusts expected to be in the SCMD are there and how complete their data is.

How many organisations do we expect to see?

Based on the SCMD metadata, we expect to see data for every NHS Trust in England. We know that Trusts occasionally merge or are acquired, but we expect to see data for these Trusts up until the point that happens.

To find out if all of the expected Trusts are included, we first have to get a list of all of the NHS Trusts in England. To do this, we can use the ORD API, which we’ve previously mentioned can be used to get information on NHS organisations using their ODS code.

Associated with each ODS code is a Role that describes the primary role of an organisation (e.g. Pharmacy, NHS Trust, primary care trust etc).

To get a list of all NHS Trusts we restrict to organisations with the roles “NHS Trust” located in England, without a recorded closure data before January 2019 (the start of the SCMD).

This gives 231 Trusts; slightly different to the 224 Trusts we identified in the previous blog. Let’s find out why.

Organisations completeness in the data

There are 13 organisations that are not included in the SCMD. These are shown below:

ODS Code	ODS Name
RYF	South Western Ambulance Service NHS Foundation Trust
RYD	South East Coast Ambulance Service NHS Foundation Trust
RYA	West Midlands Ambulance Service University NHS Trust
RX8	Yorkshire Ambulance Service NHS Trust
RRU	London Ambulance Service NHS Trust
RX7	North West Ambulance Service NHS Trust
RX6	North East Ambulance Service NHS Foundation Trust
RX9	East Midlands Ambulance Service NHS Trust
RYC	East of England Ambulance Service NHS Trust
G6V2S	North London NHS Foundation Trust
RNK	Tavistock And Portman NHS Foundation Trust
RY9	Hounslow And Richmond Community Healthcare NHS Trust
R0C	Project Nightingale NHS Trust

The majority of these are ambulance service trusts. Ambulance service trusts are responsible for providing on the scene emergency services and transporting patients to hospital. Only South Central Ambulance Service NHS Foundation Trust appears in the SCMD and shows data for a single product for a short period. It is not obvious from the dataset description whether Ambulance service trusts are expected to be included within the SCMD. If they do submit data we can build ambulance trust specific tools to help them audit and improve their medicines use. If you do know more about the very specific details of ambulance trusts please do get in touch - we are always keen to meet domain experts to help write about the gaps in our “missing manual” for NHS medicines data!

The four other NHS Trusts that do not appear in the SCMD are:

• North London NHS Foundation Trust - this is a new trust with a start date at the end of 2024 - we will expect to see data from this organisation in the future.
• Tavistock And Portman NHS Foundation Trust - This is an active trust so it is not clear why this data is missing.
• Hounslow And Richmond Community Healthcare NHS Trust - community services in Hounslow were transferred to West London NHS Trust and this trust submitted a case to NHS England to merge with Kingston Hospital NHS Foundation Trust towards the end of 2024. However, it is not clear why historical data for this trust is missing from SCMD.
• Project Nightingale NHS Trust - This was a temporary trust set up by NHS England during the COVID-19 pandemic.

Does every organisation have data for each month?

Beyond knowing whether all of the expected trusts are included in the SCMD, we also want to know whether there are any gaps in the data Trusts submit, particularly around organisational changes.

The majority of trusts have data for every month between January 2019 and February 2024, but there are some exceptions. Some examples are shown in the figure below, which shows solid lines in months where data has been submitted. Some trusts, such as The Royal Marsden NHS Foundation Trust, are missing a few months data, whilst others, such as Humber Teaching NHS Foundation Trust are missing significant periods of data. Northamptonshire Healthcare NHS Foundation Trust hasn’t submitted any data since November 2022.

Some of the missing data can be explained by organisational changes, which we described in our last blog. For example, the submission history for Northern Devon Healthcare NHS Trust, which merged with Royal Devon University NHS Foundation Trust in April 2022, shows that data was submitted to the SCMD until November 2023 (it can take time for systems to be updated following mergers, which is why data was submitted for this trust beyond the merger date). Similarly, although Staffordshire And Stoke On Trent Partnership NHS Trust merged with Midlands Partnership University NHS Foundation Trust prior to the start of the SCMD, they continue to submit data separately as the data systems they use have not been changed (this is detailed in the supplementary mapping file is provided with the SCMD data).

What does this mean when working with the data?

This makes two things clear:

1. There are some trusts with missing data that can’t be explained by organisational change. When these trusts are included in any analyses, care will need to be taken to highlight that there could be undercounting of medicines issued.
2. There are varying patterns of data submission that occur around organisational changes. Data for these trusts will need to be carefully aggregated to avoid spurious patterns in any analyses done using their data.

This is our first look into the completeness of the SCMD data for individual organisations. There may be good reasons for the patterns we have shown above, so if you think we’ve missed something, please let us know!

In this blog, we looked at individual trust data and asked Has the trust submitted data for each month? The next question, which will be covered in the next blog in this series is Has the trust submitted all the data expected each month?