EHI interview: Ming Tang

The upheaval in the NHS commissioning environment has seen traditional data flows "chucked up in the air" – and part of Ming Tang’s role is to make sure they land in a safe place.

The NHS Commissioning Board – which, as of last week has become NHS England – appointed Tang as director of data and information management systems in January.

Her job is to help the NHS make better use of information to inform commissioning and improve patient care.

"For me, the most exciting things is making sure that we have a clinically relevant dataset and services to support clinical commissioning," Tang tells EHI Primary Care.

"We collect a lot of patient information that we don’t use as well as we could. If the systems were interoperable, we could get a really good profile of what actually happens to a patient so we can focus on outcomes and make the most of that information."

From the NHS to the private sector and back again

Tang started her career as a pharmacist in the NHS, then moved to GlaxoSmithKline for about eight years. After doing an MBA, she joined Accenture and spent six years in the company’s Australia office.

After moving back in the UK, she decided she needed a change. So she dived back into the NHS, firstly managing the shared services for 17 primary care trusts in the West Midlands, and then becoming the managing director of NHS South Yorkshire and Bassetlaw commissioning support unit.

As part of these roles, she worked with the Department of Health on shaping data flows for commissioners in the NHS created by the ‘Liberating the NHS’ reforms.

The reforms, instituted by former health secretary Andrew Lansley, swept away much of the old ‘centralised’ management structure of the NHS and, in its place, created NHS England and 211 clinical commissioning groups, headed by GPs.

They also created new data and commissioning support structures, focused on the Health and Social Care Information Centre, data management integration centres, and commissioning support units.

Tang says now that the question those working on these structures sought to address was: "How should we shape business intelligence services to make them more market-relevant, to work at scale, to integrate best practice and to make the best use of talents in the NHS?"

Tang says now that the question those working on these structures sought to address was: "How should we shape business intelligence services to make them more market-relevant, to work at scale, to integrate best practice and to make the best use of talents in the NHS?"

Sorting out problems as they arise

Tang’s role straddles Tim Kelsey’s patients and information directorate and Barbara Hakin’s commissioning development directorate at NHS England.

A key project is the care.data service, which is designed to capture and link data from primary and secondary care. Her role is to make sure that the technology and structure needed to make it happen are in place and that the datasets requested are relevant for commissioning.

Another key project is the development of the nine DMICs to provide data validation, integration and storage for CCGs, CSUs and local authorities.

EHI reported in February that although the centres were originally envisaged as ‘super’ CSUs, hosted like other CSUs by NHS England, they would have to become part of the HSCIC to operate legally.

Tang explains: "Because of the changes in the Health and Social Care Act, we have had to make sure that the HSCIC has sufficient capacity and closeness to what the commissioners need.

"The most pragmatic way of doing that is to second people from the DMICs to the HSCIC through employment contracts. That gives them the legal power to process confidential data."

Tang says the secondments are a short term solution – 12 months – while work continues on the new model of data flows in the NHS and Dame Fiona Caldicott’s review of information governance.

"There’s some transition at the moment which is not ideal, but everything has been chucked up in the air and we’re trying to land it in a safe place," she adds.

Telling patients what is happening

Amid all this change, Tang sees real signs of progress on the information agenda. She argues that the NHS has moved on from talking about the quality of the data available, to talking about how to use it, while recognising that the quality still needs improvement.

The NHS Number is "key" to this transformation, she adds, and Kelsey’s directorate is doing a piece of work to increase its usage.

She acknowledges that more work is needed to convince professionals and patients of the safety and necessity of increased data sharing.

"There are changes that are needed on the commissioner side, that we don’t have to flow identifiable data as much as we do," Tang says.

"We need patient level data, but whether that needs to have all the identifiable elements is a question. Part of this migration and change is to remove the need for some of that, so we can better handle the amount of patient identifiable flows in the system."

She also emphasises that data flows have to become more transparent to everybody involved with them – including patients

"We need to be more transparent with patients because if we explain better to patients what we are doing with their data I’m not surethey would have a problem.

"The transparency part of that is communication: trying to work with providers to say we need to make patients more aware that activity data collected on you will be used to plan and manage services.

"Longer term, we are looking at giving patients access to their own files to see what’s happening to them. I’m a strong believer in giving people the power to lobby themselves and make more informed decisions about their healthcare."

Ming Tang will give the closing keynote presentation at EHI’s brand new conference on the IT and information needs of clinical commissioning groups and their support providers on 15 May.

To see the full programme and to book a place, visit the Information for Commissioning website, or email events@e-health-media.com to find out about the discounts that are still available for those working in the NHS. For information about exhibiting, contact Neil Hadland.