You may have noticed a new test result in your NHS App, referring to Johns Hopkins Adjusted Clinical Groups. The description of the result is "Johns Hopkins clinical groups system score", followed by a number. This page provides some more information about this clinical group scoring.

What are the Johns Hopkins Adjusted Clinical Groups?

The Johns Hopkins Adjusted Clinical Groups (ACG) system has been used by the NHS since 2009 with over 11 million patient records having been analysed. They categorise or ‘segment’ patients into groups based on complexity and intensity of their healthcare needs rather than just their medical conditions. They consider the number of chronic conditions, severity of the illness and level of support a patient might need. As patients needs change over time their categorisation changes with them. 

The categories or segments are shown in the chart below. The categories are grouped into:

• Low need - segments 1 to 4 are patients who do not have significant health needs and therefore need less intervention.
• Moderate need - segments 5-9 contain patients who have conditions which are well managed and so will need occasional support.
• High need - segments 10-11 are made up of those who have multiple conditions and are likely to need regular monitoring.

This result represents a number between 1 and 11, which enables us to segment patients based on health needs.  It will help the practice to understand the individual needs of patients and to give them the right support in a timely way.

How we do the segmentation?

Collect the data

Data is collected from primary and secondary care records and some public health services. Primary care records are those held by GP surgeries and examples of secondary care records admissions to hospital, emergency attendance and outpatient appointments etc. The data is updated monthly so is accurate and timely. In Oxfordshire this is done using data from the Thames Valley Sharing (TVS) Record platform. 

Identify segments

The TVS platform runs the Johns Hopkins algorithm and groups patients into the 11 segments above.

Use the segments

The practice uses the analysis to provide the best treatment to patients. For example, those with the greatest need seeing the same clinician where possible, or being called for review more frequently, etc.

What are the benefits of segmentation?

When a clinician opens a patient record it will display which segment the patient has been assigned to. This will help the clinician to;

• Make decisions regarding patient care.
• Personalise care for patients.
• Improve health outcomes by identifying patient need sooner and providing more patient-specific care.
• Provide preventative care, identifying patients who might need treatment earlier and therefore preventing complications.
• Coordinate care across teams who may need to care for a patient.

How your patient information is protected

The Johns Hopkins Health System has a strong reputation for medical excellence, commitment to data security and privacy and very well established data governance. There are a range of controls in place to protect patient data. To access the Thames Valley Sharing Record organisations must;

• Meet a qualifying standard which all organisations involved in TVS have agreed to
• Sign confidentiality agreements
• Use role based access controls which restrict permission to staff with a legitimate reason to access patient data
• Agree to carry out and submit audits of staff accessing data
• Train staff to a set standard
• Inform patients via their privacy notice

In 2023, King's Counsel reviewed and confirmed that these arrangements are suitably lawful and robust. 

For more information, please visit the ICB's website