In part two of our feature we spoke with industry experts to hear how they are progressing with sharing records across their local health economy or STP and what they have learned, achieved and what advice they have to share.
We spoke to Richard Greaves, SIDeR Programme Manager at Somerset Clinical Commissioning Group Somerset to ask about their programme:
“Somerset has a Digital Delivery Board and Digital Portfolio to oversee such initiatives, comprised of Chief Clinical Information Officers and Chief Information Officers from Somerset Clinical Commissioning Group, Taunton and Somerset NHS Foundation Trust, Yeovil Hospital NHS Foundation Trust, Somerset County Council and Somerset Partnership NHS Foundation Trust. Other members of this board include NHS England, NHS Digital and St Margaret’s Hospice.”
“Examples of some of the clinically led, digitally enabled initiatives include: All GP Practices in Somerset use the same Practice Management System, EMIS. In October 2016 we launched EMIS Viewer which allows read only access to the records of people who live in Somerset, subject to their consent, for clinical access in Taunton, Yeovil and Somerset Partnership hospitals, as well as 111/Out of Hours. EMIS Viewer has been used over 38,000 times since launch to deliver improved direct care.”
What advice would you give to other areas looking to share records and provide access to information?
“Have conversations with the health and care organisations in your area; gauge the appetite; talk to peer programmes of work; establish solid governance; determine the patient and clinical benefits; talk to your local system providers and conduct market testing to determine what is possible; define a budget/funding opportunities; engage with the public (and keep them informed); take time to recruit the best supplier to suit your needs; ensure you adhere to national interoperability and integration standards; plus learn lessons from and link to other areas doing the same.”
We heard from the CCIO from The Nottinghamshire Health and Care Portal, built on Graphnet’s CareCentric shared record software, which is being rolled out in phases across the county. The shared record provides access to acute information from both Nottingham University Hospitals NHS Trust (NUH) and Sherwood Forest NHS Foundation Trust and patient records from 157 GP practices.
Dr Jeremy Lewis, Consultant in Acute Medicine and Chief Clinical Information Officer at NUH said “Sharing information is central to our strategy for service transformation and the development of new integrated care pathways. Every day I am hearing of cases where having access to wider records in the acute environment has been of immediate and direct benefit to patient care. Having the portal integrated within our core clinical system with no separate login has made the system much more popular than other standalone sources of information.”
“For example, our stroke consultants are finding it of massive benefit to be able to access GP information when they admit hyperacute stroke patients direct from the ambulance service. This is particularly true when they are seeing patients for consideration of thrombolysis (potentially dangerous clot-busting medication) when rapid access to a patient’s medication history is critical.”
Next steps of the project include integrating community and mental health users, via Nottinghamshire Healthcare Trust, and completing the roll-out across the acute trusts. Longer term there are plans to integrate social care information into the shared record.
We asked Airedale NHSFT what advice would you give to other areas looking to share records and provide access to information?
“A shared place-based vision is essential, underpinned by appropriate information governance, systems and processes in place to ensure that as near seamless transfers of care can occur, aligned to Caldicott principles and GDPR. Strong clinical leadership to support this vision is vital.”
We also spoke with Shropshire, Telford & Wrekin STP who are at the start of their journey and they said: “We are at the very early stages of developing this project and we have set up a Digital Working Group to drive this forward. This group will be responsible for reviewing how information is shared and developing a strategic plan of action.”
In speaking with Cumbria Partnership NHS Foundation Trust it was clear a key contributing factor to the success of their project was establishing information sharing agreements, which all organisations need to signup to. They said this provides the framework for organisations to sign-up in the future and to the agreed standards.
Tony Atkinson, Information Sharing/ Privacy Co-ordinator said “The ISG has made it possible to establish the IG assurance level of our partners at a glance. We have agreed common rules of information sharing and are able to map data flows all in one place with quick and easy sign-off by the right people. Spreadsheets, paper agreements, SharePoint directories and scanned signature sheets are all, thankfully history.”
Finally we spoke with Healthier Lancashire and South Cumbria.
“There are more than 200 GPs and 4 NHS Trusts across Lancashire and South Cumbria who can all access a shared care record to improve care for local people. The Lancashire and South Cumbria Patient Record Exchange Service (LPRES) links information from GPs, hospitals and community services across Lancashire and South Cumbria together.”
“We are working in partnership with Cheshire and Merseyside to extend our record sharing to further join up care for local people – for example, if a child is seriously ill, they may get transferred to Alder Hey Children’s Hospital and we need to ensure that relevant information can be shared across area boundaries to give those young people the best care possible.”
“We have started work on a patient platform –WellPRES – to allow citizens and patients to access their full health record and to co-manage long term and chronic conditions, such as diabetes, cancer, COPD etc.”
We asked what advice would you give to other areas looking to share records and provide access to information?
“To put the person at the heart of everything and think about the requirements from the perspective of the user. Listen to your local community and frontline staff when designing systems. Work in partnership with other organisations across your area and beyond to explore how you can further integrate systems to meet the needs of your local population.”
Dr Amanda Thornton, Clinical Lead for Digital Health across Lancashire and South Cumbria said: “As a psychologist, I know that people find having to repeat their stories frustrating and intrusive so having instant access to patient information can be powerful and potentially lifesaving in an emergency. A good example of the impact that sharing records can have is an unconscious patient in A&E; shared records save vital time, helps make better decisions about the care needed, and avoids unintentional errors occurring.”
“Many patients assume that sharing information for care already happens, but a lot of hard work has taken place across Lancashire and South Cumbria to make sure we are connecting up all services that provide care across our communities.”
“We also need to assure people that the information is secured and can only be viewed by the health or care professional to help make better decisions regarding the patients immediate care needs. No identifiable information is passed on, or used for other purposes.
“Finally it also important to mention that sharing records is only a small part of how we need to use digital and technology to empower people, support health and care staff on the frontline and create a future which is about harnessing the creativity of our workforce and encouraging innovation.”
