Our closing webcast session for HTN Now September 2021 was a presentation by representatives from Healthcare Gateway and the South, Central and West (SCW) Commissioning Support Unit (CSU) – an NHS support and transformation service.
Bringing our four-day live online event to a close with an in-depth look at the Connecting Care programme, was a panel consisting of: Liam King, Managing Director, Healthcare Gateway; Tracey O’Brien, Digital Consultant, SCW; and Natasha Neads, Senior Project Manager, SCW.
The team took to the virtual floor to explain the benefits of their Connecting Care system for both care homes and post-prison healthcare settings and pathways, and how using it can support the effort to join-up care for patients who may otherwise slip through the cracks.
Liam led the introductions and provided the background to Healthcare Gateway and what they do, explaining: “We’re interoperability specialists. We provide interoperability as a service to the health and care system in the UK today. We connect over 100 different clinical systems with one another, providing that real-time sharing of patient data for direct care purposes, to support clinicians in making some critical, life-saving clinical decisions.
“We’ve been providing this service since 2010. We originally started off by unlocking silos of data and mobilising that as we tried to move information around to follow a patient, using a technology known as the ‘MIG’ – the Medical Interoperability Gateway, and we’re still doing that today. We currently connect 5,000 care settings and we are transacting around 20 million transactions, or patient records, monthly – so quite meaty numbers there.”
Liam also added that, recently, the team has been supporting “organisations as they come together in the attempt to ‘level up’ their digital maturity.”
“From project inception, right the way through to benefits analysis, we provide a managed service that supports our NHS health and care partners in achieving their digital transformation aspirations,” he said, before summing up his perspective of some of the current interoperability challenges, which Liam says include disparate system vendors, processes and national standards, proprietary formats, security and information governance, data quality, and diagnostic coding.
On how the company can help solve some of those challenges, he continued: “We provide the MIG technology, and we also have our service wrapper, which is the managed service. We look to build solutions that help solve the interoperability challenges that we see.”
To provide use cases, Liam introduced Tracey and Natasha from SCW CSU to discuss “two of the areas that resonate” with what Healthcare Gateway and their partners at Connecting Care and SCW CSU have been working on – connecting care homes with wider health and care services, and digitising health for patients in the criminal justice system.
Tracey then took over the presentation to provide her perspective on interoperability in the criminal justice system and to share some of her learnings with the audience. She said: “Connecting Care is an exemplar programme that we’ve been running for nine years in Bristol, North Somerset and South Gloucestershire. The aim of our programme is to make sure that we share information well between our health and social care organisations.”
“I’ve been working on Connecting Care for nine years, and many of our ICSs [Integrated Care Systems] are just putting their Shared [Care] Records in place. I suspect many of you are still focusing on GP, hospital, and social care data. We’re now trying to move further ahead than the Minimum Viable Specifications identified by NHSX to put more information into our shared record, to support the information sharing culture that we’ve got…there are over 20,000 IT systems contributing data,” she explained.
Tracey also noted that the service currently has 8,000 users utilising the Connecting Care platform and that it’s also one of the few shared care records that includes children’s social care information to help with safeguarding. She added that, within Connecting Care itself, there are 27 partner organisations working together, including NHS England, NHS Blood and Transplant, local councils and authorities, NHS trusts, charities, and the West of England Academic Health Science Network.
The range of data already involved in Connecting Care includes everything from hospital appointment and patient contact details, assessment information, information around vaccinations, medications, and allergies, through to family and legal relationships, consultation notes, prescriptions and results. Services used from Healthcare Gateway include the GP and Community Health data set and high-level consultation notes, as well as end of life and frailty data sets, and document delivery services.
On the importance of sharing information about prisoner health, Tracey cited the Care Act 2014 and the duty of councils and prison authorities to consider the physical, mental and emotion wellbeing of prisoners. She said: “Care and support services often used to stop once the individuals entered prison…we know that not receiving the right care and support may impair the prisoners’ ability to take part in meaningful activities…it also can impact negatively on their rehabilitation.”
With social care unable to view the health records from prisons and youth remand centre in their local area, and issues around the support required for prison discharge and discharge summaries, and mental health support requirements, as well as the risk of potential drug overdoses upon release, Tracey underlined the importance of information sharing at these crucial moments and in supporting ex-offenders to navigate the health and care system.
Progress so far, Tracey said, involved prioritising this, as well as securing funding from Public Health England and the Home Office, agreeing on the information and technical standards to be used, working to understand the digital roadmap for prisoner health information, and documenting and agreeing the informing methods, so that people know what their information will be used for.
Natasha then took over and moved the focus to interoperability in care homes, explaining how the team provided homes in the region with access to Connecting Care. “People living in care homes should expect to have the same level of support as those in their [own] home and, in parallel, staff in care homes should feel at the heart of an integrated team. Providing that information and sharing that information can support both of those,” she commented, before explaining how many homes still rely on NHSMail – and on people having the time to check this – to find out important information about residents, with the potential for mislaid information or lengthy waits.
Natasha highlighted that 55 of the homes in the region now have access to Connecting Care, following funding from the NHS Digital Social Care Pathfinder Programme, and that the team worked with NHS Digital and INTEROPen to develop the technical standards, so that other providers could benefit from the work.
After explaining more about the use and development of standards, Natasha provided an illustrated example of how the standards are used and how professionals from throughout the local health and care system can use Connecting Care to view important information at all stages of a resident’s health journey – from emergency contact preferences and end of life care wishes to real-time lists of current medications.
To view the session in full, watch the video below: