By Jon Calpin, Programme Manager for the National Record Locator, NHS Digital
NHS Digital’s Programme Manager for the National Record Locator, Jon Calpin, discusses how a pilot with London Ambulance Service has proven that interoperability of NHS systems can be achieved and how this benefits organisations, with Jo Clark from digital care software provider Servelec and Stuart Crichton from the London Ambulance Service.
The NHS is often seen by the public as a single entity that looks after us all from cradle to grave, rather than a myriad network of over 8,000 interconnected organisations all working together to provide the outstanding care that we all rely on.
With this complexity comes the technical challenges we all face in the increasingly digital landscape of health and care. Each organisation has its own systems and holds its own data on the patients that use its services. There are also a wealth of different data sharing agreements with others, to help patients get the care they need while keeping their personal information secure.
Interoperability is the technical test of our time. Finding ways to get the right information to the right people at the right time so that patients get the best possible care and clinical decisions when they need it.
The National Record Locator was set up to help meet this challenge. Rather than being a central store of patient data, it initially provides a way of finding out who has data on a patient.
Authorised clinicians, who need information on a patient for their direct care, can access the National Record Locator using the Summary Care Record application, see who holds records on the patient and, once the system is mature enough, see the records themselves.
At no point does the record move from one system to another. It remains with the organisation that holds the data, so there is no need for a central repository.
We piloted this over the last two years with staff at the London Ambulance Service, where ambulance clinicians are now able to access the mental health care crisis plans of those they are rushing to help – providing them with often vital information about the patient, ahead of their arrival.
This has enabled cross-border record sharing on a national scale and the opportunities are endless. It speaks of a system in future that, no matter where a patient presents in the country, they can be secure in the knowledge that the clinician treating them has access to all the information they need to make the right decisions, quickly.
Stuart Crichton is the Chief Clinical Information Officer at London Ambulance Service and a practising paramedic. He has witnessed first-hand what a difference having information like this at professionals’ fingertips can make to an urgent situation:
“The ability to look at a record using NRL has changed the game for those of us on the front lines. The National Record Locator has given us timely access to relevant information in a quick and easy to digest format. This means that we can improve our decision making to deliver patient-centred care.
“There are real advantages to this. We have had cases where, knowing the details on someone’s mental health care plan has meant that we’ve known before we’ve arrived that our presence has led to an escalation in that patient’s stress response. So we’ve been able to take appropriate action, avoid the need for other emergency services to be called and, most importantly, it has meant that the patient hasn’t been distressed unnecessarily.
“Our clinicians don’t have to worry about usernames and passwords to access the information, the security is all taken care of in the background enabling us to focus on patient care. I love it, our staff love it and this technology will change the face of how we access data across the NHS.”
Tech like this usually comes with a hefty price, though, in an organisation’s time and effort to set it up. This is no different but it’s not as labour-intensive as most. Servelec’s Head of Business Operations, Jo Clark, explains:
“All you need is an ODS code, a HSCN or N3 connection, the ability to verify NHS numbers through the Spine and an up-to-date Data Security and Protection Toolkit. Once your Clinical Safety Officer has undertaken their clinical safety assessment, you’re ready to onboard.
“Your supplier will handle most of the onboarding process for you. All you need to do is review the guidance, sign the connection and data-sharing agreements and work with your supplier on integration testing once they’ve built and tested it in NHS Digital’s path-to-live environment. Your supplier will support you through deployment and into live.
“You don’t have to be one of our customers either – while Servelec has led the pilot as the supplier partner, by developing the integration with our Conexes interoperability platform, we want to see other suppliers coming into this marketplace to help their customers to make the most of this technology as well.”
The pilot around mental health crisis plans and ambulance staff has proven itself a resounding success but there’s so much more that this technology can do. Any type of patient record for any type of service, anywhere in the country.
A truly interoperable system for the NHS, able to share patient data securely and quickly with the professionals who need it, regardless of the IT and record systems involved, fit for the next decade and beyond.
If you think that you could use the NRL, or have records that you think others might need, please contact NRLS@nhs.net.
