Transcript Presentation

Summary Care Record (NYHDIF)
A Mechanism for Effective Data Sharing - March-17
presented by Patrick Nolan & Robert Jordan
SCR Delivery, North of England
SCR – Current Status
• Over 55.2 million
patient records
• Over 99% of GP
Practices in England
Creation
Use
• Over 4 million
uses during
2016
• Reduced medication errors
• Reduced consultation time
• Changed chosen care
pathway
Impact
104,493
SCR views
weekly
(w/c 20/02/17)
Over 1500 healthcare settings live with SCR viewing
With ongoing rollout to other settings including Community
Pharmacy, Custody Suites, Hospices & Community Care.
2
Current North SCR Viewing
w/c 27/02/17
Trust
Views
Trust
Views
Hull & East Yorkshire
2717*
North Lincs & Goole
737
Leeds Teaching
1323
Doncaster & Bassetlaw
575
York
1025
Rotherham
289
North Tees & Hart
855
Sheffield (STH)
2388
Sunderland
847
Airedale (via TPP S1)
496~
United Lincs
1783
Durham & Darlington
507
Barnsley
630
Derby (DTH)
782
South Tees
908
Mid Yorks
880#
3
SCR with Additional Information
SCR v2.1 - Examples and Description
4
SCR with Additional Information 1.
• The technical functionality to allow practices to add further
information to the SCR is live in GP Practices.
• The information can be added by clicking on a consent radio
button in the practice system.
• This in turn automatically adds the additional information
dataset to the SCR in real time.
• The information is updated each time the practice record is
updated.
5
SCR with Additional Information 2.
Supporting person-centred
coordinated care:
SCRs with additional information include:
•
Reason for medication
• GP practices now have
capability to enrich SCRs with a
set of additional information
with patient consent.
•
Significant medical history
• Includes individual coded
items and associated free text
as recorded in the GP record.
Example SCR:
(past and present)
•
Anticipatory care information
(such as information about the
management of long term conditions)
•
Communication preferences
(as per the SCCI-1605 national dataset)
•
End of life care information
(as per the SCCI-1580 national dataset)
•
Immunisations
6
SCR with Additional Information 3.
Items from the exclusion data set include:
• Sensitive items - such as Fertility Treatments, STIs,
Terminations and Gender Reassignment
• Private/Confidential items - in the GP record are honoured and
marked not present in the SCR.
Further content customisation can be offer by:
• Adding of Manual items - to support care quality and patient
preference such as living wills etc.
7
Consent for Additional Information
• The Core SCR (Allergies, Adverse Reactions & Medications) is
based on implied consent. If a patient does not opt out then
they will have an SCR.
• In order to add additional information to the SCR the patients
‘explicit consent’ must be sought.
• There is no requirement to gain written consent, however a
combined information leaflet and consent form is available for
GP practices that wish to use it.
• CCGs are prioritising the patients who would benefit from AI
(Vulnerable, Frail, End of Life, LD, Dementia & new patients).
8
GMS Contract Amendments 2017-18
Identification and management of patients with frailty
From 1 July 2017, practices will use an appropriate tool e.g.
Electronic Frailty Index (eFI) to identify patients over 65 who are
living with moderate/severe frailty. For those patients identified as
living with severe frailty, the practice will deliver:
• An annual medication review, discuss any falls in the last 12
months and any other clinically relevant interventions.
• In addition, where a patient does not already have an enriched
Summary Care Record (SCR) the practice will promote this,
seeking informed patient consent to activate the enriched SCR.
9
Identifying priority groups for consent
End of
Life
LTCs
Frequent
fliers
Mental
Health
Over
75s
Learning
Disabilities
Frail Patients and Avoiding Unplanned Admissions
2%
Live Viewing Organisations
• Acute Trust – A&E and MAU
• OOHs
• Ambulance Service
• MIU
Optimising Benefits of SCR with AI
Expand Trust Roll Out – Specialist Services
Community Services e.g. DNs, LTCs, EoL
Mental Health Services
Hospice
10
Scarborough & Ryedale Example
•
•
•
•
•
•
CCG steering group setup (Chaired by Ass. Dir of Corporate Affairs).
Monthly Meets (CCG staff inc. comms, NHS Digital & Practice reps).
Letter sent out to practices to explain AI, direction of travel & asking to
participate.
Workshops run for practices to cover AI (consent & functionality).
Local viewing sites contacted to begin awareness and to identify further
areas for potential SCR viewing.
Practices asked to;
– Nominate an SCR AI Champion
– Add a consent box to your frailty, long term condition and other
relevant care plans/templates
– Run a search for patients cohorts to establish a consent baseline.
11
Scarborough & Ryedale Example
The main groups of patients who will benefit from this additional
information being available are those who are most vulnerable, and
phase one of the project will focus on gaining consent from patients:
– on the vulnerable patient list, including palliative care
patients
– on the frailty register
– with learning disabilities
– patients with dementia
Consent from new patients registering with the practice and those
who regularly attend A&E/Urgent care services.
12
Benefits of SCR with Additional Information
• Removes the need to provide information via telephone/fax
when patients are admitted to hospital.
• Supports local priorities around frailty.
• Updates to care plans are automatically shared through
additional information*.
• Supports end of life care.
• Supports the Accessible Information Standard
• No change for existing viewers of SCR. They automatically see
the enriched SCR with the patient consent.
• Most CCGs across Yorkshire and Humber have included SCR
with AI in their LDRs and STPs.
13
Future Work
Currently the SCR Application (SCRa) offers users access to
PDS, SCR, CP-IS and FGM information.
Future plans are forming to refresh our Spine Applications including
SCRa to include increase functionality such as:
• National Record Locator Service
– http://developer.nhs.uk/library/systems/national-record-locator-service/
• GP Connect
– http://developer.nhs.uk/library/interoperability/gp-connect/
• Reasonable Adjustment (LD Flagging)
• Non-Smartcard Access to Spine Applications
14
Any Questions?
15
http://systems.digital.nhs.uk/scr
@NHSSCR
[email protected]
[email protected]
[email protected]