The process for data accreditation, and the progress with linking practices to the Personal Spine In

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The process for data accreditation, and the
progress with linking practices to the Personal
Spine Information Services (PSIS)

• Kathie Applebee
• Advisor to the GP National Clinical Leads for
  General Practice in CfH

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PSIS

• Personal Spine Information Services - central
  database containing clinical records for each NHS
  patient.
• The PSIS record will provide an up to date
  summary drug allergies, operations, conditions,
  medication history and details of contacts with
  care providers.

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The aims of the IMT DES

• Prepare data and information governance systems
  for uploading electronic summaries to the Spine
• Promote usage of EPS (electronic prescription
  service)
• Prepare for migration to hosted systems

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Component 2 of the IMT DES

• Data accreditation

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Support for PCTs and practices

• PRIMIS provides free education and training for
  PCT facilitators for the data accreditation
  process.
• PCTs are expected to provide education and
  training for practices from either PRIMIS
  facilitators or local equivalents

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http//www.primis.nhs.uk/data-accreditation/defaul
t.asp
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3-stage accreditation process
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Stage 1- Application

• Practice to submit
• a plan with suggested letter in appendix 5 of
  Good Practice Guidelines (if not already PCT
  accredited for paperlight)
• evidence of protocols
• MIQUEST query audits (patient data anonymised)
  these will be available for practices to download
  once verified by pilot sites

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Good Practice Guidelines Appendix 5

• The practice computer system is fit for purpose
• The computer system security measures and audit
  functions are enabled.
• The practice will not seek to disable the
  security and audit functions.
• All the GPs in the practice are aware of and
  undertake to have regard to the Good Practices
  Guidelines for General Practice Electronic
  Patient Records v3.1.

• The practice has a disaster recovery plan
  verified by their system supplier and PCO
• The practices has in place a security policy that
  complies with current good practice

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Stage 1 Evidence

• Evidence of adherence to the Good Practice
  Guidelines for paper-light consulting, as agreed
  with the PCT
• Processes for updating addresses
  opportunistically

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Stage 1 Protocols

• A protocol for assisting locums with data entry
• Summarising protocols for promptly updating
  records from patient-related correspondence and
  messages
• Disaster recovery protocols

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Stage 1 Training logs

• A log of in-house training events
• including induction of new staff, locums and
  relief staff
• a signing-off process
• A training log for each member of the team,
  linked to training needs assessments

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Stage 1 IG self-assessment

• Evidence of the completion of the Information
  Governance self assessment

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Stage 2 e-audits analysis

• Submitted by practices for PCT assessor analysis
• Assessors will identify areas above or below
  expected levels of data entry
• These areas will be reviewed during assessor
  visits

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Data quality standards - 1

• Prevalence of specified significant, common
  diagnoses, relevant to the practice demographics
• Prescriptions indicative of a major chronic
  diagnosis (for example, insulin) linked to an
  appropriate diagnostic code in the summary record
  
• Problems/diagnoses classified as significant or
  important so that an accurate and complete
  summary can be created

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Data quality standards - 2

• The rate of recording of drug and other important
  allergies and adverse reactions
• The utilisation of Family History codes
• The analyses of obviously inaccurate
  gender-specific diagnoses
• The removal of any previously-used
  locally-derived codes

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Stage 3 assessment visits

• PCT assessors will visit to
• do qualitative checks of a cross-section of notes
  from every clinician who consults on a regular
  basis
• explore areas identified from the evidence
  submitted

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Accreditation

• Lasts for 3 years
• A shorter period may be applied in certain
  circumstances e.g. forthcoming retirement of a
  sole principal
• Practices that fail can reapply for
  accreditation, or appeal against their failure

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The NHS Care Records Service (NHS CRS)
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NHS CRS

• Will provide electronic health care records for
  every patient in England.
• The core Summary Record will be coded using
  SNOMED CT - the Systematised Nomenclature of
  Medicine.
• Greater depth and coverage of healthcare than
  Read Codes
• Designed to share and exchange healthcare and
  clinical knowledge worldwide.

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Summary Record

• The coded summary will contain
• significant and recent diagnoses and problems,
  with date of onset
• all repeat prescriptions currently in the GP
  record and issued in the past 18 months
• acute prescriptions issued within 6 months with
  date of issue
• suspected adverse and allergic reactions to
  medication.

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NHS CRS stage 1

• Initially, a summary of a limited amount
  information will be extracted from GP records
• Repeats 18/12
• Acutes 6/12
• Allergies and adverse reactions
• Extracted as/converted into text for transmission
  to the Spine
• Patients and GPs can add or subtract items for
  inclusion

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What the project will be testing

• Key concepts
• the provision and upload of the information
  extracted from GPs records
• the clinical benefit of the information extracted
  from GPs records for unscheduled care
  environments
• the use of the protected, web-based HealthSpace
  for patients to access and validate their
  records
• the deployment processes and
• patient consent to information sharing.

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Early Adopters project

• Implementation of the GP contribution to the NHS
  CRS beginning early 2007
• Project designed to allow the NHS CRS
  implementation to gain a mass of critical support
  through evidence and experiences
• There will be a detailed academic evaluation by
  Birmingham University
• The project is designed to enabled the EA
  project, once validated, to develop to full
  roll-out.

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EA requirements

• Sufficient numbers and proportion of
• practices using one GP system (approx 60 per
  PCT) and Choose and Book and/or the Electronic
  Prescription Service (60 of practices)
• data quality (key data quality initiatives in
  place eg PRIMIS initiatives and/or preparation
  for the IMT DES)
• patient population (maximum, 500,000) and
  relatively geographically stable
• interest in the project

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Users of the GP summaries

• Unscheduled care available within the boundaries
  of the PCT
• One OOH service
• One WiC (Walk-in Centre)
• One AE and one secondary care setting
  (sufficient volume of patients who access the
  Emergency Department from the chosen PCT)
• NHS Direct

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Early adopter sites

• gt50 applications
• Shortlist of 6, currently being assessed
• Practices will receive special support

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The process for data accreditation, and the
progress with linking practices to the Personal
Spine Information Services (PSIS)

• Kathie Applebee
• Advisor to the GP National Clinical Leads for
  General Practice in CfH