Delivering Single Assessment within the NHS National Programme for IT

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Delivering Single Assessmentwithin theNHS
National Programme for IT

• Dr Paul WhatlingSenior Clinical Consultant

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Sept 1998
Jan 2001
June 2002
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The National Programme for IT

• To deliver a 21st century health service through
• the efficient use of information technology
• To improve the quality and convenience of care by
  ensuring that those who receive care have the
  right information, at the right time
• To implement projects vital to the NHS
  modernisation programme using IT to directly
  improve the patient experience and clinical care

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NHS National Programme for IT

• NHS Care Record Service
• Choose and Book
• N3 Broadband
• Electronic transfer of prescriptions
• PACS

NorthEast
NorthWestWestMids
East
London
South
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The NHS Care Record

• Will enable details of the key events of a
  persons healthcare history throughout their life
  to be
• collected, stored retrieved
• made available at all times
• across the whole country
• to those with authority to view

A better use of information and communication
technology within the NHS would improve
efficiency and cut costs Wanless Report April
2002
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Concepts behind NHS Care Record

• Support current and future generations of patient
  and care provider a life-long care record for
  every person in England
• Ensure that the right information is available to
  the right people at the right time 24 / 7 / 365
• Re-shape the healthcare system around the needs
  of the patient rationalising and harmonising
  NHS IT systems
• Implement consistent national standards for
  patient record information transfers and
  confidentiality / security principles
• Support national audit / data collection

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Improving Communication
The Care Record will make a dramatic improvement
in
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How it works Data capture

• It starts with a clinical event
• Details are put onto a local service
• Information turned into standardised Spine
  message
• Message is then transmitted to the NHS Data Spine
• And, stored with other records for that patient

Clinical Event
Information
Information
Back Pain
Chest infection
Broken leg
Back Pain
more
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How it works Retrieving data

• A request sent to the Spine
• Security checks are performed against protocols
• If OK, searches for patients messages
• Saved messages are retrieved and sent to
  authorised person making request
• Data displayed on-screen

Information Request sent by Staff
Security Checks Performed
Search
Chest Infection
Broken Leg
Back Pain
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Benefits of the Spine

• It will provide secure instant access to patient
  records, diagnostic images and results 24/7
  across the country
• Improve the quality of time spent with patients
• Reduce the amount of administration and paperwork
• Significantly increase the amount of information
  that can be easily accessed
• Deliver healthcare to patients across
  disciplines, organisations, boundaries and
  locations

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Single Assessment Process

• Summary record attached to the Spine record
• SAP acts as a gateway to multiple care pathways
• Computers will enable tracking and audit of
  progress along the care pathway
• The work to develop SAP solutions offers a
  powerful model for similar work in related areas
  (ISA, CPA) but also across all areas of care

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Timeframes

• Full implementation of SAP within NPfIT is rolled
  out from 2007-8
• Implementation of SAP is already an NSF
  requirement across the country
• Electronic tools rolled out under NPfIT from this
  year
• Interim solutions required
• Design and implementation quick
• Off the shelf packages
• Six assessment tools currently accredited by the
  DH
• Accenture - 3 solutions available
• CCA Output may be captured from any assessment
  tool

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Interim Solution Contents (London CCA)

• Basic information capture, sharing and reporting
• A forms base covering Basic information,
  contact/overview/specialist/comprehensive
  assessment, care plan and review. If staff are
  not able to complete everything concentrate on
  the assessment conclusions on needs and risks and
  the care plan the key items which are shared
  with the service user.
• Summary data concerning the forms that exist for
  a service user (for example, type of form, date
  completed)
• Support for attachments, textual fields, coded
  data. Allow user to choose which is appropriate,
  though only structured data can be reported or
  compiled into a Current Summary Record
• Data elements of different tools will not be
  supported only the conclusions on needs and
  risks and the care plan, which should be products
  from all tools. The solution is therefore tool
  independent
• Re-imbursement form for delayed discharge
  supported and sharing of this form between
  organisations
• Some limited operational reporting from Interim
  Solution. Further reporting for national reports
  from the Data Warehouse

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Issues

• Access to the data and the systems
• Connectivity
• Role based access controls
• Legitimate relationships

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Care Record Development Board

• Identify the values, principles and processes of
  care and ensure that these are taken into account
  in the implementation of systems for NHS and
  social care
• Ensure that ethical issues are adequately
  addressed and that agreed ethical principles are
  consistently applied

• Patient focused
• Improves patient outcomes
• Improves choice and control for patients
• Helps clinicians patients to make better
  decisions
• Reduces errors
• Practicable, usable, effective and safe

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Care Record Development Board
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SAP Action Team

• Chair - Glenys Jones
• Vision for the future
• Stakeholder network

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Single Assessment Process

• Whatever you can do or dream, begin it.
• Boldness has genius, power and magic in it.
• Begin it now.
• Goethe

www.npfit.nhs.uk/crdb