NHS Care Record the Spine

1
NHS Care Record (the Spine)

• Briefing 9th December 2003

2
NHS Care Record Spine Components
Data
Personal Demographic Service
Personal Spine Information Service
Directory (Yellow Pages)
People/Population
Clinical Records
Messages
Processes/ Logic
Other Links
The Engine
Applications
Spine On-line
Statistics
Infrastructure/ Services
Data Quality
Security
DR
Information Governance
3
Benefits of the Spine
At Home
On-line Information Self Management On-line Advice
Self care Digital TV/Web Provides access to
personal health records
eBooking Spine Handles Messages
?
Primary Care
Primary Care
History Spine contains national level summary
eTP Transfer of Prescriptions
eTP Dispensing
Community care Use in the community
Secondary/ Tertiary care
Remote Orders Arrangement Of Transport
Unscheduled Care Available for Emergencies
4
NHS Care Record Spine Benefits

• Single Source of staffing data
• Single sign-on/one password
• Clinical and Information Governance
• Authentication/accreditation
• e.g. of Clinical staff
• Links to e-mail/staff records

• Shared Clinical Record
• Safer, more effective and efficient patient care
• Care across boundaries/within clinical networks
• Support patients choice ( where and when)
• Supporting multiple provider model
• Ensuring standards and equity

• Single Source of patient data
• - Reductions in misdirected mail
• Reduced administrative activity
• Confidence of patients
• Basis for national registers
• Updates when changes occur
• Updates on death

Personal Demographic Service
Directory (Yellow Pages)
People/Population
Clinical Records

• Communications Engine
• - Infrastructure for NPfIT
• Improved, more efficient communications
• Reduce faxes, post, vans
• Standards in communication,
• e.g. referral or discharge summary
• Monitoring and alerts

• Secondary Uses
• - Information by-product of process
• National data sets on-line E.g
• current activity sets
• NSF data sets
• prescribing from eTP
• Public health monitoring and alerts
• E.g pathology or prescribing data as a early
  warning system

The Engine
Spine On-line
Statistics

• National Applications
• - National coverage in certain areas E.g.
• Breast cervical screening
• Stop gap developments in line with local service
  provider plans
• Flexibility to introduce new national
  applications
• My Health Space for the public/patients

Data Quality
Security
DR
Information Governance

• Information Governance
• New standard necessary for core system
• Secure method of communication
• Support for
• consent,
• legitimate relationships and
• sealed envelopes

• Help Desk
• To NHS staff
• To public/patient

5
Benefits of the Spine

• The Spine
• Is the infrastructure of the national Integrated
  Care Record Service.
• Enables eBooking and the Electronic Transfer of
  Prescriptions
• Delivers a way to involve patients in their own
  health care sharing their records with
  clinicians.
• Supports the care of patients whose care network
  spans local communities/clusters.
• Offers ways to study health, diseases and
  treatments across the country in new and very
  significant ways whilst safeguarding
  confidentiality.
• Underpins the modernised NHS, making it a single
  organisation through shared information in ways
  that cannot be achieved through separate local
  systems. E.g. links with Diagnostic and Treatment
  Centres

6
NHS Care Record Spine Components
Data
Messages
Processes/ Logic
Other Links
Applications
Infrastructure/ Services
7
Spine eBooking, eTP, ICRS plus costed options
Data
Personal Demographic Service (PDS)
Personal Spine Information Service (PSIS)
Messages
Processes/ Logic
Other Links
Links to National Services
My Health Space
Applications
Infrastructure/ Services
8
Take-up Rates

• eTP 650m prescriptions per year
• eBooking 16-20 million bookings (plus
  additional services)
• ICRS Encounters, Referrals, Summaries,
  Assessments, Administrative, Demographics,
  security and on-line access
• Pathology existing flow

9
Summary and Service Levels

• Unique national system
• Large scale but not unprecedented
• Rapid response times, high availability
• New standards for Information Governance

10
Implementation

• Clinical standards (NCAB)
• Record keeping, common language/codes
• New ways of working e.g. alerts
• NHS capacity (Clusters)
• Training and education
• Infrastructure
• Legacy Systems (Clusters)
• Consent (NCAB/PAG)
• Opt in/ Opt Out