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Electronic Health Records in the United Kingdom of Great Britain


Electronic Health Records in the United Kingdom of Great Britain & Northern Ireland Lorraine Nicholson MIHM, MRSH, FHRIM, President of IFHRO, Chief Executive IHRIM, – PowerPoint PPT presentation

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Title: Electronic Health Records in the United Kingdom of Great Britain

Electronic Health Records in the United Kingdom
of Great Britain Northern Ireland
  • Lorraine Nicholson MIHM, MRSH, FHRIM,
  • President of IFHRO,
  • Chief Executive IHRIM,
  • Independent Health Records Consultant

The United Kingdom of Great Britain Northern
  • The UK is made up of the two countries of England
    and Scotland, the principality of Wales and the
    province of Northern Ireland.
  • Total Population is 59.6 million people 
  •          - England 49,805,700 (83.7 of total)
  •          - Scotland 5,057,400 (8.5 of total)
  •          - Wales 2,938,000 (4.9 of total)
  •          - Northern Ireland 1,702,600 (2.9 of
  • Each country has a National Health Service (NHS)
    and in Northern Ireland there is integrated
    health and social care.
  • Each of the four countries has its own approach
    to the development and implementation of
    Electronic Health Records.

National EHRs in England (1)
  • NHS Care Records Service (NHS CRS), - key
    component of the National Programme for
    Information Technology (NPfIT), a 6.2 billion
    programme, which supports the delivery of the NHS
  • "the world's biggest civil information
    technology programme".
  • An individual electronic NHS Care Record every
    NHS patient in England by 2010 (2 years behind
  • Parliamentary Inquiry in 2007 - estimates of the
    total cost of NpfIT ranged from 6.2 billion to
    20 billion at the time of the inquiry.

National EHRs in England (2)
  • NHS Number is fundamental to the NPfIT NHS CRS
  • A national unique patient identifier (10 digit
    number) to enable sharing of patient information
    across the whole of the NHS in England safely,
    efficiently and accurately
  • The Personal Demographics Service is the central,
    single source for patient demographic information
    in England
  • The Personal Spine Information Service (PSIS) is
    the central database containing clinical records
    for each NHS patient.

National EHRs in England (3)
  • NHS Care Records Service will provide all 50
    million NHS patients with an individual
    electronic NHS Care Record
  • For the first time in the 60 year history of the
    NHS, information about patients will be mobile,
    as patients ar
  • will connect more than 30,000 GPs and 270 acute,
    community and mental health NHS trusts in a
    single, secure national system
  • two elements to the NHS CRS Detailed Records
    (held locally) and the Summary Care Record (held

National EHRs in England (4)
  • The NHS CRS will enable each person's detailed
    records to be securely shared between different
    parts of the local NHS e.g. GP surgery and
  • Patients will also be able to have a summary of
    their important health information, known as
    their Summary Care Record, available to
    authorised NHS staff treating them anywhere in
    the NHS in England.
  • Patients will also be able to access their
    Summary Care Record using the secure website

National EHRs in Wales (1)
  • The NHS in Wales is large and complex
  • Over 10 million face-to-face healthcare events
    per annum
  • Care delivered by a wide range of national,
    local, statutory, contractor and voluntary
  • High levels of deprivation, an increasingly
    elderly population and poor lifestyle
  • Has an annual budget of approximately 3.1
  • Wales needs a modern healthcare system with
    services integrated around the patient.

National EHRs in Wales (2)
  • Informing Healthcare (IHC) is a Welsh Assembly
    Government programme set up to improve health
    services in Wales by introducing new ways of
    accessing, using and storing information
  • IHC is working with NHS medical staff and
    consulting with the public to develop a national
    electronic health record the Individual Health
    Record (IHR)
  • Secure web page - My Health Online to view
    medical history, order prescriptions, book

National EHRs in Wales (3)
  • NHS in Wales cannot achieve a single universal
    care record immediately - therefore adopted a
    flexible incremental strategy

National EHRs in Wales (4)
  • Wales shares demographic services with England
  • NHS number is the unique identifier to provide a
    unique patient identifier for the Individual
    Health Record
  • Phased migration of all demographic systems to
    replacement systems provided by England's new
    Personal Spine Information Service (PSIS), which
    is part of the NHS Care Records Service (NHS CRS)
  • Negotiating with the NPfIT in England to use
    selected services including allocation of NHS

National EHRs in Scotland (1)
  • Modernisation strategy Delivering for Health
    focuses on the EHR as a core feature in
    delivering pro-active care to the population of
  • Health Information System built around the EHR
    will facilitate a shift from the current care
    model to anticipatory, preventative and
    continuous care.

National EHRs in Scotland (2)
  • The Community Health Index (CHI) is a population
    register used in Scotland for health care
  • The CHI number uniquely identifies a person on
    the index - Scottish equivalent of the NHS number
    in England and Wales
  • The CHI number is the unique patient identifier
    throughout the NHS in Scotland

National EHRs in Scotland (3)
  • Scotland and Northern Ireland have recently
    issued a joint tender to purchase a patient
    management system, with rich clinical
    functionality, worth between 30-120m over four
  • Possible pilot sites - NHS Ayrshire and Arran,
    NHS Borders, NHS Greater Glasgow and Clyde, NHS
    Grampian and NHS Lanarkshire (all Scottish health
  • After piloting system will be made available to
    all health service organisations in Scotland and
    health and social services organisations in
    Northern Ireland

National EHRs in Northern Ireland
  • Joint tender with Scotland
  • Population of 1.8 million people
  • Integrated Health and Social Services
  • Unique, very manageable and compact centralised
  • Single Health and Care Number (equivalent of the
    NHS Number) to provide a unique identifier for
    national Electronic Health Records

In Summary
  • All four home countries are working actively
    towards national EHRs
  • Each country has its own approach to development
    and implementation
  • All are using a unique identifier for each
  • The next four years will see considerable changes
    nationwide in the UK

Contact Details
  • Lorraine Nicholson
  • l.nicholson_at_zen.co.uk
  • Tel Fax 01706 355957
  • Mobile 07788 405910
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