Camden Integrated Digital Record (CIDR) Nigel introduction

CIDR Camden Integrated Digital Record (CIDR) Camden CCG has developed an online record that links health and social care data together, working in partnership with health and social care providers in Camden. This is called the Camden Integrated Digital Record (CIDR) system. A joined up digital record allows health and social care professionals to view vital information about you at the right time, and place, to provide you with the best possible care.   Nigel Speaks

What is an integrated digital record? The CIDR system currently includes health and social care data from these different sources: Camden GPs University College London Hospitals (UCLH) Royal Free Hospital NHS Foundation Trust (RFH) Central and North West London NHS Foundation Trust (CNWL) Camden and Islington Foundation Trust (C&I) Coordinate My Care (CMC) (part of the Royal Marsden NHS Foundation Trust) London Borough of Camden (LBC)   Nigel Speaks

Benefits What are the benefits of having an integrated digital record?   What are the benefits of having an integrated digital record? There are a number of benefits to linking up health and social care information into an integrated digital record. These include: Health and social care professionals being able to access the information required to provide optimal care for you. Potential safety benefits - as health and social care professionals will be more aware of important information such as what prescription medications you are taking etc. You will not have to repeat information about yourself to multiple different professionals - improving your care experience. Nigel Speaks

CIDR Case Study   Ehsan speaks

University College London Hospital (UCLH) CIDR Ethel’s test results View Ethel’s Camden GP University College London Hospital (UCLH) Ehsan speaks Ethel is in her early 80s and lives alone in Camden. Aside from being on warfarin she is in very good health, receiving some home care. Every year Ethel has her iron levels checked to ensure she is not anaemic. Normally it takes a week to get these results, but 3 days after the test Ethel goes to the GP for a check up on a cough she has had for 3 weeks. Her cough is nothing to worry about, but whilst there, with her permission, her GP is able to check her blood test results from the hospital using Camden Integrated Digital Record, and can see that Ethel is slightly anaemic so is able to prescribe her some iron tablets. Since her GP was able to check the results, Ethel didn’t have to wait until she received the letter from the hospital advising her to go make another appointment.

Royal Free Hospital A&E CIDR Warfarin and bad reaction to morphine View Medications, allergies and adverse reactions to medications from Ethel’s GP Record Ehsan speaks The following winter on her way home after her bridge club on a Friday evening, Ethel slips on a patch of ice and breaks her hip. Ethel is taken to the Royal Free Hospital, but due to the pain is unable to recall what medication she was on. In A&E the consultant is able to find out what dosage of warfarin Ethel is on using CIDR. Whilst checking Ethel’s CIDR record, the consultant can also see that Ethel has a bad reaction to morphine so knows to give Ethel something else to ease the pain. Normally they would not be able to find this information out until the GP surgery was open again on Monday morning. Royal Free Hospital A&E

Hospital Discharge Team CIDR Contact details for Ethel’s care team View Hospital Discharge Team Adult Social Care Ehsan speaks A week later Ethel is discharged from hospital. When she is being discharged, the discharge team using Camden Integrated Digital Record are able to see that Ethel is known to adult social care and are able to get in touch with her care team to ensure that the correct care is ready for Ethel for when she gets home. Royal Free Hospital Ethel’s Home

Ethel receives the care she needs to be safe at home View Ethel’s Camden GP Adult Social Care Occupational Therapist details Ethel receives the care she needs to be safe at home Nick speaks Another couple of years pass by and at a routine GP appointment, Ethel tells her GP that she is having some difficulties getting around at home. With her permission Ethel’s GP checks her Camden Integrated Digital Record and can see that Ethel has not been assessed at home recently. Her GP then contacts Adult Social Care to get an Occupational Therapist to visit Ethel at home. Following the home assessment, hand rails are installed to make getting about much easier. Also using Camden Integrated Digital Record her OT is able to check that Ethel is receiving all the community care she needs, and refers Ethel to the community podiatrist. View Ethel’s Occupational Therapist Community Care Ethel's’ community care information

Confidentiality and Security The CIDR system is designed to provide a high level of both confidentiality and security to the information that it holds. This includes the transfer, viewing and storage of all information in a secure environment. Access to the system and records within this are only provided to approved and authorised users which are validated by their respective organisations. Access is based on their role and responsibility within their respective organisation. Access is limited to only users who have an approved N3 connection. Access and use of the CIDR system is auditable in regards to access and usage of the system. The internal audit functions have been developed line with the NHS Care Record Guarantee Nick speaks

Confidentiality and Security Only authorised health and social care professionals are permitted to use the CIDR system. There is a robust process for professionals to be authorised by their organisation before their access is approved.   Staff with permission to use CIDR can only view your record once you have given consent for the approved organisation to do so. When a care professional views your record they will only be able to see information available to support delivering care to you at that time. All access is strictly monitored to ensure it is appropriate and legitimate. In emergency cases, where time is limited and pre-defined justifications are met, a care professional may view a record without explicit consent from the individual (e.g. there is clinical urgency and the individual is unconscious). Nick speaks

Can I choose not to have an integrated record? Yes you can. The CIDR system is designed to support your individual wishes in relation to both the creation of a record and the level of information available. You can opt out entirely or you can reduce specific information that can be viewed in the system. If you want to opt out, at any time you can discuss this with you GP practice. Alternatively, you can speak to your local NHS Trust (e.g. UCLH, RFH, CNWL and C&I) or the Camden Council, to stop specific information from being included. Nick speaks

Questions ?

Communications Posters and leaflets in practice, pharmacies, libraries Slide show and a version of the poster for your practice TV screen Communications pack for all practices including FAQ’s CCG website contains information and FAQs for the public. Patient survey underway Patient leaflet (currently being tested with patients) Nigel speaks

Resident feedback Commissioned community researchers to survey 270 residents across Camden Asked a series of questions to gather awareness of CIDR, views and opinions on consent and the benefits to integrating records. Tested the patient leaflet (to be sent to all Camden residents registered with a GP) and have incorporated feedback In six months will re-survey Camden residents to gauge feedback from public awareness campaign Following slides snapshot of feedback Nigel speaks

Base: All respondents (263) Nigel Spaeks Base: All respondents (263)

Nigel Speaks

Nigel Speaks

Ethel receives the care she needs to be safe at home View Ethel’s Camden GP Adult Social Care Occupational Therapist details Ethel receives the care she needs to be safe at home Ehsan speaks Another couple of years pass by and at a routine GP appointment, Ethel tells her GP that she is having some difficulties getting around at home. With her permission Ethel’s GP checks her Camden Integrated Digital Record and can see that Ethel has not been assessed at home recently. Her GP then contacts Adult Social Care to get an Occupational Therapist to visit Ethel at home. Following the home assessment, hand rails are installed to make getting about much easier. Also using Camden Integrated Digital Record her OT is able to check that Ethel is receiving all the community care she needs, and refers Ethel to the community podiatrist. View Ethel’s Occupational Therapist Community Care Ethel's’ community care information

Where can I go for further information? There is a CIDR website you can visit for more information: cidrportal.camdenccg.nhs.uk Camden CCG will publish information about any changes and developments to the CIDR system on the website. If you can’t find the information you need on the CIDR website, you can use the ‘Feedback’ form on the website to contact the CIDR team at Camden CCG. Or, you can email the team directly: cidr.project@nhs.net   Nigel Speaks

Questions ? Nick Speak