Sharing information to improve patient care in West Sussex Adrian Woolley Head of Strategic IT NHS Coastal West Sussex CCG NHS Crawley CCG NHS Horsham & Mid-Sussex CCG June 2014

Sharing information to improve communication & inform patient care Photo: sparkle glowplug

The 15 million people in England with long term conditions… their treatment and care absorbs 70% of acute and primary care budgets in England.

Fragmented care: the healthcare system…not being considered in a whole system approach with social care… Lack of informational continuity: care records which can’t be accessed between settings... Reactive services, not predictive services: failure to identify vulnerable people who might then be given extra help to avoid hospital admission or deterioration / complications of their condition… The issue…failure to provide integrated care

LTCs Admission Avoidance Proactive care planning Joint working between health and social care End of Life care

Significant diagnosis DNACPR Social Services visit daily ECG Diabetes clinic In-patient discharge letter Specialist nurse record Care providers can have ‘silos’ of information held within their organisational boundaries Dementia nursing GP practice system Social Services Hospitals Community Nursing Mental Health Admission Avoidance DES Care Plan MH Crisis Plan Contingency Care Plan

Significant diagnosis DNACPR Social Services visit daily ECG Diabetes clinic In-patient discharge letter Specialist nurse record Care providers can have ‘silos’ of information held within their organisational boundaries Dementia nursing GP practice system Social Services Hospitals Community Nursing Mental Health Admission Avoidance DES Care Plan MH Crisis Plan Contingency Care Plan

A real time Read Only viewer for use in direct patient Care, with Information derived from both Health and Social Care ROCI

The classics – stakeholder engagement etc x n 2. Information Governance, legal opinion Data access. Paternalism Commercial self interest of system suppliers Finding care plans Waiting for Spine 2 Challenges for this type of project

A Virtual IDCR Live data (no data warehouse) Live data (no overnight updates) Consent to view at point of need

Real time messaging to multiple systems – ‘send pertinent information for unscheduled care’ GP Social Services NHS No, Name, DoB Community Nursing Mental Health Integration Engine and VIPER360 portal Hospital Consent record for audit RBAC

a patient summary problems diagnoses medication (current, past and issues) risk and warnings procedures investigations blood pressure measurements encounters, admissions and referrals patient demographics What data could be available? From GP (via MIG): current meds allergies adverse reactions From SCR: Main Address Current Address Placement Address Allocated Worker, Open/Closed Agency Providing Care Package Funded? Emergency Next of Kin details Does the Subject Have a Carer? Is the Subject a Carer? From Social Services: recent admissions & discharges EDD From Acute Trusts : open referrals From Community Trust LC anticipatory care plans From care plan repository:

GP Admission Avoidance DES care plans Proactive Care EoLC Plans NHS mail – special template AmbulanceA&E (ROCI) OOH GPs Sussex wide care plan database Data readers Data sources One place to find care plans = reduced conveyance by ambulance.

Patient details Examinations Events Summary Investigations Problems Procedures Risks & warnings Live data from the GP clinical system

Recent tests Biochemistry ECG Haematology Imaging Microbiology Cytology Others Physiology Urinalysis Potentially useful in admission avoidance

PIA and Information Sharing Agreement signed by relevant parties Trust Interface Engine (messaging technology) installed and operational. Several practices signed up to supplying data (MIG). Pull of MIG data through system tested and working. Social Services record to include NHS numbers Next steps Turn on integration to Social Services data Turn on integration to Care Plan repository Clinical safety sign off Pilot go-live at A&E So where have we got to?

Discharge planning / Alerting Hospital in-reach Planned Care Potential other applications of the technology

Thank you Photo: garryknight