1 Delivering Single Assessment within the NHS National Programme for IT Dr Paul Whatling Senior Clinical Consultant

2 Sept 1998 Jan 2001 June 2002

3 The National Programme for IT To deliver a 21 st 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

4 NHS National Programme for IT  NHS Care Record Service  Choose and Book  N3 Broadband  Electronic transfer of prescriptions  PACS North East East South North West & West Mids London

5 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

6 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

7 The Care Record will make a dramatic improvement in … Improving Communication

8 ●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 Broken leg Chest infection Information Back Pain … more Back Pain How it works … Data capture Information

9 How it works … Retrieving data … ●A request sent to the ‘Spine’ ●Security checks are performed against protocols ●If OK, searches for patient’s messages ●Saved messages are retrieved and sent to authorised person making request ●Data displayed on-screen Information Request sent by Staff Security Checks Performed Broken Leg Chest Infection Back Pain Broken Leg Search Chest Infection Back Pain

10 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 Benefits of the ‘Spine’

14 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

15 Timeframes  Full implementation of SAP within NPfIT is rolled out from  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

16 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

17 Issues  Access to the data and the systems Connectivity Role based access controls Legitimate relationships

18 Care Record Development Board 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  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

19 National Programme Board (Chaired by John Bacon) Care Record Development Board Cyril Chantler Jo Williams Board Member Talib Yaseen Harry Cayton 12 Board Members Care Record Development Board Ethics Advisory Group Joan Higgins

20 SAP Action Team  Chair - Glenys Jones  Vision for the future  Stakeholder network

21 Single Assessment Process “Whatever you can do or dream, begin it. Boldness has genius, power and magic in it. Begin it now.” Goethe