1. Emergency Care Data Set (ECDS)
General Show and Tell No.9, 25 July 2017
Peter Sherratt, ECDS implementation lead (NHS Digital)
Tom Hughes, ECDS lead clinician (Royal College of Emergency Medicine)
Iain Wallen, Director of Information and Analytics (NHS Improvement)
Martin Orton, Director of Delivery & Development (PRSB)
Darren Wooldridge, Project Manager, Emergency Care Discharge Summary Standard Project (PRSB)
Version: v1.0
The ECDS project is a collaborative project between the Department of Health, the Royal College of Emergency Medicine, NHS England, NHS Digital, NHS Improvement, NHS Providers and Public Health England. This document has been produced on behalf
of the ECDS Project Board in collaboration with the organisations listed above.

2. Next general show and tell is 30th August @ 2pm
Before we start
We’ve enabled “PC audio” so you can listen on your PC speakers as well as phone
We are recording the webinar for the benefit of others
The previous webinar links are available through the QA document
Most people will be muted – please send your comments and questions via the WebEx chat function to Rozanne Addams
We’ll be running a quick poll towards the end
We’ll share the following after the meeting:
The slides
The links to the recordings
The transcript of the QA session along with written answers
Supporting documents are available on the ECDS web page (
Next general show and tell is 30th 2pm
Send your comments to :

3. On this afternoon’s call:
Emergency care discharge summary presentation by the PRSB
More on streaming and how to implement it with ECDS
ECDS clinical champions and the Early Adoption scheme
Crib sheets and other ECDS support materials
Quick progress update:
SUS+ progress is good
First early adopters expected to submit during August
The ECDS web page has been updated:
Technical user guidance to v1.4

4. Vision and mission OUR VISION OUR MISSION
To optimise the health and wellbeing of UK citizens through the wide spread adoption of high quality, standardised records.
OUR MISSION
To become the authoritative voice for the development and widespread use of standards that ensure all digital health and social care records are of the highest quality.
A record is the information that health and care professionals, and increasingly patients themselves, capture for their ongoing care.
Standardising the information will make sure the records are of a consistently high quality and the same information is captured every time.
What is a standardised record?
High quality records are about good patient care – we all need to be interested in that.

5. About us We are unique PRSB Member organisations
We work with member organisations who represent more than 750,000 frontline clinicians and care professionals as well as patients and the public.
PRSB Member organisations
Academy of Medical Royal Colleges
Royal College of Nursing
Royal College of General Practitioners 
Royal College of Paediatrics and Child Health 
Royal College of Pathologists 
Royal College of Physicians 
Royal College of Psychiatrists 
Royal College of Surgeons of England 
Royal College of Obstetricians & Gynaecologists
Royal College of Emergency Medicine
Royal College of Anaesthetists
Royal College of Midwives
Royal College of Radiologists
Royal College of Occupational Therapists
National Voices
British Computer Society 
British Psychological Society
Royal Pharmaceutical Society
Association of Directors of Adult Social Services
Association of Directors of Children’s Services
Care Provider Alliance
Allied Health Professions Federation
Public Health England
Resuscitation Council (UK)
Institute of Health Records and Information Management
INTEROPen
HL7
Tech UK

6. About us We build national consensus
We work across all of the professions, patient groups and the public to build support for standards. Our job is to bring all the right people together from across the UK - clinicians, social care workers, patients and the public.
We are a ‘not for profit’ community interest company
We are an independent voice owned by our members. Our members are the professional bodies who represent the health and care professions and patient/carer representative groups

7. What is a care record standard?
Each care record has a list of headings. The record standard headings define what you see when you are recording or reading information in a care record, particularly making sure that information is recorded in the right place. They are developed with extensive research so that they are easily understood and reflect what works best for patients and care professionals.
Example of a record standard heading

8. Developing a standard ✔ 1 2 8 7 3 6 ✔ ✔ 5 ✔ 4 ✔
In consultation the PRSB identify a priority area 1
PRSB puts together an expert group 2 8
Keeping standards up to date – maintenance and support 7
Pilot and implementation 3
Work collaboratively to develop a standard 6
Member organisations sign off and endorsement ✔
Literature review ✔ ✔
Workshops 5 ✔
Online surveys (UK wide)
PRSB independent assurance committee 4
NHS Digital creates technical messaging
Professional standards authoring ✔

9. Current record standards
Published record standards
Standards for the clinical structure
and content of patient records
Revised e-discharge summary
Emergency care discharge summary
Ambulance handover process
Mental health discharge summary
Crisis care (Healthy London)
In development
Care home information sharing
Child health events
Outpatient letters
Digital care and support plans

10. E-discharge summary standard
The revised e-discharge standard is designed to facilitate better care for patients after hospital discharge to GP.
The standard, which was published in May, has developed information models for 11 key headings in discharge summaries.
It also includes information on medicines and revised information models for diagnoses, procedures, allergies and reactions.

11. What will it mean for patients and professionals?
The model and implementation guidance will help professionals safely transfer patient information.
NHS Digital has developed technical standards so that the e-discharge summary can be implemented across the UK. It means GP systems can pull the information straight through from hospitals.
The standard NHS contract mandates providers to use PRSB headings to structure the discharge summary - from October 2018 they will be need to send structured and coded discharge summaries to GPs.
You can find out more on our website

12. Emergency care discharge summary standard
The standard, published in June, is practical and easy to implement as it was led and designed by the professionals who will be using it.
The project was commissioned by NHS Digital and managed by the PRSB, supported by the Royal College of Physicians Health Informatics Unit.
Clinical leads included the Royal College of Emergency Medicine and the Royal College of General Practitioners.
The standard builds on the emergency care data set (ECDS) project, which has created a new data set for urgent and emergency care services.

13. What will it mean for patients and professionals?
Details on emergency visits will be available more quickly to GPs to improve on-going patient care.
Key information will directly enter the GP record, reducing the risk of transcription errors and improving the safety of care.  
The EC discharge summary project supports The Keogh Urgent and Emergency Care review, by helping to enable improved discharge from hospital EC departments.
The PRSB is able to offer support and guidance on how to implement the standard.
You can find out more on our website

14. Standards into practice
Standards are not useful unless they are put into practice. We need to raise awareness and drive culture change to adopt use of standards as the norm
Standards are a key enabler that supports the system’s vision for a high quality, safe and efficient health and care system making best use of digital technology to improve services
Buy-in from front line staff is critical for success – technology is the means not the end
Shifting the culture of health and care will take time, persistence and consistent messages and actions
We need to recognise there is wide variation in maturity and technical sophistication in local care systems
We will work closely with the most advanced to prove what is possible whilst providing practical help and direction to those further back in their plans
Our offer includes tested tools, training and support to put standards into practice

15.
@ProfRecordsSB

16. Tom Hughes ECDS Clinical Lead
ECDS and Streaming
Tom Hughes
ECDS Clinical Lead

17. Streaming: initial announcement
£100m capital fund in 2017 budget
(Luton) model specifications:
Band 7 nurse performs streaming
x 365
2xGP, 1x (Band 5) nurse, 1x (Band 2) HCN
No diagnostics
This was the model announced at the time of the budget.
Now no longer rigid application of Luton model

18. Subsequent Clarification
Flexible about model
‘Urgent Treatment Centre’
Streaming must be measured
Need to understand patient flow (CCG)
Clinical Governance (clinicians)
UTC activity = type 3 ED
[ECDS not compulsory in type 3 until 2018]
Row back on ‘single model’
Terminology of UTC replacing Urgent Care Centre
Consensus about need to record streaming
Directive from NHSE/ NHSI that UTC activity must be recorded as type 3

19. Minimum ECDS Streamed data set
Patient Name
Patient Identification - NHS number / demographics
Arrival Date / Time (automatically entered)
Chief Complaint
Acuity
Discharge Status – service to which streamed
Departure Date / Time (automatically entered)
ECDS does not define streaming process
ECDS just defines the data collected, not how streaming occurs.

20. Streaming options Streamed to primary care service / GP
Streamed to Urgent Care Centre
Streamed to Emergency Department
Streamed to Ambulatory Emergency Care service
Streamed to falls service
Streamed to frailty service
Streamed to mental health service
Streamed to pharmacy service
Streamed to dental service
Streamed to ophthalmology service
Streamed to Emergency Department only used when patient is streamed from UTC / type 2 (Specialist ED) / type 3 (MIU) / type 4 (Walk in Centre)

21. Capturing streaming in ECDS
Key points
Streaming = 1x complete ECDS episode
Streaming does not attract tariff
4 Hr standard start from first streaming
Reported through standard ECDS structure

22. Scenario A Alice falls breaking her femur and is taken to the ED.
Straightforward type 1 ED attendance
attracts tariff
four-hour standard applies.
Type 1 ED

23. Scenario B
Bob sustains a 5 cm laceration to his arm. Attends ED, streamed to co-located GP.
Two ECDS patient episodes
one streaming, attracts no tariff
one type 3, which attracts tariff.
Four-hour standard applies from the time of streaming
Stream to GP
Type 3 ED

24. Scenario C
Carol sustains a 5 cm laceration to her arm. Attends ED, streamed to adjacent MIU/ UCC.
Two ECDS patient episodes
one streaming, attracts no tariff
one type 3, which attracts tariff.
Four-hour standard applies from the time of streaming
Stream to UCC
Type 3 ED

25. Scenario D
Dan - 62-year-old man, presents to ED with a toenail infection, streamed to co-located UTC.
On arrival at the UTC it turns out he has a fever and diabetes and is streamed back to the ED.
Three ECDS episodes
Two streaming – attract no tariff
One treatment – attracts tariff
four-hour standard applies from first streaming
Stream to UTC
Stream to ED
Type 1 ED

26. Tiers

27. Tiers – default = 1

28. Questions?

29. ECDS Champions and Early Adopters scheme
Presented by Peter Sherratt on behalf of NHS England

30. ECDS Clinical Champions have now been recruited and trained
The ECDS Early Adopters scheme
Over £¾million has been identified by NHS England CCIO Keith McNeil and CIO Will Smart to support early adoption
Funds will be allocated to the first ~40 Trusts to go live before 1 October
Primarily aimed at Type 1 ED’s
First of each Eye and Paediatric Type 2 to go live
Additional funds will be available to support early adopter case study sites – maximum of 6
ECDS Go-live will be verified by a clinical champion on-site presence and SUS+ data submission
Full details will be given during August
If you think you may be going live before 1 October and have not been in touch, please let us know via

31. ECDS Crib Sheets and Supporting Materials
Presented by Peter Sherratt and Tom Hughes

32. Reception Chief Complaint Acuity Diagnosis ECDS flyer

33. Next webinar is 30th August @ 2pm
Future webinars….
They’re totally open – invite anyone
Future topics will include:
Data quality dashboards / validation
More detail on the early adopters scheme
Benefits case studies and lessons learned from our early adopters
Let us know anything particular you’d like us to cover again or in more detail
Next webinar is 30th 2pm
Send your comments to :