1. Emergency Care Summary SCIMP Conference - Dunblane 7 th November 2007

2. Agenda ECS Definition Progress to Date NHS24 Security and Audit Gold Standards Framework Future Developments

3. What is ECS? Emergency Care Summary Patient information is extracted from GP Practice computer systems Sent to ECS store twice daily Explicit Consent to view ECS record The information is ‘Read only’ and available to Emergency Care clinicians

4. Agreed Dataset Patient demographics (address, telephone, CHI number) Allergies and Adverse Reactions to medications Medication history - Repeat prescriptions and - Acute prescriptions in past 30 days Consent Flag – Patients can opt out

5. Progress to Date 95% of GP Practices connected –GPASS, EMIS, InPS live –iSoft and Ascribe due shortly NHS24 linked in directly OOH Rollout Complete Some A+E Departments Cross Border Access switched on

6. Progress to Date Over 5 Million Patient Records extracted 1025 patients have ‘opted out’ 340,000 accesses to date –c.220,000 NHS24 –c.35,000 A+E Expected increase in use over Christmas period

7. NHS24 Call Process

8. NHS24 – Call handler

10. NHS24 – Nurse Advisor

11. ECS Security and Audit Access and security controls with passwords and log on for all clinicians Patients must give permission for the clinician to view their records Practices can check who has accessed their patients’ records Audit controls run regularly: –Practice Reporting –Health Board Audit –Cross Border Audit –National Audit

13. ECS Access Report

16. Palliative Care Summary MacMillan Nurses led initiative Palliative Care Forms –Based on Gold Standards Framework Scotland (GSFS) –Paper process already in place in many GP Practices –IT Development to assist with key patient group

17. GSFS Solution Extension to ECS dataset to include more detailed information to send to OOH for Palliative Care patients (known as PCS) Move from paper to electronic information Reduction in faxes from GP Practices to OOH Centres Consent Model ECS – Implied to send, Explicit to view PCS – Explicit to send, Implied to view

18. Palliative Care OOH Summary

19. Palliative Care Dataset Captured within GP system – some already pre-populated: –Palliative care register flag (Read code) consent –Carer details and key professionals –Diagnosis and current treatment –Preferred place of care –Current care arrangements –Patients and Carers Awareness of Conditions –Advice for OOH care –Review date

20. Current Progress of GSFS 4 out of 5 GP Suppliers have completed SEF testing ECS – central ECS development complete NHS24 / Adastra / Taycare – development ongoing Communication materials to follow Rollout to start early 2008

21. Future Developments Practice Pack ECS Information Integration with National A+E System Scottish Ambulance Service Preparation of Outline Business Case –Patient Access –Extension of Users –Extension of Data Set NO DEVELOPMENT WITHOUT CONSULTATION

22. RCGP and SCR in England RCGP published UK wide recommendations on the GP Summary Arising from Ministerial Taskforce Automated extract the same as ECS in Scotland Configurable use of significant medical history in England Patient Preferences if requested HealthSpace in development

23. Summary Good progress with use of ECS Security built in with fully integrated solutions Audit at all levels including Cross Border Palliative Care Summary development well underway Consultation and communications in planning

24. Questions? Dr Libby Morris (libby.morris@nhs.net) Jonathan Cameron (jcameron2@nhs.net)