1. Dr Libby Morris The Emergency Care Summary Dr Ian Kerr The Emergency Care Summary NMAHP Meeting 6 th March 2007 Dr Ian Kerr

3. Background The new GP contract meant changes to Out of Hours (OOH) arrangements A “useful summary” was needed for OOH services –A&E, Ambulance, NHS24

4. Emergency Care Summary Patient information is copied from Practice Computer systems Sent to SCI-store twice daily The information is ‘Read only’ and available for OOHs clinicians NHS 24 will be linked in June 2007

5. 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)

6. S E C S Security Access and security controls with passwords and logon for all clinicians Patients must give permission for the clinician to view their records. Practices can check who has accessed their patients’ records with web based Audit controls run regularly

7. System Overview OOH clinician ECS summary request & display ECS update 1. During consultation 2. Due to prescription 3. Other Patient contact Who saw who for practice? ECS System NHS 24 A&E Ambulance TBD… Practice Admin. Staff GP consultation PRACTICE

8. Warning to clinicians before viewing You must ask the patient for permission before viewing their clinical data. Your details will be recorded and monitored, and the patient's practice will be able to see that you have looked at this record. This record shows all prescriptions issued by the GP clinical system in the last year. It may not include handwritten prescriptions, or drugs prescribed by other prescribers in other clinics. Allergies will be indicated if known and recorded. The patient should be asked by the clinician if he/she is aware of any new or unrecorded allergies. It is good practice to check the accuracy of this data with the patient

9. Patients Search Results

10. Patient Record – Medical Details

11. Patient Record – Consent Withheld

12. ECS Access Report

13. Patients’ Views of ECS 8 focus groups were held in Scotland 6 members of the public 2 groups of people living with HIV and mental health problems

14. Key findings Patients generally supportive of ECS Main concerns related to security and who would access the ECS Patients wanted to be informed and have the chance to opt-out Most thought they should have the right to see their ECS Recognition of advantages of single patient record with concerns about confidentiality

16. New Developments A pilot study has been carried out in two A/E departments in Ayrshire. Initial evaluation shows that this was extremely successful, there were a large number of patients ECS records accessed, and clinical staff found the information useful, esp with patients who had taken an overdose of medication.

17. Publicity Campaign Letter to all GPs and Practice Managers Leaflet sent to every household in Scotland Helpline dedicated to enquiries 180 calls in first week Opt out, general enquiries, odd requests Very few requests to view records Very few opt outs

19. The Future of SECS ??? Integration with NHS24, A&E, Ambulance Service Clinician inter-Health Board patient data access Shared palliative care forms Lab results Extension of data set

23. Contact details Libby.morris@nhs.net