Nhs shared care records progress, projects and privacy

Former director of both digital transformation at NHS Digital and digital technology at NHS England, Beverley Bryant, said she tried to drive the uptake of sharing care records when she was at the NHS between 2013 and 2017, by getting A&E consultants access to the GP Summary Care Record (SCR).

But this is just the tip of the iceberg. The idea of a shared care record is that all health practitioners; consultants, GPs, emergency services, social care, nurses and mental health professionals can all access patient information, in real-time.

So why has it taken so long to start working on this? According to Bryant, who is currently chief operating officer (COO) at System C and Graphnet Care Alliance, which works on shared care records, many of the issues stemmed from the early 2000s, when a decision was made to lessen the influence of strategic health authorities and then remove them altogether.

“This led to a sense of competition between health care providers, so it was difficult to get anyone to agree to anything,” Bryant told Computer Weekly. And this was crucial, because unlike many other projects the NHS has initiated, the current idea around shared care records doesn’t involve taking directions from the top-down. Instead, it has been cultivated at a local and then regional level. This means hospitals, GP surgeries and other health and care organisations have to work together. The bids are coming

Mark Wright is head of IT at Manchester Clinical Commissioning Groups (CCGs), which is formed by the region’s CCGs joining up together and is one of the organisations invited to bid. His team has been working on shared care records for the best part of the last four years.

“This helps to paint the picture of the patient – and this is what we’re trying to do so that everyone that interacts with the patient has an understanding of them, can make them comfortable and ensure they get the best quality of life and outcome,” he said.

if a patient who frequently falls but does not find it comfortable to recover in hospital and instead prefers if someone from the family can help them at home, a health professional can be notified of this. The information could also alert a doctor that while a patient’s blood pressure may seem abnormal – it is normal for them for whatever reason.

“The bid requires a certain population size, so none of [the Yorkshire and Humber collective] would independently hit that population size, which is a good thing because people are coming together as a larger group,” said Cindy Fedell, CIO of Bradford Teaching Hospitals NHS Foundation Trust.

“It’s almost like a proof of concept that can then be grown across counties; they’re looking for places where they’re using open standards and can link up systems, and this is why they’re asking for a bigger population,” she said. Replicating LHCRE

“Many areas now have patient GP summary care records that hospitals can view online. The medical interoperability gateway (MIG) and developments in the main GP programmes from EMIS and TPP have enabled some areas to move to a more integrated view,” he said. Care.data 2.0?

“We must not hide our intent behind 15 layers of conditions that the public never reads; lets be straightforward and honest, and that’s how you build trust because the people are really confident that you’re not going to do something daft with the data and give it to a commercial company that the patient doesn’t want it to go to,” she said.

However, that is not to say that the data couldn’t or shouldn’t be used to help the NHS in other ways aside from direct care. “The next stage is an opportunity to move onto population health management and make use of the big rich database of patient records that shared care records gives us,” said Bryant. Stumbling blocks

There are stumbling blocks to this – but Bryant is confident that if dynamic consent models could be in place to ask patients whether they’d be happy to share their data for population health management, then there would be no reason why companies like Graphnet wouldn’t attempt to do this.

“LHCRE is helping because we’ll have regional shared care record platforms and then have a national locator service that allows you to see whether or not there is a record held of that person in another local database across the country,” she said, adding that about a decade ago, the NHS did some research which found that 90 percent of care is delivered in about 15 regions – and this means individuals can be cared for on a regional level.

Although no one can be completely sure that a national programme isn’t going to be the ultimate aim of the programme, or that new leadership within the NHS may decide to go this way in the years to come. “You never know, they might decide they want to do this,” said Bryant.

“If we’re going to do shared care records over a three to five million population, then there will need to be integration with different software and systems, so we’re busy working with competitors to make sure we’ve build in integration around boundaries,” said Bryant.

“The fact that NHS want to ‘co-develop’ with us, suggests that they realise they can’t just issue something and hope it will work,” said. “This will mean defining exactly what certain data points mean, so a time stamp in one organisation may be interpreted differently in another, but you have to work together to get the definition.”