Statement: The ending of the Core Information Standards Service (CISS) with NHS England

The Professional Record Standards Body (PRSB) and NHS England (NHSE) recognise and value the significant contributions of clinicians, professionals, people, and key health and care stakeholders from across the country in supporting the development of care record standards over the past four years. This expertise and commitment have been instrumental in advancing the use of these standards to improve care, with the CISS contract, established at the start of 2022, serving as a key enabler of this progress.

NHS England is establishing a new operating model for developing and maintaining standards that will build on these strong foundations. As this transition takes place, the contract that NHS England holds with PRSB will be finishing at the end of its term in December 2025.

PRSB will continue to develop professional record standards and support widespread implementation, working with UK health and care organisations, system suppliers, clinical professionals, care professionals, patients, and the public. We will continue to offer standards conformance assessments to IT suppliers through our Standards Partnership Scheme.

Our work will support the development of high-quality standardised data and interoperability for the benefit of direct care, as well as improving data required for research, audit, clinical trials and artificial intelligence.

We will continue to collaborate with NHSE, Department of Health and Social Care and other national and international organisations that develop health and care information specifications. Our community remains committed to contributing constructively to major transformative developments in health and care data. PRSB is part of the Building Information Standards framework that NHS England owns, through which NHS England and other organisations in the Health domain can publish initiatives aligned with NHS England’s national data strategy.

NHS England has set out a ten-year vision that places a strong focus on delivering a Single Patient Record. Achieving this vision will depend on the continued development and adoption of robust, nationally agreed standards underpinned by clinical, social care, patient, and service user input. These standards will be central to enabling digital transformation across health and care, and clinical and professional engagement will be more vital than ever. NHS England is already working to develop this new model and is committed to ensuring it reflects the needs and insights of the clinical and professional communities that use and shape these standards.

Over the coming months, NHS England will provide more information on this work and how people may get involved and help shape the future of standards in health and care. We want to thank our members and partners for their invaluable contributions to this work so far. Both NHS England and PRSB look forward to collaborating with you in the future.

If you have any questions for NHS England or PRSB about this information, please email us at info@theprsb.org, and we will respond.

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CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”