PRSB thanks Dr Philip Scott

We would like to say a big thank you to Dr Philip Scott, who is stepping down from our board. Philip worked with PRSB since inception, and contributed hugely to both our long and short-term goals. Philip will continue in his roles as chair of BCS Health & Care, Co-chair, Medinfo 2021 Scientific Programme Committee, deputy editor, BMJ Health & Care Informatics, board member, HL7 UK and chair of the EFMI Evaluation Working Group. 

Speaking about his departure, he said: “I’ve thoroughly enjoyed my time with PRSB, seeing it grow from an idea in Iain Carpenter’s (former chair) head, through its fledgling stage, to where it is now as a mature and respected organisation. I’m hopeful that the fresh approach to interoperability from NHSX and PRSB’s industry outreach will be catalysts to wider implementation of PRSB standards. BCS Health & Care remains a strong supporter of PRSB and will do what we can to promote clinically-led and technically-informed standards across the whole UK.” 

PRSB CEO, Lorraine Foley, said: Philip brought exceptional technical expertise to the PRSB, and has been a huge supporter of our work from the outset. He’s been a mainstay of the board and led the assurance committee to new heights of scrutiny and rigour. Although he’s leaving the organisation, we know we’ll be working together in future to champion the implementation of standards and information sharing for better care.” 

Health and care leaders share plans for standards and interoperability at round table 

Forty leaders from across health and social care met this month at an NHSX round table, convened by PRSB, to share their ideas and solutions to the challenge of driving use of standards and interoperability.

It was a lively discussion, chaired by NHSX Director of Standards and Interoperability, Irina Bolychevsky and facilitated by Jon Hoeksma, CEO of Digital Health. Participants agreed that in order to make real progress with interoperability we need agreed processes for identifying and prioritising which standards are developed and adopted, and clarity about who does what and when to produce useful, usable standards that get used to drive interoperability across the health and care system.

We need to make it easy for vendors and provider organisations to comply by building in the right levers and incentives through robust procurement processes and regulation, for example. Participants also agreed that aligning information for direct care with data for research, commissioning and other purposes must be addressed. And importantly, these plans need to be shared widely and communicated regularly if we are to succeed.    

The round table was the final consultation event held by PRSB on behalf of NHSX to support developing the strategy for standards and interoperability that will embed digital ways of working across health and social care. NHSX will be publishing its findings shortly. 

Zoe’s story illustrates how we can improve shared decision making 

Zoe McNeill has had mixed experiences of shared decision making (SDM) in her care since she was diagnosed with cancer – some good experiences and some that fell short of best practiceShe’s hoping that standardisation of the process will help to ensure a more consistent approach, where sharing of information between clinicians and patients is the norm.

Why did you choose to get involved with the SDM project?

I was diagnosed with breast cancer in 2016 and sadly experienced the fallout that can occur when shared decision making (SDM) isn’t carried out properly. There were a number of decisions that needed to be made about what treatments to have and when to have them. Although I was consulted on some of these, it soon became apparent that I had not been made aware of all relevant potential outcomes of the treatments being offered.

All patients have a right to be involved in decisions about their care and health professionals must ensure that all relevant information is shared. However, I am particularly passionate about SDM being delivered consistently in cancer services given that a cancer diagnosis results in a patient making some of the most important decisions of their lives. 

As a result of my experiences, I have been involved with my local hospital Trust in a project to improve the consistency of SDM provision (currently deferred due to COVID). Part of this was investigating the possibility of a SDM record.

I’d always hoped that the process of shared decision making could be standardised, to ensure that people get the level of care they need and deserve. I became involved with the PRSB project to support the development of a standard because it’s the key to enabling patients to receive equality of care in relation to information sharing and treatment decisions.

What are the benefits of SDM?

For me, the real benefit is that it gives clinical teams and patients the chance to work in partnership and share responsibility for decisions about treatment and care. This partnership facilitates good communications and enables mutual understanding and respect. The patient’s voice is not only being heard and listened to, their personal views are being actively sought.

For this reason SDM also helps to facilitate personalised care. Having information from the patient about what matters to them is essential, so that medical professionals can make sure they are fully informed of all treatment options, as well as the benefits, risks and consequences that are relevant to them as an individual. For example, shared information and understanding regarding the order of some cancer treatments enables the right decision for the individual patient. Clinicians can’t assume that what’s important to one patient will be the same for another. 


SDM allows patients to have self-determination with regard to what benefits, risks and consequences of relevant treatment options matter to them. It is so important as it is the patient’s body and life that will be impacted by treatment outcomes.

What needs to change to make it better/why is information integral to improvements?

Formal SDM processes based on an information standard need to be embedded into routine clinical care so that patients are guaranteed to always receive good quality SDM.

In consultations where SDM has been routine I have had a much better experience of care, compared to where it wasn’t. When I was involved completely in decisions, I felt as though I had more control over my health and care. The sharing of information is integral to improvements because valid treatment decisions cannot be made without the relevant information from both the clinical team and the patient. 

The record of information as detailed in the SDM information standard needs to be made available to both clinical teams and patients. This will allow both parties to verify mutual understanding of the information shared and enable patients to have more time to consider decisions outside formal consultations.

Why is standardisation of care so important to patients?

Patients have a right to be involved in decisions about their care, but studies have shown that my varied experiences of SDM are not unusual. An SDM information standard should ensure equality of care for all patients with regard to decisions about their treatment. 

An SDM information standard that reflects professional SDM guidelines (particularly with regard to the equal importance of the clinical team’s and the patient’s input) will enable all patients and healthcare professionals to exchange the information needed in order to make a valid treatment decision.

End of life care key focus for PRSB 

Good end of life care is a vital part of wellbeing, helping people and their families to feel more in control of their own wishes. This month we signed a letter that was published in the Independent from our member organisation Compassion in Dying, which highlighted the need for improvements to end of life careThe organisation’s work has fed into a wider CQC review into the use of DNACPR (do not attempt cardiopulmonary resuscitation) decisions during the pandemic and the actions required. A recent report published by Compassion in Dying shows that some of the public’s main concerns include protection from CPR and miscommunication about DNACPR, which have been exacerbated by the covid crisis 

Meanwhile Compassion in Dying has also been supporting the work of the PRSB to develop standards for end-of-life care, so that we ensure we get the information right. A survey sent out in partnership with them attracted more than 1700 responses, one of the highest rates we’ve ever recorded. Many of the same themes that emerged through the Compassion and Dying report and CQC reiew were reiterated by patients and carers, highlighting the importance of shared information between health and social care. People want to feel involved in the decision making around their care and have faith that this information will be transferred correctlyA second strand to the work is now underway, to determine how younger people with life limiting or complex conditions feel their information should be recorded and shared. This survey will be issued in partnership with the charity, Together For Short Lives in the next month. 

For more information on the project or to get involved, please contact info@theprsb.org 

PRSB seeks support for next stage of shared decision-making work 

PRSB was delighted that 130 people took part in our online workshop to discuss what information should be recorded in a person’s care records when discussing treatment options, preferences and concerns. Known as shared decision making, this is fundamental to ensuring care is centred on a person’s treatment needs and goals whether it’s for cancer, a mental health problem or to manage medications better.  We’ve produced a draft of the standard for information sharing and we are looking for clinicians and people who’ve used services to test it in mid-April.  

We will be asking people to participate through role plays to test if the standard is easy to use in practice, and whether it can provide enough information about the discussion and decision without taking too much time to complete.   

The role plays involve a maximum of two hours plus preparation time (reading) and will cover the following clinical areas: 

  • elective surgery 
  • cancer 
  • mental health problems 
  • gynaecology 
  • children’s surgery 
  • genetic conditions 
  • polypharmacy 
  • multiple long-term conditions  

We are looking for clinicians who practise in each of these fields and people who have some relevant lived experience or professional actors experienced in medical role play to participate.  Reimbursement for your time will be available, depending on circumstances. Feedback from our last online workshop was very positive. 

For further information pr to get involved please contact info@theprsb.org 

Standard in action: What’s next for social care? 

NHSX aims to ensure standards are fit for purpose and widely adopted so that health and care information can be shared digitally across systems to support better care. PRSB has been asked to support the strategy to drive this work forward and we are having a rich and stimulating series of discussions with professionals and people who use services about their ideas for improvement.  

The work is being carried out in three phases and the first two are nearing completion – to develop a list of existing standards for social care that should be adopted by system suppliers and identify what social care standards are needed. PRSB is also supporting work to review the maturity of digital information sharing and recommend how further progress can be made and measured.   

The first phases of work identified priorities for implementation, as well as gaps in standards. The key areas people felt were important included having the right information at transfer of care, information feeding into wider shared records and About Me, the personal information that is most important to an individual. Other important gaps that people highlighted included the information that’s digitally available about a person living in a care home, day to day recordings of medications and making sure that existing standards can be adapted for use in social care. 

This work is being followed by a series of consultation events, now taking place, that are informing NHSX’s strategy for standards and interoperability. The aim of the events is to consider and recommend how we build on standards and interoperability successes to date to improve outcomes. This includes ensuring we have one clear approach to standards that includes how they will be adopted, their success measured. 

Feedback so far is fascinating with participants citing the need to set clear priorities, work closely with strategic programmes and specialist interests, bring clarity to procurement and support adoption nationally and locally. 

We are holding a series of interactive sessions with colleagues from the NHS, Department of Health and Social Care, our Advisory Board members, providers, vendors and public representatives as well as having several individual interviews. The outputs of this work will form a set of recommendations to a round table of senior system leaders in April that will produce actionable findings to drive forward NHSX’s strategy for standards and interoperability.  

For more information contact info@theprsb.org 

PRSB to define new nursing standard requirements

Nurses are a crucial part of care across a wide range of sectors, with patients and other professionals often reliant on their expertise. That’s why the PRSB has been asked by NHSx to determine what’s needed from a new nursing standard for use across all the different health and social care settings. 

The standard will aim to improve quality and safety of care in key nurse-led areas, including care planning. It will reflect best practice and standardise documentation across different nursing settings, to free nurses and give them more time to care. For example, it will standardise information that a district nurse in a care home setting can access and share in the same way as a mental health or hospital nurse, with a focus on the person’s overall wellbeing. 

Whilst the emphasis is nurse-led care, we will also speak to other professionals and people who use services to build consensus and support for the standards.   

The first stage of the project is to determine exactly what needs to be included in a nursing standard, and how it can benefit systems, clinical staff and patients. We will be holding a series of interviews with patients and citizens, technical and clinical professionals, as well as key decision makers. The goal will be to outline the key benefits of this new standard and any challenges that might arise. 

To get involved with this work, please contact info@theprsb.

 

Catch up online: Health and Care Plus

This month we discussed how standards are working in action at Health Plus Care Online. You can find a list of sessions below:

Reimagining innovation and delivery  
Sam Bergin Goncalves, citizen lead on the PRSB’s social care project, and Professor Adam Gordon, president elect of British Geriatrics Society, discussed the publication and implementation of new social care standards. Sam shared her experience of using a care passport with her son Shane, and the impact standardised information is having on their lives. Watch here.

Residential and care home 
Katie Thorn, Digital Engagement Manager, Registered Nursing Home Association and Lucy Mcculloch, care home digital integration consultant for NHS South West London CCG joined forces to talk about the implementation of the PRSB’s standards for sharing information from care homes to hospitals in an emergency. They shared the benefits and challenges of standards adoption. Watch here.

Digital transformation 
Our chair, Professor Maureen Baker, joined panellists to talk about how the pandemic had changed the face of primary care. You can find the recording here.

How the new Standards Partnership Scheme will improve the drive for health and care data   

Blog: How the new Standards Partnership Scheme will improve the drive for health and care data   
Prof Maureen Baker, Chair of the PRSB

“Since the pandemic began, many countries have struggled to provide data in near real-time in order to act swiftly to combat the virus. The recent WHO SCORE report estimated that while 60% of the participating countries have systems to review progress and performance of their health sector, only half have the capacity to monitor quality of care, and a third have the capacity for a national digital health strategy based on recommended standards. 

Although the UK government has responded to the challenge by rapidly creating a single place to gather and analyse data and feed it back across the health and care system, it still highlights the need for robust information, both for direct care and planning of care.  to manage the pandemic in real time. This was also confirmed in our latest report Health and Care and Covid 19which analysed the ways we need to tackle digitisation  

For the past five years, the PRSB has been developing standards and guidance for the content of health and care records to support the collection and sharing of high-quality data. Where standards have been adopted, we’re already seeing positive benefits, including increased efficiency for professionals and better personalised care. But adoption of standards and sharing information between systems remains a huge challenge in health and care that needs to be addressed urgently.   

The new Standards Partnership Scheme will visibly recognise and support vendors across the UK that are implementing professionally endorsed record standards. By offering a targeted, practical support programme for partners that focuses on co-production and learning, we can help vendors access the skills and expertise they need to deliver a truly integrated system. We also hope that the Quality Partnershipwhere vendors test conformance to PRSB standards, will help to support adoption and spread of standards. In turn they should demonstrate best practice to other organisationshelping all sectors of the health and care system to come together and be able to deliver this shared goal of integration. Later this spring we’ll be expanding the partnership scheme to work with NHS and social care providers to help them adopt standards, to complement the vendor offer we have just introduced. We’ve always said that we need collaboration across the board to make this happen, and we’re pleased that we can give people the tools to support this.  

By working together we can make the changes necessary to ensure information is at the fingertips of everyone in the health and care system whether they are caring for someone at the bedside or planning care at a national level.”   

PRSB launches new vendor scheme to support integrated care

The Professional Record Standards Body (PRSB) has launched the Standards Partnership Scheme to visibly recognise and support vendors across the UK that are implementing professionally endorsed record standards to improve and integrate care through interoperability.  

The scheme, which is supported by NHS and social care system leaders, enables Partners to send a strong signal to customers and stakeholders that they are at the forefront of the drive toward standards and interoperability in the NHS and social care.   

The Standards Partnership Scheme offers a targeted, practical support programme for partners that includes tailored workshops, briefings and guidance, as well as networking opportunities for Partners to contribute and influence standards development and priority setting. An annual fee will entitle organisations to access responsive advice and guidance on implementing standards and learn more about our standards and future priorities from the experts who develop them.  

Our scheme is about co-production and mutual learning. Vendors will improve, local adoption of standards will improve, and the standards themselves will improve as we learn from real experience of implementing – so that they are useful, usable and used.  

Vendors that want to demonstrate organisational best practice and standards conformance should apply to be a Quality Partner. For Quality Partners we will set an achievable bar for conformance with standards that is safe and delivers clinical value, recognising that best practice may take a little longer. The bar will move upwards over time as the system matures and we all learn. The scheme is designed to be developmental and will flex to meet the needs of different health tech organisations, no matter what their size or level of digital maturity.   

PRSB will also shortly be introducing a local provider partnership offer that includes training, support and advice for implementing standards and using them to support information sharing within their organisations and for continuity of care across settings and services. 

Partners will join one of the largest professional networks in health and care across the UK that is committed to ensuring that standards are useful, usable and used to support better and safer health and care.   

Professor Maureen Baker, Chair of the PRSB, said: “Clinical standards enable health and care professionals to swiftly access the crucial information they need to support the delivery of good quality, personalised care. “Through our new partnership community, vendors will get the chance to work closely with clinical and professional leaders, system leaders and patient advocacy groups to make these standards work in action.”  

David Turner, Chief Technology Officer at NHSX added: “At NHSX we work closely with the PRSB and other partners to drive the adoption of standards to support better care and improved interoperability. This new partnership scheme is an important contribution to developing a truly joined up health and care system. Now is the time for vendors, clinicians, social care workers to join forces and adopt standards for a future focused on better, safer and more integrated health and care.”