New standard to make joined-up care a reality

The PRSB has published a new standard for shared care records, that determines the vital information about a person that should be shared between health and care systems so care is safer, timely and more effective.

The government has outlined ambitious plans for health and social care over the next decade, from improvements to maternity care to better services that help ensure that people stay healthier in the community and avoid hospital stays where possible. In order to provide the right care, information about people needs to be safely shared between different systems across health and social care.

Working with NHS England, the PRSB has asked citizens and health and care professionals to help produce a ‘core information standard’ that defines exactly what information should be shared in a person’s care record throughout their life.

The standard includes a wide range of information from different services, including the GP, hospitals, social care and mental health services among others. It will incorporate an ‘about me’ section, which outlines what people want professionals to know about their care, as well as other crucial information, such as allergies, medications and alerts. Once implemented, it will mean that everyone involved in a person’s care, including the patient, carer and guardian, will have access to relevant data. As a result, people won’t have to repeat their history and services can deliver tailored, personalised care. It will be piloted in regions across the UK, as part of the Local Health and Care Record programme.

The standard has been produced following consultation with more than 1,500 individuals and organisations through online and face-to-face workshops and a survey. More than 1000 people completed the survey for this project, with 90% agreeing that joining up digital health and care information will lead to better, safer and more personalised services across the UK. Around 80% of respondents also supported personalising care through use of an ‘about me’ section in their care records.

National guidance on information governance is being tested by local health and care records to ensure that patients can be confident their information will be viewed by professionals on a ‘need to know basis’ only. They are also adopting guidance on cyber security to make sure that patients’ sensitive health and care data is held securely.

The first regions that have been selected to pilot the standard are Greater Manchester, Thames Valley and Surrey, Wessex, One London and Yorkshire and Humber. However, the standard can be used across the UK.

Professor Maureen Baker, PRSB chair, said: “As a GP, providing safe, high quality care for my patients depends on having the latest information from colleagues in hospital and the community about my patients’ care. That is why I am so pleased to that PRSB has produced the core information standard and why I am so keen it is in use as soon as possible. Having up-to-date information helps me make better clinical decisions and work more effectively with other services and it helps people stay closer to home with more control of their own health and care.”

Professor Maureen Baker to judge Digital Health Awards

We’re delighted to announce that our chair, Professor Maureen Baker, has been confirmed to judge at the Digital Health Awards, as part of our partnership on this year’s Digital Health Summer Schools.

The Digital Health Awards recognises and celebrate the achievements of the leaders making the biggest contributions to UK healthcare IT. Now in its second year, it is the only health IT awards in which all 3,000 members of Digital Health Networks are invited to vote online for the winners.Maureen joins a host of high-profile digital health leaders on the judging panel, including Will Smart, CIO of Health and Care, NHS England (chairman of judges), Prof Jonathan Kay, Vice Chair, Faculty of Clinical Informatics; Dr Indra Hardy, Digital Health and AI Clinical Lead, NHS England; Lisa Emery, CIO, Royal Marsden NHS FT / Chair, London CIO Council; and Dr Shera Chok, Medical Director, Tower Hamlets GP Care Group CIC.

The nominations are open to everyone, you can nominate yourself or someone else, and it takes only five minutes to submit your entry. The winners will be announced at the networking dinner of the annual Digital Health Summer Schools, 18-19 July, University of Leeds and as part of their prize, they will receive a free place at next year’s Summer Schools 2020.  

The online form is quick and easy – just confirm who you are putting forward, for which category and three reasons why. The 31 May deadline is fast approaching, so enter now!

 

NEW GUIDANCE: Medicines information guidance to improve safety across health and care

We’ve now published new guidance to enable the digital sharing of medications information between care settings, which will help improve patient care and reduce medication errors across the NHS and social care.

Research estimates that there are 237 million medication errors in the UK each year and as many as five deaths each day from errors in prescribing, dispensing or monitoring medications use. Many of them occur when information is transferred on paper because critical prescribing information can’t be shared from one computer system to another.

PRSB has worked with NHS England and NHS Digital to produce clear guidance for recording and sharing standardised computer-readable information between hospital, GP and community-based services. This will vastly reduce the current practice of sharing paper-based medicines information and re-keying it into computers which can lead to errors.

This will improve patient safety, increase efficient use of clinicians’ time and reduce medicines wastage.  The guidance will also help hospitals integrate electronic prescribing systems and pharmacy stock control which also will reduce waste and inefficiency.

At the moment, hospitals, GPs and other community-based services use different methods of prescribing so that when a patient transfers from one setting to another, clinicians need to  manually translate prescribing information to ensure the correct medicines, dosages and timings are identified and administered. Previous attempts to standardise and computerise this information failed because of the complexity and variety of prescribing methods, doses, timings and instructions.

Dose information has now been standardised for the most common uses. There is also guidance available for handling more complex cases. It sets out rules for translating medicines information between the different prescribing methods used in different care settings.  The solution will support digital sharing of medications information, with clinicians still deciding when to use or record the information. The guidance covers the majority of prescriptions, approximately 90%, with a few complex exceptions.

PRSB was asked to undertake a consultation with clinicians, professionals and people who will be using the standardised guidance to test whether it is safe, workable and would gain widespread support and acceptance.  PRSB’s report, digital medication information guidance, is available here. 

“Improving medicines information sharing by computerising processes and replacing paper-based ones that were prone to errors is a significant achievement. Thanks to the combined efforts of NHS England, NHS Digital and the PRSB, prescribing for patients should be safer, more efficient and fewer medicines will be wasted,” said Professor Maureen Baker, chair of the PRSB.

 

“The benefits to patients and the system are significant and for this reason, this project has been identified as the top priority of the NHS England interoperability programme, “ said Dr Simon Eccles, Chief Clinical Information Officer, NHS England. “Health and care providers should prioritise implementing this guidance urgently.”

Take our survey! Help us define core information for joined-up care!

We know that information sharing between health and social care needs to improve and that’s why PRSB is asking for your help to complete a new survey.

The survey is a key part of the work which was commissioned by NHS England to define the core information that needs to be shared in local health and care records. It will then be piloted before roll-out across the UK. Once it’s put into action, this will also help people take greater control of their health and care.

Making sure that the right information is available whenever and wherever it is needed for care means information needs to be recorded in a standardised way. Standards enable digital systems to share information without losing or changing its meaning. Not all information will be used all the time and staff’s access will be determined by their role and need. PRSB has produced a set of FAQs and other materials to answer your questions about this, which you can find here.

The draft standard in this survey has been developed following extensive consultation with patients, carers and other citizens, health and care professionals and system vendors. We would therefore be grateful if you could complete the survey and circulate widely among your networks so that we get as much helpful feedback as possible.

It follows on from a series of webinars in February and a successful workshop, which took place in central London earlier this month with more than 60 people.

We value the opinions of everyone involved in health and care, including patients and carers. The survey is open until 1 May and will take no more than 15 minutes to complete.

You can find the survey here.

Welcome to our newest PRSB members

The Faculty of Public Health (FPH) and the Health and Social Care Alliance Scotland have become the latest members of the PRSB.

The Faculty of Public Health, which represents nearly 4,000 public health professionals across the UK and around the world, is a registered charity, originally set up by the Royal College of Physicians. They work closely with local government and public health teams to develop strategies on tackling issue like air pollution, smoking, obesity and drug-use in their local communities. They also help to aim to raise awareness on issues like infectious illness and housing concerns that impact health.

Meanwhile, the Health and Social Care Alliance Scotland has more than 2,500 members. They include large, national support providers as well as small, local volunteer-led groups and patients and carers. The organisation’s vision is to give a voice and platform to those who are disabled or living with long-term conditions, as well as unpaid carers and other citizens.

NICE endorses e-discharge summary standard

We’re pleased to announce that our e-discharge summary standard has been formally endorsed by the National Institute for Health and Care Excellence (NICE). Their endorsement will help drive adoption of PRSB’s standard which aims to improve safe transitions for people between hospitals and the community.

The NICE Endorsement Programme endorses resources from organisations that support the implementation of NICE guidance and the use of quality standards.

The organisation has agreed that our discharge summary reflects and supports recommendations in NICE guidelines on transitions of care between different settings. It also supports the NICE quality standard on transition. The standard can now be found under a list of endorsed resources on the NICE website.

PRSB CEO, Lorraine Foley said: “At PRSB our goal is to develop standards that can support better information sharing and safer, more efficient care. We want to facilitate integrated care between different services, by ensuring that accurate and standardised information can be easily transferred between systems. We are delighted that NICE has chosen to approve our e-discharge summary standard, which sets out best practice in information sharing when someone is discharged from hospital. The endorsement reinforces the importance and visibility of these standards and encourages adoption, making it easier for local organisations to do the right thing. Change won’t happen overnight, but we are delighted to work with our partners to promote this kind of initiative.”

Professor Gillian Leng, deputy CEO and director of health and social care at NICE, added: “A smooth transition between inpatient and community or care home settings can have huge benefits for everyone involved. NICE is pleased to endorse the PRSB’s e-discharge summary standard, which accurately reflects our evidence-based recommendations on these transitions.”

New pharmacy standard now complete 

Patients will be better supported to take their medications safely and effectively by a new standard, which defines the information that needs to be shared by community pharmacies with GP practices.

Community pharmacies are offering a wider range of services than ever before, including vaccinations, medication reviews, support for new medicines as well as support with minor illnesses. If they are recorded in a standardised way, it means that the information can then be shared between different systems more easily. This will help to improve patient safetyby reducing medication errors, ensure that information on pharmacy services is appropriately transmitted to other healthcare providers and reduce administrative work for busy staff. Over time it should help to eliminate the use of paper templates.

The second stage of the two-part standard has been published here by the Professional Record Standards Body. It covers:

  • Medication Reviews (which support patients to take medications in the right way and prevent medicine-related problems)
    • Appliance Use Review (e.g. for a stoma appliance or catheter)
    • New Medicine Services (a service which provides support to people with long-term conditions to help them to take their medications.)
    • Digital Minor Illness Referral Scheme (a service to assess patients with minor illness after a referral from 111 services).
    • Hospital discharge summaries to community pharmacy

Meanwhile, the first stage of the standard, which was published in October last year, details what information should be recorded about vaccinations that have been administered and emergency supplies of medicines by community pharmacies. The two standards have now been combined and will provide high-quality data for service planning, commissioning and public health initiatives.

Stephen Goundrey-Smith, Royal Pharmaceutical Society’s advisor to the PRSB and a clinical lead on the project, said: “We are pleased that the pharmacy information flows standard is now complete, so that community pharmacists can start sharing vital information with GPs. Once it’s put into practice, we expect this to support better, safer and more personalised care, and to demonstrate the valuable services that pharmacy professionals provide.”

Dr Vishen Ramkisson, senior clinical lead for Medicines and Pharmacy at NHS Digital, said: “The first part of this data standard, along with the corresponding FHIR message definitions (which are technical standards to support the digital transfer of information), was published in October last year. Already, pharmacy and GP system suppliers are working hard to develop their systems to send and receive these standardised messages.

We are looking forward to starting to see this initial part of the standard used in practice ahead of winter 2019/20. We hope that GP and pharmacy IT suppliers will continue to develop against the next set of FHIR message definitions once they are available.”

Next steps  

  • NHS Digital last year used the first part of the standard to develop message definitions using Fast Healthcare Interoperability Resources (FHIR) – a standard for the digital exchange of healthcare information.
  • These definitions, relating to vaccine administration and emergency supply of medication, are now being used by GP and pharmacy system suppliers to develop their systems. NHS Digital is supporting these suppliers to implement the capability.
  • NHS Digital will now develop the second stage of the standard into FHIR message definitions to allow IT system suppliers to include the additional pharmacy services.

Standards ready for action

To see real results, standards must be put into action and we are working to support this. We have published instructions from NHS Digital, in the form of an information standards notice, for the healthy child record standard. This informs vendors, suppliers and service providers that the standard needs to be adopted and the timeframe for doing this.

In line with the government’s vision for a digital health and care system, this is a major step towards bringing together information about a child’s health into a digital redbook. Vendors can now start the adoption process, working towards making better records a reality. Trials will take place in early 2019 in North East London, and will complement local programmes of work in Lancashire, Bristol and other parts of London. After evaluation, the standard will be rolled out nationally. For more information on the updates, please go to our website.

In addition to the healthy child record standard, we have also outlined the next steps for implementing the maternity record standard, with a timeline for the next steps available here. The goal is to have the standard in use by the end of 2020. Please contact info@theprsb.org if you’d like to know more or you are interested in implementing standards.

Join our webinars and support the development of the local health and care record programme

We are working with NHS England to determine what information needs to be shared in a person’s digital health and care record.

The aim of the local health and care records programme is to help local organisations move from today’s position, where each health and care organisation holds separate records for the individuals they care for, to one where an individual’s records are connected up from across the health and care system.

This will help health and care professionals to share information safely and securely as the people they care for move between different parts of the NHS and social care. It also enables individuals to be able to access their records irrespective of which part of the health and care system that has provided them with their care.

To help us to determine exactly what needs to be contained in this record, we are holding a workshop on 5 March to discuss this important work. This will be attended by a selection of professionals across a wide range of different sectors, as well as patients and carers.

There will also be a series of online discussions (webinars) taking place, which will cover the following topics. You can join these by phone or web and you can find the details for each below:

End of Life

On Tuesday 19 February at 10.30am – 12pm, we are holding a webinar to inform the end of life section of the care record.

Who should attend? Clinicians, palliative care nurses, carers, hospice professionals and other end of life care specialists.

Maternity and child health

On Tuesday 26 February at 10.30am – 12pm we are hosting a webinar to inform the maternity and child health section of the record.

Who should attend? Pregnant women, parents, midwives, obstetricians, gynaecologists, surgeons, paediatricians, paediatric nurses, genomics experts, social workers, health visitors, dieticians, dentists and other professionals from across health and social care.

Social care

On Tuesday 26 February at 10am – 12pm, we are hosting a social care webinar, to determine how care in this area will inform the record.

Who should attend? Social workers, carers, patients, health visitors and care home professionals.

Mental Health

On Tuesday 26 February at 2 pm – 3.30 pm, we are hosting a mental health webinar, to determine how care in this area will inform the record.

Who should attend? Mental health professionals, carers and patients.

Patient and Carer needs

On Wednesday 27 February at 10am – 12pm we will be holding a webinar to focus on patient and carer needs, to find out exactly what you feel should be held in your record.

Who should attend? Patients and carers.

Sign up now

If you’d be interested in joining one of these webinars and giving us your views, please contact support@theprsb.org.

Seeking your views to help improve medications safety

Sharing data with pharmaciesWhen people move between different healthcare settings, it’s important that the information about their medications can be shared easily with all the professionals involved in their care. That’s why we need your help in assuring technical guidance that will help medications information flow digitally between hospitals and community-based services. This will make it easier for clinicians to provide the right care and will improve medication safety for patients.

At the moment, hospital and primary care clinicians prescribe differently which means that details about medications and their use instructions vary between settings. The information has to be checked and sometimes translated manually by clinicians when a person’s care moves from one service to another. This is time consuming and can lead to errors in translation and transcription.

The new technical guidance will define how to communicate medication dose and timings digitally between systems in all care settings without any change or loss of accuracy or meaning.

How to get involved

We’d like to invite patients, vendors, carers and health and social care professionals across all sectors to complete our survey by 14 Feb, which will help us to make sure we achieve clarity and consensus on the guidance and standards.

Webinars

We are also hosting a series of webinars which you can take part in to help advise on this.

Webinar: Professionals and patients
A webinar for professionals and patients will take place on 7 February from 1-2pm,

Webinars: Informaticians
Two more webinars for informaticians will take place on 14 February and 28 February, both from 10am to 11am.

If you’d like to get involved with these, please contact support@theprsb.org.