What does PRSB do?

We develop standards for digital health and social care records, based on evidence and research and agreed by professionals, carers and people who use services. We promote their use and we advance the wider objectives of digital health and care, in order to create safer, more streamlined and efficient services, tailored to each person’s needs.

What is a care record standard?
PRSB standards are made up of information headings such as diagnoses, medications and allergies and a description of the information that should be recorded under each heading. These standards are intended for use by all health and care organisations and they support better sharing of information between organisations and individuals You can find more information on how standards are developed at www.theprsb.org.

Why do we need care record standards?
Care record standards exist to improve the safety and quality of health and social care, in particular to ensure that the right information is recorded correctly, in the right place, and can be accessed easily, by any authorised person who needs it, wherever they are.

Developing and using electronic cared records built on the same standards means that the information recorded while providing or receiving health or social care can be shared between whomever, whenever and wherever appropriate. The record standards ensure the information made available is exactly how it was recorded.

How do care records benefit patients and professionals?
People who use services will only have to share information once, and their records will be available in every care setting including at home. In addition to helping professionals to provide safe and effective care, it also means that people have access to their own records and can take greater control of their care.

The information collected from people can also be used to make care better for the future through audit of existing treatments and services, improving the quality of care and research so we know more about illnesses and develop new and better treatments and care options.

Our role

The PRSB is supporting the NHS and social care system to develop interoperable IT systems that share information digitally, which will ensure that the right information is available when it is needed to support safe, reliable care.

As part of this work, and to enable information to be shared in a meaningful and consistent way, the PRSB is bringing together health and care professionals, and patients to develop standards for care records. This means that everyone agrees what information should be recorded at any stage of a patient’s treatment and care to ensure high quality care can be provided. It also means that IT systems can be designed to share and retrieve the relevant information when it is needed.

Who do you work with?
The PRSB works across the four nations of the United Kingdom. We are a unique and independent body of 60 health and care professional bodies and patient representative groups. We also work closely with people who have used services and systems experts and suppliers. Our work is commissioned by different bodies, including NHSX and NHS Digital among others.

When and how should clinicians use standards?
PRSB has developed a wide range of different standards and guidance for use in clinical and care settings. PRSB standards are published on our website and set out the detailed information models for each standard and the guidance that explains how to implement them in IT systems and use them in clinical and professional practice.

Do your standards cover health and social care?
PRSB standards aim to provide a common language for health and social care so that we can 'bridge the gap' and provide truly integrated care with information flowing in real time between health and care staff and systems. We have published five standards for integrated care to ensure services are ‘joined up’.

How would NHS teams commission PRSB?
Teams should contact PRSB directly to discuss the potential commission and agree a proposal.

At present NHSX commissions come via NHS England. Gillian.Pringle@nhs.net chairs the Operational Group who have oversight of our work and she can advise how best to commission work. NHS Digital uses the Building Information Standards (BIS) framework contract for any work which is relevant for PRSB. The contractual arrangements with PRSB are managed through Davie Hay davie.hay@nhs.net and the NHSD procurement team. For other organisations it will depend on their own procurement arrangements. PRSB requires at a minimum, acceptance of our proposal and a purchase order number.

Developing a standard

What is the process to develop a standard?
The need for standards is identified collaboratively with NHS England, NHSX, NHS Digital, PRSB and other views sought about requirements. A proposal is developed and agreed and PRSB will undertake a discovery phase of work to gather evidence based on input from users to determine what is needed from the new standard. A draft standard is produced and tested through consultation. Views and opinions are gathered through a series of methods including focus groups, workshops, surveys and expert groups. During this time the standard is fine tuned through a series of iterative drafts. Early pilot sites will implement and test the standard early into the lifecyle, reviewing the process and allowing for further evidence gathering and feedback. PRSB works with NHS Digital to develop technical specifications and issue an ISN, as needed.

The standard will be published in draft form awaiting endorsement from relevant member and partner organisations. The standard is routinely tested and reviewed following publication. Timing varies depending on the nature of the project.

How do PRSB standards support sharing information between systems?
PRSB standards use an information model that ensures that information can be recorded in a consistent way into digital patient records. The model provides the structure for information to be recorded in a given situation. For example, when a person is discharged from hospital and their record needs to be sent to their GP. The sections of the model (eg ‘Diagnoses’) are coded wherever possible using nationally-used coding conventions. These include the NHS data dictionary, SNOMED-CT (Systematised Nomenclature of Medicine Clinical Terminology - Clinical Terms) and PDS (Person Demographics Service). The model can also include free text.

The electronic health record (EHR) can then be exchanged between systems using FHIR (Fast Health Interoperability Resources - see https://www.hl7.org/fhir/). FHIR was adopted in 2019 by the NHS as the agreed technology standard for sharing information between systems. The standard is made up of data elements (called ‘resources’) and an API (application programming interface) for exchanging electronic health records. In order for this to work, both the sending and receiving systems should have the correct structure (information model), and coding where appropriate, for a given set of information, so that information can be shared between systems without the need for human intervention. To make this work technically, the systems must also be able to send and receive FHIR messages.

Does PRSB publish guidance to support using standards?
All our standards include implementation guidance, which can be found on our standards pages. However, we also offer additional support through online tools which can be found on our website under Using Our Standards. These include case studies and training videos. If you have any questions about a standard, our door is always open. Please contact us at support@theprsb.org.

Can providers and vendors get formal recognition from PRSB for implementing standards to show they are compliant?
We are piloting this service with plans to launch in early 2021. Anyone interested in working with us on an assessment, should contact support@theprsb.org.

If you have any other questions that have not been answered here you can email us at info@theprsb.org.