Summary Care Record

1. Summary Care Record • Gary James – Director of Informatics • Tina White – Programme Manager • April 2009

2. What is a Summary Care Record? • The SCR is an electronic summary of key health information. It will hold limited essential information derived initially from the patients GP Summary. This will include medication, adverse reactions, allergies and a patient’s significant medical history. • (Approx 240,000 records of this type now exist)

3. 9 million patients approx are seen every year by OOH Services 18 million patients approx seen in A&E, Minor Injury Units per annum 40% of emergency calls attended result in admission, whilst at least 50% of these could be cared for at the scene or in the community 1 in 16 hospital admissions are the result of an Adverse Drug Reaction (72% avoidable) Adverse Drug Reactions as a cause of hospital admission, cost the NHS £466m pa Why ?

4. What are the benefits ‘better, safer clinical care’ • Clinician benefits • Improved appropriateness of clinical care • Faster recognition of critical clinical need • An end to "flying blind" with access to medical history for confused or non-verbalising patients • Patient benefits • Treated faster in the most convenient setting • Care can be provided closer to home • No need to repeat clinical history • Service benefits • Reduction in emergency admissions • Reduction in A&E attendances • Faster decisions to treat/admit/discharge in A&E • Reduction in face-to-face contacts in out-of-hours services

5. Principles of the SCR: It will remain a Summary Only significant aspects of a person’s care Key items will be added in time Initially created via GP uploads Patients access via HealthSpace A patient will be asked before their record is accessed, except in certain circumstances

6. Understanding Patient Choices - Do you want a Summary Care Record? - Can I view your Summary Care Record?

7. Do nothing and a record will be created for you When you present for care, you will be asked* if your record can be viewed. YES NO Creating the Record:Do you want a Summary Care Record? Inform your GP Practice of your choice and no record will be created Using the Record: Can I look at your Summary Care Record? *In an emergency where you are unable to be asked, or certain medical/legal circumstances (such as court order) the clinicians involved in your care may access the record without asking. Any such actions will be recorded for investigation.

8. Do nothing and a record will be created for you. Creating the Record:Do you want to have a Summary Care Record? YES NO Inform your GP Practice of your choice and no record will be created.

9. SPINE PSIS Personal Spine Information Service Patient’s Data: Medications, Allergies& Adverse Reactions – followed bysupplementary datato enrich the GP element PDS Personal Demographic Service Yes - I would like a Summary Care Record or no objection raised GP SUMMARY containing Medication, Allergies & Adverse Reactions plus other ‘supplementary’ dataADDEDTO SUMMARY CARE RECORD Following the Public Information Programme the patient has requested that a Summary Care Record is created, or has raised no objection. A record will be created containing medication, allergies and adverse reactions, followed by any other relevant supplementary data to enrich the content of the Summary Care Record.

10. SPINE PSIS Personal Spine Information Service Message stating patient has requested that no record be created PDS Personal Demographic Service No - I don’t want a Summary Care Record GP SUMMARYcreated with NO clinical datauploaded. A statement will appear stating that the patient does not wish to have a SUMMARY CARE RECORD. . Patient has decided they do NOT want a Summary Care Record to be created. The patient can change their mind at any time by contacting their GP Practice asking to have a Summary Care Record created.

11. When you present for care, you will be asked* if your record can be viewed. Using the Record:Can I look at your Summary Care Record?

12. Can I look at your Summary Care Record? When a patient presents at a care setting, they will be asked* if their Summary Care Record can be viewed to ensure appropriate treatment is provided. The Patient can say “Yes” or “No”. *In an Emergency, where a patient is unable to be asked, a clinician can look at the record without asking the patient. All such actions will be recorded for investigation.

13. Informing Patients - the Public Information Programme (PIP)

14. Practice meets all Data Quality and Technical requirements and Authorised to ‘Go Live’ FP69 PIP to SCR Creation Don’t do anything and one will be created for you! Let your GP Practice know your decision and they will record your choice in their system. Following the end of the Public Information Programme… PCT Patient Information leaflet and PCT/ Practice Letter SCR CREATION Yes – I want a Summary Care Record No - I don’t want a Summary Care Record I need some time to think about this… What are my choices? What should I do? Where can I get some more information? Decision made! NHS Care Records Service Information Line 0845 603 8510 • Care Record Guarantee Leaflet • www.nhscarerecords.nhs.uk

15. Key Practice Requirements • GP Practice must be IMT DES accredited • GP system must be Full Rollout Approved • Public Information Programme Complete

16. There are 4 ways to access the SCR • The Summary Care Record Application (SCRa) • 1 Click Access from a compliant local system • A fully integrated view from a compliant local system • HealthSpace advanced account • Security • Smartcard, the function on the smartcard, clinical need at that time (RBAC) • Requires 2-stage log-in ie. password, and grid-reference

17. System One Journal View

18. SCR Implementation Next Steps • There will be an Early Adopter model for: • SCR clinical content from 3 clinical environments • Inpatient Discharge Summaries • Emergency Department Reports • Outpatient Clinic Letters

19. Future SCR Implementation (tbc) • Clinical contributions will be supported from a wide range of care settings including: • Ambulance Service Patient Reports • Mental Health Documents • Diagnostic Imaging Reports • Admissions Report • NHS Direct Documents • Central Medication Record (possibility being explored)

20. SCR in Lincolnshire • Pilot at Market Rasen • 8 weeks into a 16 week PIP • 21 public information events planned, 11 completed • 9250 patients mailed • 117 opt outs to date (1.25%) • Practice ‘goes live’ 16thJune 2009

21. The Next Steps Phase 2 Roll Out Possible total of 102 GP Practices System and Data Quality compatibility Phasing of Practices to be decided Training of Secondary and Emergency Care users of SCRa

22. Q&Awww.connectingforhealth.nhs.uk/systemsandservices/nhscrs/scrQ&Awww.connectingforhealth.nhs.uk/systemsandservices/nhscrs/scr