Post on 02-Jun-2020
How do you Commission
a Paperless NHS?
Dr Masood Nazir General Medical Practitioner at Hall Green Health National Clinical Lead – Patient Online programme NHS England Clinical Information Lead & Senior Information Risk Owner - Birmingham CrossCity Clinical Commissioning Group Governing Body Chief Clinical Information Officer – Your Care Connected programme
Wednesday 17th June 2015
www.england.nhs.uk
Towards a digital revolution
Online access has transformed many industries, including:
music, retail, travel and banking
What are the benefits of paperless
to the NHS?
Clinical diagnosis
Patient & staff experience
Safety
Reduce burden & improve efficiency
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We owe patients a seamless, paperless NHS, but if they want a letter - fine
www.england.nhs.uk
Policy development – timeline
The Information Revolution
August 2011
Power of Information
May 2012
NHS Mandate
November 2012 & November 2013
RCGP Road Map
March 2013
Enhanced Service Specification (ESS)
April 2013
GMS Contract
April 2014
2011 2014
Personalised Healthcare 2020
Nov. 2014
Five Years Forward View
Oct. 2014
GMS/PMS Requirements2015/16
April 2015
Strategic context: national information board
http://www.england.nhs.uk/wp-content/uploads/2014/11/nib-report.pdf
The right information at the right
time for patients, carers,
clinicians, managers
www.england.nhs.uk
BMA GPC document
www.england.nhs.uk
New ways of working
Using technology to improve services to patients
Increase productivity and reduce practice workload
Re-assessing long-standing ways of working
Set up and embed new systems
Potential medium and longer-term benefits
Full primary care team is up to speed
www.england.nhs.uk
Blueprint for building General Practice
www.england.nhs.uk 9
Patient Online – building each layer
Support & Guidance required
Evidence & case studies
Promotion
Webinar & support
RCGP Guidance
Simple guide & support
How much support and guidance is needed?
Enhanced
service
2013/2014
GMS Contract
2014/
2015
GMS Contract
2015/
2016 Coded data/
meaningful data
for patients
Working with EPS
Telephone
triage Nurse
clinic Minor ops clinics
What is right percentage of
appointments online?
Click & Collect
Identity
Management
Simple
guidance
www.england.nhs.uk
Some of the aims for the digital approach
View or order repeat
prescriptions
Patients
registered
with GPs
View medical records 99% 97%
97%
Book or cancel
appointments online
www.england.nhs.uk 11
Next steps 2015/16 – practices
Guidance &
support
Benefits &
evidence
System & GPSoC
functionality
National
implementation
Track progress
www.england.nhs.uk 12
• Online prescriptions • ‘Flags’ to warn of review required
• Diagram of process?
• Hyperlink to medication information
What could be better?
• Online Appointments • Wider span of times to be available
• Nurse reviews to be included
• Option to add to personal electronic calendar
• Detailed Record • Not patient friendly /not intuitive / Apps??
• No search facility, charts, trends etc
• Not transparent eg. what is facilitated
Your Care Connected and other data sharing initiatives
Public information programme
1 Preparation development - engagement with patients and stakeholders in creating information and campaign so we know its clear
2 GP Practices awareness raising, engagement events and toolkit to help support practices
3 For patients - awareness raising advertising and PR campaign so patients know they should receive information by post – buses, radio, events
4 Opt out - Letter and leaflet to patients informing them of what is happening and how to opt out
5 Ongoing support through helpline for practices and patients through process
Your Care Connected from a patient’s perspective
A patient visits the
hospital or mental
health trust
The doctor or nurse treating them asks to
view the patient’s record using Your Care Connected
The clinician contacts the patient’s practice
and requests the record via fax or post. If the
practice is busy or closed, this may cause significant delays or even overnight stays
The clinician accesses the patient’s record
using Your Care Connected and is
provided with all the relevant information to provide better, safer
care in about 15 seconds
The patient receives the necessary treatment
Patient grants access
Patient refuses access or has
opted out at their practice
But don’t just take our word for it…what we have heard and learnt during our local Proof of Concept
“Patients assume we have full access to their medical history and therefore they may not reveal medical conditions which might impact their treatment”
“The fact that I could view my patient’s blood results meant I didn’t need to repeat the blood test”
“YCC was extremely easy to use, being accessed intuitively through the existing Clinical Portal”
“On accessing the patient’s record, I became aware of a range of medical conditions and past illnesses I didn’t previously know about. Without this information there could have been a serious impact on the care of my patient“
“Very useful - means we don't have to wait ages on the phone to GP practices”
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www.england.nhs.uk
Shared information is a relationship
of trust
Cartoon with thanks to the British Medical Journal
Patients and information are the two most under-used resources in the NHS
Dr. Richard Fitton
Electronic Data Transfer: What are the benefits of this?
• No paper, resulting in:
– No opening of mail
– No date stamping
– No scanning
– No opening, twice daily, of NHS Net account
Address staff anxieties and concerns
www.england.nhs.uk
M6
M5
M6
M1
M1
M54
M69
M40
M42
M50
M6 toll
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1 4
Mobile Working
Sharing Information
Education
NHS TREASURE MAP
Innovations – Promote, Share & Spread your GEMS
How does a commissioning body influence anything?
•Mandatory elements in contracts
•Funding projects
– National
– Local
•Transfer of good practice
– Galley of examples Awards
– “Do once and share”
•Influence by… influence
The challenge
• Implementing a Paperless NHS is a challenge, a major project and a substantial change in the way care is delivered
• But it is achievable, and organisations are starting to achieve it and gained many benefits
• Once it is in use most health care professionals would not want to go back to paper
www.england.nhs.uk
“High quality care for all, now and for future
generations”
Masood.nazir@nhs.net