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Centrally Optimising Vulnerable Individuals through Data.

Prescribing Services

COVID PROTECT

Fully Integrated with:

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PS/BC/SC/11720/NTL/GB/a

Prescribing Services Ltd2 Regis PlaceKing’s LynnPE30 2JNEngland

Company No: 05913240

Data Protection Registration Number: Z2536678

© 2020Except as provided by the Copyright Designs and Patents Act 1988, no part of this publication may

be reproduced, stored in a retrieval system or transmitted in any form or by any means without

the prior written permission of the publisher.

NHS Digital Assurance with FRA certification NHS England Section 251 Accredited

Dr Julian Brown - GP, PCN Director and Clinical Lead, Prescribing Services LtdJulian.brown@nhs.net

Steven Platt - IT Lead, Prescribing Services Ltdsteven@prescribing.org

Julian Young - Operations Lead, Prescribing Services Ltdjulian.young@prescribing.org

We are potentially facing the worst healthcare crisis that I have witnessed in my 26 years as a GP. Unfortunately we do not have the capacity to deal with thousands of vulnerable or elderly individuals needing ventilation.

An effective solution is instant identification of those most likely to need hospitalisation, proactive support of these individuals to ensure they are effectively self-isolated and then utilise the large number of self-isolated medical personnel in remotely supporting these vulnerable individuals. This enables effective reduction in the utilisation of ITU beds ensuring that we can manage all patients requiring intensive medical support.

The COVID PROTECT system is now available for 20 million patients within England due to its full integration with the NHS Digital Advice & Guidance interface and can be rapidly escalated to support the entire United Kingdom.

Dr Julian Brown

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Data Security and Protection ToolkitOrganisation Name: Prescribing Services Ltd

Organisation Type: Commercial Third Party

Organisation Code: 8HX18

Date Published: 29/03/2019

Approved NHS Health Research Authority databaseScholar (Secure Clinical Hub Leading to Online

Learning And Reporting)

Date Approved: October 2017

ISO 27001 : 2013

Organisation Name: Prescribing Services Ltd

Certificate Number: 14128929

Original Approval: 29 July 2013

Current Certificate: 22 February 2018

Certificate Expiry: 28 July 2023

ISO 9001 : 2015

Organisation Name: Prescribing Services Ltd

Certificate Number: 14127268

Original Approval: 12 July 2013

Current Certificate: 01 November 2017

Certificate Expiry: 11 July 2023

ISO 14001 : 2015

Organisation Name: Prescribing Services Ltd

Certificate Number: 14127269

Original Approval: 21 August 2013

Current Certificate: 01 November 2017

Certificate Expiry: 20 August 2023

ICO. Data Protection RegisterOrganisation Name: Prescribing Services Ltd

Registration Reference: Z2536678

Date Registered: 04 February 2011

Registration Expires: 03 February 2021

GP IT Futures Organisation Name: Prescribing Services Ltd

Lot 1 Qualification

SCCIO129

Organisation Name: Prescribing Services Ltd

Clinical Risk Management

NHS Digital Assurance of Prescribing Services Ltd. Advice & Guidance ServicePhase 1 Assurance December 2016

Phase 2 Assurance October 2017

Full Rollout Approval (FRA) Certificate

issued Nov 2017

NHS England Section 251Prescribing Services are accredited as a supplier

of risk stratification solutions.

Data Provision Accreditations & Governance Summary

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Prescribing Services Background

PSL provides over 20 million live patient portals for the NHS.

Our Advice and Guidance (Eclipse Live) service gained NHS Digital central assurance in

2017 and is being supported by NHS central funding. The service has been commissioned by more than

2000 GP Practices and over 80 CCGs and is currently actively risk stratifying more than 20 million patients

and continues to expand across the NHS. Regions utilising the service benefit from the creation of a

dynamic centralised patient database containing individual patient clinical data information

and proactive risk stratification.

The Advice and Guidance (Eclipse Live) service empowers regions with:

• Highly effective risk stratification capability.

• Dynamic monitoring of patients across multiple therapy areas.

• Enhanced prescribing safety and patient outcomes.

• Optimised resource / GP Practice efficiency.

• Effective Patient Portals

• Reduced service variability.

All of the above are delivered through the creation of a central patient database

with integration across multiple healthcare settings.

The use of our services have been associated with significant

reductions in secondary care utilisation. In our 2015 service

Impact Assessment*, carried out on eight million patients, a

10% reduction in A&E admissions was identified.

The impact of the system has been validated through objective and standardised assessment. Its use is associated with:

*www.eclipsesolutions.org/Impactassessment

EMERGENCY ADMISSIONS

INTO HOSPITAL

ATTENDANCES INTO

A & E

TOTAL HOSPITAL

ADMISSIONS

TOTAL OUTPATIENT

ATTENDANCES

-5.1% -9.5% -4.5% -3.4%

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Coronavirus OutbreakBackground

On 12 January the World Health Organization (WHO) confirmed that a new coronavirus was the cause of a

respiratory illness in a cluster of people in Wuhan, Hubei Province, China, who had initially come to the attention of

the WHO on 31 December 2019. The situation rapidly escalated with the Coronavirus outbreak confirmed to have

spread to the United Kingdom on 31 January 2020.

As soon as cases appeared in the UK on 31 January a public health information campaign was launched to advise

people how to lessen the risk of spreading the virus. Further cases in early February prompted the Secretary of

State for Health and Social Care, Matt Hancock, to introduce the Health Protection (Coronavirus) Regulations 2020

statutory instrument. Guidance on infection prevention and control, how to detect and diagnose COVID-19, and

daily updates, including advice to travellers have been published by the UK’s Department of Health and Social Care

(DHSC) and Public Health England (PHE). In addition, the NHS set up COVID-19 drive-through screening centres at

multiple hospitals.

Chief Medical Adviser to the UK Government, Chris Whitty has explained a strategy to tackle the outbreak, based

upon four aims: Contain, Delay, Research and Mitigate.

Analysis

As of 17 March 2020, 50,442 people have been tested in the UK, of which 48,492 were confirmed negative and

1,950 were confirmed as positive. There have been 71 deaths. Estimates are that there are as many as 50,000

patients infected in the UK. The official government stated risk to the UK has been raised to high.

The global learnings from the COVID – 19 Pandemic so far point to:

1. Speed and accuracy are the keys to identification and detection.

2. Make the right decisions at the right time, the right place, for the right people.

3. Big data and information technology.

4. Protect Front Line Clinical resources and continually evaluate medical response systems.

5. Implementation of preventative measures will influence the trajectory of this epidemic.

6. Keep the public and patients informed.

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COVID PROTECTCentrally Optimising Vulnerable Individuals through Data

Objective

COVID PROTECT has 3 key objectives:

1. To evaluate the entire population and dynamically evaluate which patients are most likely to be hospitalised

by Coronavirus.

2. To ensure these vulnerable individuals at high risk are effectively shielded minimising their risk

of hospitalisation.

3. To effectively utilise healthcare workers that are either self-isolated or housebound due to carer / parenting

responsibilities.

COVID PROTECT will provide a detailed live analysis of the population, educate to minimise the risk of spread and

allow escalation of those with healthcare needs and then allow Healthcare Teams to accurately assess the individual

without compromising the safety of emergency practitioners and A&E / clinical resources.

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1. Instant identification of need.2. Focus on those patients that need urgent support.3. Ensuring best practice is applied.4. Reducing avoidable patient interactions.

5. Protecting the NHS workforce.6. Enabling integrated care.7. Empowering Healthcare Teams and Patients.8. Reducing Hospitalisation.

The COVID PROTECT Service is fully integrated with the NHS Digital Assured and GPIT Futures Framework funded Advice and Guidance (Eclipse Live) Platform.

The integrated information can combine data from; Primary Care, Secondary Care, Mental Health, Social, Housing, Lab Results, 111, Ambulance and more. This enables remote priority patient identification and assessment, remote action plans to be developed, continual patient appraisal to be completed on-line and patient interaction to be highly targeted and highly effective. This ensures the high risk patients are protected and educated whilst Healthcare Teams are shielded from potential risk.

This integrated solution has the potential to ensure the NHS can manage the Coronavirus Outbreak with maximum impact and minimal risk.

Step 1: Identification of Individuals At Risk of Hospitalisation

PRIMARY CARE DATA (EMIS & SystmOne)

Secure Advice & Guidance Database

SECONDARY CARE DATA

SOCIAL CARE DATA

AMBULANCE DATA

COVID PROTECTPathway

PUBLIC HEALTH DATA UPDATES

SOCIAL CARE EMERGENCY SERVICES

INTERNATIONAL COVID-19 OBSERVATIONS/RISK

STRATIFICATION

COVID PROTECT Patient Portal

RemoteClinical Support

Priority Patients (5% of the population)

Aged over 70 with co-morbidities.ACCESS PATIENTSAFETY REPORT

ACCESS CLINICALPROJECT REPORTS

REMOTE HOME BASED HEALTH WORKERS

PRIMARY CARE

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Our PROTECT* interfaces automatically apply risk stratification across a Practice population identifying the COVID-19 Priority Patient Groups.

These Priority Groups can then be remotely educated and supported to allow effective self-isolation minimising the probability of hospitalisation. These patients can be effectively supported while providing NHS staff with the protection of working remotely.

The interface utilises the latest COVID-19 learnings and population impact insights to apply remote and effective patient stratification.

Step 2: Ensuring Priority Patients Are Effectively Self-Isolated

*Population Risk Optimisation Through Eclipse Clinical Triage

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Individual patient’s essential COVID-19 related clinical information presented within a dynamic, intuitive and role based interface.

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Step 3: Enabling Effective Utilisation of our Remote Healthcare Team.The COVID PROTECT Service. Population Risk Optimisation Through Eclipse Clinical Triage.

MANAGEMENT PLAN

Every target patient receives a

standardised remote assessment

operated within the interface by a

remote HCP.

1. Allows remote self-isolating workers to safely view

Patient Portals with Role Based Access.

2. Instantly identifies which patients are at risk and

require remote assessment.

3. Ensures standardised assessment of the Patients

utilising a secure web based portal.

4. Uses the information entered by the Healthcare Team

to further evaluate any actions needed and to inform

ongoing remote support actions.

5. Enables the patients to provide constant daily

updates on their health and self-isolation status.

6. Constantly evaluates the relative performance

of each region validating the reduction in hospital

admissions.

7. Empowers Patients, Carers and Healthcare assistants.

8. Validates holistic outcomes utilising VISTA Analytics.

The PROTECT Service enables effective remote Population Health Management. The Service:

Service Summary

IDENTIFY

COVID-19 PROTECT instantly identifies

the at risk patients needing protection

from the Coronavirus.

PATIENT ANALYSIS

Automated analysis to create a

standardised COVID-19 specific

patient review summary for all at risk

patients.

CONTINUAL AUDIT

To ensure protection of vulnerable

patients.

COMMUNICATION

The system allows effective patient

to clinician and clinician to clinician

communication.

OUTBREAK RESPONSE

Identification of at risk patients likely to

need hospital support for enhanced capacity

management.

PROTECT

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Remote Patient Data Retrieval

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Ongoing Patient Education

Also available to download from NHSpatient.org is the Survival Guide to Coronavirus for Highest Risk Category Patients a simple but in-depth guide that educates patients on Coronavirus safeguarding.

These can be given out with repeat prescriptions, emailed to or downloaded by patients or posted.

Your Survival Guide to CoronavirusHighest Risk Category Patients

Important Advice to Keep You, or the Person You Care For Safe

Fully Integrated with:

STAY AT HOME!

www.nhspatient.org

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The COVID PROTECT interface has already been activated for the East of England Ambulance PROTECT interface currently empowering frontline paramedics in Norfolk.

Web based proactive patient specific clinical summary, patient medication summary and dynamic risk stratification alerts.

PROTECT – Integrated Ambulance Interface

Integrated Product Offering - PROTECT

The Right Patient Information at the Right Time

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Protecting Our NHS in this Time of Crisis.Reducing NHS Burden through Data Driven Clinical Excellence.

Proactive creation of PROTECT Management Plan

Identification of At Risk Patients within the population

Creation of

COVID-19 portal for

all high risk patients.

Allows easy

identification of

patients in need of

support.

Empowering effective

shielding and

support of vulnerable

individuals across the

population.

Reducing burden on

ambulance service,

A&E service and

hospitals.

Dramatic reduction

in the admission

rate of Coronavirus

patients in the

community.

Reduced load on

secondary care enables

improved capacity to

provide appropriate

clinical resources

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PS/BC/SC/11720/NTL/GB/a

Prescribing Services Ltd2 Regis PlaceKing’s LynnPE30 2JNEngland

Company No: 05913240

Data Protection Registration Number: Z2536678

© 2020Except as provided by the Copyright Designs and Patents Act 1988, no part of this publication may

be reproduced, stored in a retrieval system or transmitted in any form or by any means without

the prior written permission of the publisher.

NHS Digital Assurance with FRA certification NHS England Section 251 Accredited

Dr Julian Brown - GP, PCN Director and Clinical Lead Prescribing Services LtdJulian.brown@nhs.net

Steven Platt - IT Lead, Prescribing Services Ltdsteven@prescribing.org

Julian Young - Operations Lead, Prescribing Services Ltdjulian.young@prescribing.org

Through effective and intelligent integration of patient data from multiple settings, appropriate and compliant

data visibility and an outcomes-based validation the PROTECT Interface can transform the effectiveness of a

region’s COVID-19 outbreak response reducing admissions, protecting frontline clinicians and effectively utilising

home based healthcare workers / volunteers. This system is designed to integrate with and enhance informatics

from NHSE/I and NHSX to enable additional insight to be attained throughout the Coronavirus.

Summary

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COVID PROTECT