Digital ProgrammeUpdate

Industry Briefing13th December 2016

Child Health and Maternity Services

IntroductionTracey GraingerHead of Digital Child Health NHS England

Healthy Children – what is our vision ?

‘Knowing where every child is and how healthy they are’

‘Appropriate access to information for all involved in the care of children’

Why focus on children’s health and information?

Public Health England and the NHS Outcomes Framework 2015/16 stress that a focus on children’s health is essential and that we should be striving to provide the best start in life possible for our children.

The recent National Maternity Review has highlighted that this begins not just with the newborn child but with the mother’s experiences in pregnancy and the birth itself.

The importance of ensuring this good start for the future health of children for the sustainability of the NHS and the economic prosperity of Britain is one of the key themes of the Five Year Forward View.

We need to redesign information services to support the new emphasis on:

• the importance of early interventions and preventive measures • integration across different care settings, particularly joining up maternity and newborn care• the need to enfranchise children, young people and parents as equal partners in their care.

We also need to take on the challenges posed by the current organisation of information services.

Whole environment transformation

www.england.nhs.uk

Linking Programmes to Outcomes

Whole system governance

Digital Child HealthTom BurnettProgramme ManagerNHS Digital

What will this mean for suppliers ?

New information services for parents, families, carers, children and young peopleGrowth in the market for personal health records and apps

New information services for professionalsGrowth in interoperability between professional health record systems and personal health records, new lightweight professional applications

New information services for public healthGrowth in population health management tools and analytics

We need to overcome current challenges

National Personal Child Health Record (PCHR) still on paper.

Limited capability to manage children unregistered to GPs and offer them preventative services.

Deficiencies in managing local populations highlighted by National Incident Team report, children at risk of missing out on preventative services.

Healthcare professionals don’t have access to a core summary of child healthinformation, records are fragmented across systems.

Closure of LSP programmes left funding and accreditation gap for CHIS IT.

Services still very paper driven and manually intensive.

How – by introducing digital basics

Access to key child health data at the point of care

Interoperability to allow data sharing between health and care professionals

Patient empowerment through the use of personal health records

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Public Health England

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Pub

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Services

Delivery of Healthy Child Programme(All Children)

Delivery of all other care services (Some Children)

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

CHIS / CHRD

School NursingPrimary CareHealth VisitingMidwifery

Education ServicesVoluntary ServicesMental Health Services

Emergency & Acute Services

Justice ServicesSocial ServicesCommunity ServicesNeonatal Services

Maternity Information Systems

Screening Information Systems

Primary Care Systems

GPESCYP Dataset CAMHs Dataset

PCHR

90CHRDs

Research & Policy

Maternity Dataset

SCR

National Audit

Delivery Timeline

Years 1-3 Years 4+

Healthy Children – where do we start?With the basic building blocks:

A first layer of essential child health information for exchange

A first phase of systems exchanging that information - Maternity, Child Health GP systems and Personal Child Health Records

A roadmap for growing the scope and sophistication of the information exchange

Adding in new services as they become available, for example, national Failsafe for Healthy Child Programme

Test Assumptions

Trial New Methods

Deploy New Services

March 2017

1st layer of child health information

Q: Can events be standardized for exchange rapidly?

Trial 1st layer information in eRedbook (London)

Yes Content Agreed

Yes

Collaboration on standardization

Q: Can this standard be widely supported?

Events Catalogue for child health information created

Q: Can systems be modified for interop

Yes

Potential to deploy new PCHRs with standard content in other regions

June 2017

Systems development

Yes

Q: Trial a success?

National events management service ready to go-live

Interoperability between CHIS, Maternity, GP systems and PCHRS begins

Mar 2018

Enabling essential information exchange Why? So there is a core record of a child’s health and development available

to professionals and to parents to assist in diagnosis and treatment

How do we decide what is essential? We use what is already agreed as being essential to the foundation of a child’s health:

• By the Royal College of Paediatrics and Child Health – the Personal Child Health Record (PCHR) owned by parents

• By Department of Health – the Healthy Child Programme

• By commissioners – the Maternity and Children and Young People’s Datasets

This is only the first layer of interoperability, other events messages will be designed through a design authority and new publishers and subscribers to those events will be accredited through a registration authority.

33 events in first interop layer

17

Maternity Screening Health Visiting Primary Care School Nursing Personal Other

E1 Birth Details E2 NIPE

E3 Blood Spot

E4 Hearing

E5 New Baby

ReviewE6 Imms

E7 6-8 Wk Review

E8 6-8 Wk Review

E9 Height & Weight

E9 Height & Weight

E9 Height & Weight

E9 Height & Weight

E9 Height & Weight

E10 Vitamin K

E11 1 Year

Review

E12 Conditions

E13 Special Needs

E14 Allergies and Drug Reactions

E12 Conditions

E14 Allergies and Drug Reactions

E14 Allergies and Drug Reactions

E15 Accidents & Injuries

E15Accidents& Injuries

E17 Family

Conditions

E18 2/2.5 Yr Integ Review

E16 Family

Relationships

E18 2/2.5 Yr Integ Review

E19 School Entry Check

E20 Professional Advice

E20 Professional Advice

E20 Professional Advice

E20 Profession

al Comment

E22/33 Hep B/ BCG

Indicated

E23 Responsible Professionals

E23 Responsible Professionals

E23 Responsible Professionals

E23 Responsible Professionals

E24 Address Add or Change

E24 Address Add or Change

E24 Address Add or Change

E25 Interpreter Required

E25 Interpreter Required

E6 ImmsE26 Rest of NIPE

E27 Breast

Feeding Status

E28 Developm

ental Firsts

E29 Teeth

E30 Parental

Comment

E31 Personal Comment

E32 ‘About Me’

Event recorded

once

Multiple Events across

Systems

Year 12017

Phased Information Exchange

Healthy Child

Programme

PCHR (Red book)

CYP MDS

Maternity MDS

CAMHS MDS

SEN Dataset

Asthma Dataset And many

more. . .

Turning secondary uses datasets into primary uses messages to support point of care decisions initially

Diabetes Dataset

Year 32019

Year 52021

Year 12017

Phased interoperability between systemsYear 32019

Year 52021

CHIS

Screening

GP

Maternity

Mental Health

Social Services

A&E & Acutes

Education

And many more. . .

Prove interoperability on tight scope, then extend interoperability and events to other systems, domains

PHRSChild &

Maternity