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
0d 5d 8d 11d 7w 9w 12m 13m 24m 40m 4y 5y
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Public Health England
Per
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ealth
Pub
lic
Hea
lth CommissionersDirectors of Public Health & Children’s
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
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