Sharing information to improve patient care in West Sussex

1. Sharing information to improve patient care in West Sussex Adrian Woolley Head of Strategic IT NHS Coastal West Sussex CCG NHS Crawley CCG NHS Horsham & Mid-Sussex CCG June 2014

2. Sharing information to improve communication & inform patient care Photo: sparkle glowplug

3. The 15 million people in England with long term conditions… their treatment and care absorbs 70% of acute and primary care budgets in England.

4. The issue…failure to provide integrated care Fragmented care:the healthcare system…not being considered in a whole system approach with social care… Lack of informational continuity:care records which can’t be accessed between settings... Reactive services, not predictive services:failure to identify vulnerable people who might then be given extra help to avoid hospital admission or deterioration / complications of their condition…

5. LTCs Admission Avoidance Proactive care planning Joint working between health and social care End of Life care

6. Care providers can have ‘silos’ of information held within their organisational boundaries Significant diagnosis DNACPR GP practice system Admission Avoidance DES Care Plan ECG Diabetes clinic In-patient discharge letter Hospitals Specialist nurse record Community Nursing Contingency Care Plan Dementia nursing Mental Health MH Crisis Plan Social Services visit daily Social Services

7. Care providers can have ‘silos’ of information held within their organisational boundaries Significant diagnosis DNACPR GP practice system Admission Avoidance DES Care Plan ECG Diabetes clinic In-patient discharge letter Hospitals Specialist nurse record Community Nursing Contingency Care Plan Dementia nursing Mental Health MH Crisis Plan Social Services visit daily Social Services

8. A real time Read Only viewer for use in direct patient Care, with Information derived from both Health and Social Care ROCI

9. Challenges for this type of project • The classics – stakeholder engagement etc x n2. • Information Governance, legal opinion • Data access. Paternalism • Commercial self interest of system suppliers • Finding care plans • Waiting for Spine 2

10. A Virtual IDCR Live data (no data warehouse) Live data (no overnight updates) Consent to view at point of need

11. Real time messaging to multiple systems – ‘send pertinent information for unscheduled care’ GP NHS No, Name, DoB Hospital Community Nursing Integration Engine and VIPER360 portal Mental Health RBAC Social Services Consent record for audit

12. What data could be available? From GP (via MIG): From Social Services: a patient summary problems diagnoses medication (current, past and issues) risk and warnings procedures investigations blood pressure measurements encounters, admissions and referrals patient demographics Main Address Current Address Placement Address Allocated Worker, Open/Closed Agency Providing Care Package Funded? Emergency Next of Kin details Does the Subject Have a Carer? Is the Subject a Carer? From Acute Trusts: From SCR: recent admissions & discharges EDD current meds allergies adverse reactions From care plan repository: From Community Trust anticipatory care plans LC open referrals

13. One place to find care plans = reduced conveyance by ambulance. OOH GPs A&E (ROCI) Ambulance Data readers Sussex wide care plan database NHS mail – special template GP Admission Avoidance DES care plans EoLC Plans Proactive Care Data sources

14. Live data from the GP clinical system Patient details Examinations Events Summary Investigations Problems Procedures Risks & warnings

15. Potentially useful in admission avoidance Recent tests Biochemistry ECG Haematology Imaging Microbiology Cytology Others Physiology Urinalysis

16. So where have we got to? • PIA and Information Sharing Agreement signed by relevant parties • Trust Interface Engine (messaging technology) installed and operational. • Several practices signed up to supplying data (MIG). • Pull of MIG data through system tested and working. • Social Services record to include NHS numbers Next steps • Turn on integration to Social Services data • Turn on integration to Care Plan repository • Clinical safety sign off • Pilot go-live at A&E

17. Potential other applications of the technology • Discharge planning / Alerting • Hospital in-reach • Planned Care

18. Thank you adrian.woolley@nhs.net Photo: garryknight