Next generation shared data: the Longitudinal Care Record

1. Next generation shared data: the Longitudinal Care Record Digital Primary Care Congress Presented by Laura Sato

2. Structure • Longitudinal Care Records (LCRs) • Context – Local Health & Care Records (LHCR) initiatives • Vision • Progress and plans • Digital First Primary Care Vision This Photo by Unknown Author is licensed under CC BY-SA-NC

3. 1. Longitudinal Care Records Context Vision Progress / Plans

4. Longitudinal Care Record Context – Local Health & Care Record organisations (LHCRs) are… regional coalitions of health and care organisations, working together with their local communities to deliver a new set of data services, for both care delivery and for local research and service analysis • … intended to enable • seamless and real-time data sharing across care providers for care delivery • citizen access and ability to contribute to their shared care data • the availability of rich care data for local population management and research first established (Wave 1) in 2018 each to receive £7.5m (capital) as a central investment to start-up, with matched local investment in the start-up period (first 2 years)

5. LHCRs – Wave 1 5 Wave 1 Exemplars Greater Manchester The Greater Manchester devolution Pop. 2.8m Exemplars engage with… Yorkshire & Humber West Yorkshire, South Yorkshire & Bassetlaw, Humberside and North Yorkshire Pop. 5.4m One London All of London Pop. 8.5m Thames Valley & Surrey Buckinghamshire, Berkshire, Oxfordshire and Surrey Pop. 3.2m Wessex Hampshire, Isle of Wight and Dorset Pop. 2.6m 5

6. LHCR Future Waves Wave 1 Greater Manchester One London Thames Valley & Surrey Wessex Yorkshire & Humber Cumulative Wave 1 – 22.5m. 41.6% Wave 2 – 11.06m 63.0% Wave 3 – 20.0m 100% Announced in 2018 Wave 2 Great North Care Record Share 2 Care (NW) One South West Mobilising Wave 3* Wave 3 delivery approach to be informed by Waves 1 and 2 Eastern West Midlands Remaining Areas that did not bid Subject to business case

7. Surrey Heartlands and East Surrey Thames Valley & Surrey (TVS) Geography = six care systems Frimley A coalition of health and care organisations, working together with their local communities. We serve a total population of 3.8m and include: 5 Integrated Care Systems 6 Global Digital Exemplars 3 Sustainability and Transformation Partnerships Buckinghamshire Oxfordshire Berkshire West Milton Keynes

8. The Longitudinal Care Record (LCR) is…

9. Bi-directional data flows in / out of the Longitudinal Care Record

10. Longitudinal Care Record Structured Data per the PRSB national ‘Core Information’ Standard V1

11. From the Thames Valley & Surrey LHCR: The other theme relevant for Primary Care is the generation of the key safeguarding data needed for Children’s social care teams, either by direct access to a report, or an automated report generated in the practice and then shared.    Primary Care will also benefit from access to ambulance and CHIS data, not currently included in most local shared records. “Primary care data is core, forming the basis of the longitudinal care record when integrated with acute, community, mental health, ambulance and social care data.  The new Longitudinal Care Records platform will support the role of Primary Care Networks and population health analytics – e.g. … excellent work has been undertaken in Frimley providing local and place based analytics linking data (predominantly in primary care) with well known data sources on mortality, admissions and other data sources that enable practices, PCNs and other grouping to measure their performance and provide data to enable gaps in care or poor performance against the norm to be identified and then action taken to improve.   Typically this will be used to better manage long term disease cohorts or ensure that targeted performance measures based on data can be introduced.   The population health management work of PCNs will be supported and benefit from use of the platform, accessed via each PCNs local shared record. 

12. 2. Digital First Primary Care Vision Slides from NHS England & NHS Improvement team

13. Digital first primary care – the vision What can patients expect? The NHS Long Term Plancommits that every patient will have the right to be offered digital-first primary care by 2023/24.  The use of digital channels will be at the choice of the individual patient, with those who can’t or don’t wish to use digital tools still able to access services over the phone or in person.  Patients should be able to easily access advice, support and treatment from primary care using digital and online tools.  These tools should be integrated to provide a streamlined experience for patients, and direct them to the right digital or in-person service for their needs. 

14. Digital first primary care – the vision In practical terms, patients should be able to use online tools to access all primary care services, such as receiving advice, booking appointments, having a consultation with a healthcare professional, receiving a referral, obtaining a prescription etc.  Access to appropriate services should be as easy to request and receive online as by phone or in person. Digital first primary care should also include providing clinicians with the information they need at the point of care to effectively support patients, relevant digital tools to allow services to be provided to patients (such as a consultation, prescription, referral etc.), and tools to support clinical and shared decision-making. 

15. The digital first patient journey Go online NHS App NHS.uk 111.nhs.uk Practice website Local Apps Patients are able to easily access and flow through primary care pathways using digital tools. A&E UTC Hub SIGNPOSTING Entry points Get advice, check my symptoms Secondary care referral  Outpatients Finding the most appropriate care pathway Get the right medical help (triage) Self Care Self referral Pharmacy Book appointments online View records online GP practice Order meds online Online messages Video consults

16. Online consultations – simplified patient journey SIGNPOSTING Check symptoms e.g. at NHS.uk Self care Pharmacy Online consultation Triage (automated or manual) A&E/UCC/111 Go online using your smartphone, tablet or computer Directed to the appropriate person in the Primary Care Team Prescription Referral Test Advice Messaging Face to face Response Telephone APPOINTMENT TYPE Video consultation Online appointment booking select time and date