Summary Care Record

Gary James – Director of Informatics

Tina White – Programme Manager

April 2009

What is a Summary Care Record?

The SCR is an electronic summary of key health information. It will hold limited essential information derived initially from the patients GP Summary. This will include medication, adverse reactions, allergies and a patient’s significant medical history.

(Approx 240,000 records of this type now exist)

Why ?

• 9 million patients approx are seen every year by OOH Services

• 18 million patients approx seen in A&E, Minor Injury Units per annum

• 40% of emergency calls attended result in admission, whilst at least 50% of these could be cared for at the scene or in the community

• 1 in 16 hospital admissions are the result of an Adverse Drug Reaction (72% avoidable)

• Adverse Drug Reactions as a cause of hospital admission, cost the NHS £466m pa

What are the benefits‘better, safer clinical care’

Clinician benefits • Improved appropriateness of clinical care • Faster recognition of critical clinical need • An end to "flying blind" with access to medical history for confused or

non-verbalising patients

Patient benefits • Treated faster in the most convenient setting• Care can be provided closer to home• No need to repeat clinical history

Service benefits • Reduction in emergency admissions• Reduction in A&E attendances• Faster decisions to treat/admit/discharge in A&E• Reduction in face-to-face contacts in out-of-hours services

Principles of the SCR:

• It will remain a Summary

• Only significant aspects of a person’s care

• Key items will be added in time

• Initially created via GP uploads

• Patients access via HealthSpace

• A patient will be asked before their record is accessed, except in certain circumstances

Understanding Patient Choices

- Do you want a Summary Care Record?- Can I view your Summary Care Record?

Creating the Record:Do you want a Summary Care Record?

*In an emergency where you are unable to be asked, or certain medical/legal circumstances (such as court order) the clinicians involved in your care may access the record without asking. Any such actions will be recorded for investigation.

Do nothing and a record will be

created for you

Inform your GP Practice of your choice and

no record will be created

YESYES NONO

Using the Record:Can I look at your Summary Care Record?

When you present for care, you will be

asked* if your record can be viewed.

Creating the Record:

Do you want to have a Summary Care Record?

YESYES NONO

Do nothing and a record will be

created for you.

Inform your GP Practice of your choice and

no record will be created.

Following the Public Information Programme

the patient has requested that a Summary Care

Record is created, or has raised no objection. SPINESPINE

PSISPersonal Spine Information Service

PDSPersonal DemographicService

Yes - I would like a Summary Care Record or no objection raised

Patient’s Data:

Medications, Allergies& Adverse Reactions –

followed bysupplementary datato enrich the GP element

GP SUMMARY containing

Medication, Allergies & Adverse Reactions plus

other ‘supplementary’ data ADDED

TO SUMMARYCARE RECORD

A record will be created containing medication, allergies and adverse reactions, followed by

any other relevant supplementary data to

enrich the content of the Summary Care Record.

SPINESPINE

PSISPersonal Spine Information Service

PDSPersonal DemographicService

No - I don’t want a Summary Care Record

The patient can change their mind at

any time by contacting their GP Practice asking to have a Summary

Care Record created.

Patient has decided they do

NOT want a Summary Care Record to be

created.Message statingpatient has requested that no recordbe created

GP SUMMARYcreated with

NO clinical datauploaded.

A statement will appear stating that the patient

does not wish to have a SUMMARY

CARE RECORD..

Using the Record:

Can I look at your Summary Care Record?

When you present for care, you will be

asked* if your record can be viewed.

Can I look at your Summary Care Record?

When a patient presents at a care setting, they will be asked* if their

Summary Care Record can be viewed to ensure appropriate

treatment is provided.

*In an Emergency, where a patient is unable to be

asked, a clinician can look at the record without asking

the patient. All such actions will be

recorded for investigation.

The Patient can say “Yes” or “No”.

Informing Patients

- the Public Information Programme (PIP)

PIP to SCR Creation

Practice meets all Data Quality and Technical requirements and

Authorised to ‘Go Live’

Following the end of the Public Following the end of the Public Information Programme…Information Programme…

NHS Care Records Service Information Line0845 603 8510

•Care Record Guarantee Leaflet•www.nhscarerecords.nhs.uk

FP69

Patient Information leaflet and

PCT/Practice

Letter

Patient Information leaflet and

PCT/Practice

Letter

SC

R C

RE

AT

ION

I need some time to think about this…

What are my choices?

What should I do?

Where can I get some

more information

?

Decision made!

Patient

Yes – I want a Summary Care Record

Don’t do anything and one will be created for you!

No - I don’t want a Summary Care Record

Let your GP Practice know your decision and they will record your choice in their system.

Key Practice Requirements

• GP Practice must be IMT DES accredited

• GP system must be Full Rollout Approved

• Public Information Programme Complete

There are 4 ways to access the SCR

• The Summary Care Record Application (SCRa)

• 1 Click Access from a compliant local system

• A fully integrated view from a compliant local system

• HealthSpace advanced account

Security

• Smartcard, the function on the smartcard, clinical need

at that time (RBAC)

• Requires 2-stage log-in ie. password, and grid-reference

System One Journal View

SCR Implementation Next Steps

There will be an Early Adopter model for:

• SCR clinical content from 3 clinical environments

- Inpatient Discharge Summaries

- Emergency Department Reports

- Outpatient Clinic Letters

Future SCR Implementation (tbc)

• Clinical contributions will be supported from a wide range of care settings including:

- Ambulance Service Patient Reports

- Mental Health Documents

- Diagnostic Imaging Reports

- Admissions Report

- NHS Direct Documents

• Central Medication Record (possibility being explored)

SCR in Lincolnshire

Pilot at Market Rasen

• 8 weeks into a 16 week PIP• 21 public information events planned, 11 completed• 9250 patients mailed• 117 opt outs to date (1.25%)• Practice ‘goes live’ 16thJune 2009

The Next Steps

Phase 2 Roll Out

• Possible total of 102 GP Practices

• System and Data Quality compatibility

• Phasing of Practices to be decided

• Training of Secondary and Emergency Care users of SCRa

Q&A

www.connectingforhealth.nhs.uk/systemsandservices/nhscrs/scr