Summary Care Record

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Summary Care Record

• Gary James Director of Informatics
• Tina White Programme Manager
• April 2009

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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 patients significant
  medical history.
• (Approx 240,000 records of this type now exist)

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Why ?

• 9 million patients approx are seen every year by
  OOH Services
• 18 million patients approx seen in AE, 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

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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 AE attendances
• Faster decisions to treat/admit/discharge in AE
• Reduction in face-to-face contacts in
  out-of-hours services

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• Principles of the SCR
• It will remain a Summary
• Only significant aspects of a persons 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

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Understanding Patient Choices - Do you want a
Summary Care Record? - Can I view your Summary
Care Record?
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Creating the RecordDo you want a Summary Care
Record?
YES
NO
Inform your GP Practice of your choice and no
record will be created
Using the Record Can I look at your 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.
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Creating the RecordDo you want to have a
Summary Care Record?
YES
NO
Inform your GP Practice of your choice and no
record will be created.
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Yes - I would like a Summary Care Record
or no objection raised
GP SUMMARY containing Medication, Allergies
Adverse Reactions plus other supplementary
data ADDEDTO SUMMARY CARE RECORD
Following the Public Information Programme the
patient has requested that a Summary Care Record
is created, or has raised no objection.
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.
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No - I dont want a Summary Care Record
GP SUMMARYcreated with NO clinical
datauploaded. A statement will appear stating
that the patient does not wish to have a
SUMMARY CARE RECORD. .
Patient has decided they do NOT want a Summary
Care Record to be created.
The patient can change their mind at any time by
contacting their GP Practice asking to have a
Summary Care Record created.
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Using the RecordCan I look at your Summary
Care Record?
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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.
The Patient can say Yes or No.
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.
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Informing Patients - the Public Information
Programme (PIP)
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PIP to SCR Creation
Dont do anything and one will be created for you!
Let your GP Practice know your decision and they
will record your choice in their system.
Following the end of the Public Information
Programme
PCT
Patient Information leaflet and PCT/ Practice
Letter
SCR CREATION
Yes I want a Summary Care Record
No - I dont want a Summary Care Record
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!
NHS Care Records Service Information Line 0845
603 8510

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

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Key Practice Requirements

• GP Practice must be IMT DES accredited
• GP system must be Full Rollout Approved
• Public Information Programme Complete

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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

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System One Journal View

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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

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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)

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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

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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

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QA www.connectingforhealth.nh
s.uk/systemsandservices/nhscrs/scr