NHS NPfIT Clusters

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Care Records Service Vision

• Working together we will deliver the worlds
  best healthcare system.
• We will establish a safe, secure and
  cost-effective integrated health records service,
  empowering NHS staff to deliver the highest
  quality of patient care. This will enable a step
  change in healthcare provision.

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NPfIT Deliverables

• Infrastructure
• National approach to authentication, security and
  confidentiality
• Electronic booking
• Electronic transfer of prescriptions
• Integrated Care Records Service

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Projected Benefits
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Patient Journey Pre CRS
Told date/ visit
Arrange/ visit
Told date/ visit
Arrange/ visit
Told date/ visit
Arrange/ visit
Patient
Further tests
Further diagnosis
Initiate treatment
GP
Referral
Database / Manual records
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Patient Journey Post CRS
Patient
GP
Referral
Database / Manual records
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Focus on the care continuum

• Beds or no beds, consistent patient care

Clinics
Hospitals
GP surgeries
Patient bedside
Doctors homes
Interoperability
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Benefits of the LSP Programmes
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Benefits come from various sources ....
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NHS NPfIT Clusters
From www.e-health-insider.com
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The London Cluster

• 5 Strategic Health Authorities
• 7.2m People
• 32 Acute Trusts
• 10 Mental Health Trusts
• 1,660 GP Practices in 31 PCTs
• Total Potential Users 195,000
• 4,600 GPs
• 15,000 Practice Staff
• 5,400 Consultants
• 10,400 Other medical staff
• 130,000 Non-medical
• 30,000 Social Services

NC
NE
NW
SE
SW
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The Capital Care Alliance
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The Southern Cluster
Thames Valley
Avon Glos Wilts
Kent Midway
Hants IOW
Dorset Somerset
Surrey Sussex
SW Peninsula
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The Fujitsu Alliance
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The Fujitsu Alliance
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Local Service Providers and NPfIT
LSP South West, South East Fujitsu Alliance
Local Service Provider London BT
LSP North West West Midlands CSC
LSP North East, Yorkshire Humberside Accenture
LSP East Midlands, East of England Accenture
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London LSP Architecture
CCA Gateway Portal
CCA Gateway Portal
IDX ICRS
Niche Systems
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Key Milestones
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What can New Zealand learn?

• Integrated regional system
• National spine and transferable records
• Strong authentication of users
• Choose-and-Book (eBooking)
• Best Practice Process Design
• Sealed envelopes
• ePrescribing

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Best Practice Process Design
What must the
What must we do
What must the
What must we do
system do for us
differently to gain
system do for us
differently to gain
Best Practice
Best Practice
Best Practice
Best Practice
Process Design
to be able to do
the most benefits
Process Design
to be able to do
the most benefits
Process Design
Process Design
our job?
from the system?
our job?
from the system?
Informing the
Informing the
Informing the
Informing the
design
design
design
design
of the system
of the system
of how we work
of how we work
Standardised customisation
Local Process Redesign /
Standardised customisation
Local Process Redesign /
of the system build for London
Change Management
of the system build
Change Management

clinical need

local flexibility?

clinical need

local flexibility?

national mandate

case for change

national mandate

case for change

system constraints

ownership

system constraints

ownership
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What needs to be done?
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Best Practice Approach
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• Sealed Envelope Principles
• Some investigations are sensitive before
  resulted
• Patients may give or remove consent for data
  unsealing at any time
• Patients may give consent for all data to be
  unsealed
• The Clinician may need to make the patient
  aware of the potential clinical implications and
  risks of their request

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• Sealed Principles (contd)
• Users will know if there is sealed off data
  from any system
• The Patient may not select to seal data whose
  absence may lead to the degradation of the Care
  Process
• The Clinician has veto on the restricting of
  data e.g. where there is risk to others

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Different Scenarios
Radiology Reports P1R2 Pathology and
Radiology Requests P2R1 Sealed Envelopes
P2R2
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Programme Approach