Caring and Sharing: Back to the Future

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Caring and SharingBack to the Future

• Lewis Ritchie

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Small men..cannot handle great events

• General Charles de Gaulle

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Office
Lewis Ritchie MBChB etc.
General Practitioner, Professor etc
(and still a disappointment to his mother)
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Back to the Future

• Reflecting back and looking forward
• Vision, values and leadership
• Opportunities and obligations
• The future - a word of encouragement

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Reflecting back.and looking forward
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Guiding principles

• Patient centred care patient centred records
• Electronic records only practicable option as the
  way forward
• Patient and health professional needs main
  drivers - not available technology
• Imperative of strong clinical leadership and
  professionalism

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Guiding principles

• Universal CHI - key for successful record linkage
  journey of care
• Cultural change and confidentiality concerns
  likely to be ultimate obstacles - not
  technological constraints
• Predictions of rapid progress are likely to be
  elusive (or even illusory)

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Prove all thingshold fast to that which is good

• The imperative of evaluation establishing
  resilient models, sharing success and the
  avoidance of duplication of effort

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These are my principlesif you do not like
them, I am prepared to find others

• Marx

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Looking forward..
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Policy context

• Primary care remarkable and relentless change
• Multiprofessional, multidimensional and evolving
  rapidly
• Patient-centred care patients as partners - a
  shared endeavour

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PG eHealth implications for primary and
community care

• Efficient and effective flows of information to
  support whole patient journey
• - including links with partners - principally
  Local Authorities and the voluntary sector
• Information to support anticipatory care
• Information to support patient involvement

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PG eHealth Strategy What might be new?

• (Long) list of desirable options cant all happen
  resource and capacity constraints.
  Implication whats desirable may not be
  deliverable
• Prioritisation needed, and the levering of real
  benefit from previous investment
  Implication Playing to
  strengths, avoiding duplication, sharing best
  practice

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A patient centred service the journey of care
In the past organisational and perceptual
barriers have separated primary and secondary care
CH, RGH, DGH
Patient enters hospital
Patient Home
Available as and when required
NHS 24
Specialists 65 Specialties GPwSI
Health information etc
Primary Care
Diagnostics
Sexual Health Services
Mental Health Services
Pharmacy Dentistry Optometry
Emergency Care
Community Care
GPs GPwSI Practice, District Nursing, Health
Visiting, AHPs
Source Carol Black (modified), 2006
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Strategic Fit with NHS Scotland eHealth Strategy

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DARTS
SCI-DC NETWORK
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Vision, values and leadership
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Without vision, we perish without values, we
decaywithout leadership, we lose our way
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Dr Ronnie Graham Professor James Crooks
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October 1978

• A uniform method for indexing patient records in
  primary and secondary care will transform
  services and research, leading to a more
  integrated approach to health care.

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Vision, values, leadership

• Traditional boundaries of care demarcated by
  sectors of provision - must give way to
  integrated care, focused on the patient
• Primary and secondary care the language of the
  past?

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.and the leadership thing?
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essentialin partnership with technical and
other health professional and administrative
support staff the team
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TF RCN Scotland IT initiatives

• Continuing to modernise
• Applying the lessons from e-health agenda
• Developing knowledge management for RCN Scotland
• Working with RCN UK to improve the RCN website
  and online resources

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Opportunities Obligations
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Opportunities.
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Opportunities

• Clinical care and new model developments
• Educational endeavours developing our staff
  etraining, eLibrary etc
• Research and development shaping our future

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Knowledge Management Cycle
NMAHP KMS
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Equity a principle that holds good for health
professionals as well as patients
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Obligations..
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a romp through issues of consent,
confidentiality and security..

• Professor Sir Brian Robson

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BR tried to persuade us that..

• (Information Governance) rules are important
• We need to be more aware of them
• We may not need more
• We need to do things differently in future
• We need to (re)gain the trust of our patients

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FF reminded us of the importance of the
clinician-patient relationship

• Essential humanity
• Intimacy
• Safety
• Truthfulness
• Mutual understanding
• Workable consent for information sharing

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..The nine most dangerous words in the English
language areIm an academic and Im here to
help you

• Professor Phil Hanlon (modified)

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The futurea word of encouragement
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Q What does this represent?
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Much has been achievedthere is much still to
do
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Unless we share information reliably we cant
care optimally
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That will require high quality leadership,
professionalism and commitment at all levels
aligned to realistic, planned investment in
training and technical infrastructure
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So,in conclusion
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One must wait until the evening to see how
splendid the day was

• Sophocles

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Packing it all in..
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Thank youfor listening
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Final Guiding Principle

• Do unto others as you would have done unto
  yourself..

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- Caring For Children In Need -
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