The West Midlands Quality, Innovation, Productivity and Prevention Challenge To improve patient care we need to share i

2. The West Midlands Quality, Innovation, Productivity and Prevention Challenge To improve patient care we need to share information; Technology can help improve patient safety;

3. Patients trust in the professionalism and expertise of our Health Care Professionals to give us Best Possible Care

4. Patients’ PerspectiveMB ( Patient with SCR South Birmingham)

5. Public Information Programme All patients above 15yr 9months receive a letter Contents of letter Letter from PCT Chief Executive Summary Care Record Leaflet Opt out request form ( different languages) Freepost envelope

6. Ensuring confidentiality and access N3 network Smartcards/Role Based Access Control (RBAC) Legitimate Relationships Audit and alerts Professional and contractual controls

7. My Role

8. “Flying Blind” or …………

9. Actual case studies SCR identified that a actually had four allergies/adverse reactions when they thought they had none SCR used to see list of repeat medications that an elderly patient couldn’t remember – he was on 11+ SCR – Integrated system improving data quality due to PDS functionality enabling more accurate Out of Hours encounter notes to be sent more quickly and accurately to GP Practices SCR used to easily retrieve all the required details to refer the children of a patient with acute mental health illness to Social Services (the patient was unwell, worried about who would look after the children whilst in hospital but was unable to remember childrens details)

10. End of Life Care High up the agenda NHS Next Stage Review DH End of Life Care Strategy National Audit Office report Bury and Bolton are piloting using SCR to communicate end of life wishes and care. Perceived benefits include: Ability to deliver more appropriate informed care Reduced administration – paper forms, faxing End of life information communicated to a wider group of people via SCR viewer & Integrated Adastra The recent National Audit Office report into End of Life Care reviewed the delivery of End of Life Care. It identified a number of key issues: The majority of people approaching the end of life wish to be cared for and die in their own home. However, the majority of people actually die in hospital. Many people approaching the end of life are admitted to hospital unnecessarily. This is due to a lack of timely access to advice medication and other services in the community and a lack of information recording and sharing across agencies delivering care. In one PCT, 40% of patients who died in hospital had medical needs that could have been managed in the community. Many people receive inappropriate care because their wishes are not known or not recognised such as Do Not Attempt Resuscitation orders. The recent National Audit Office report into End of Life Care reviewed the delivery of End of Life Care. It identified a number of key issues: The majority of people approaching the end of life wish to be cared for and die in their own home. However, the majority of people actually die in hospital. Many people approaching the end of life are admitted to hospital unnecessarily. This is due to a lack of timely access to advice medication and other services in the community and a lack of information recording and sharing across agencies delivering care. In one PCT, 40% of patients who died in hospital had medical needs that could have been managed in the community. Many people receive inappropriate care because their wishes are not known or not recognised such as Do Not Attempt Resuscitation orders.

11. SCR Demo – Health Space Access http://www.healthspace.nhs.uk/

12. Use of the SCR in Out of Hours Dr Zahir Mohammed, GP at BARDOC (Bury and Rochdale Doctors On Call): “Summary Care Records are now starting to have an impact on the way we work making it much easier to find out key information about the patients we are treating and using this to provide improving standards of complete and safe care” Dr Rob Stokes, BARDOC Director of Clinical Governance: “Summary Care Records are an invaluable tool for doctors working in BARDOC. Even the basic information such as knowing what medication a person is taking is really very helpful. We often get patients who phone up who have run out of their ‘white tablets’ but the Summary Care Record can give us the exact details of the drugs we need to prescribe. “We are really starting to see the benefits for patients and for clinicians and as a result are accessing the electronic record more and more. It is without doubt a wonderful development that is improving patient care significantly in Bury.”

13. Use of the SCR in A&E Dr Chris Moulton, A&E Consultant, Royal Bolton Hospital: “The Summary Care Record is a great safety net for A&E staff who have only minimal information about some very challenging patients. It is definitely the way forward” Dr Kassim Ali, A&E Consultant, Fairfield General Hospital, Bury: "Since we’ve been able to view Summary Care Records, there is no doubt that sharing medical information between health professionals improves patient care.I believe that this system delivers real benefits for patients and I am proud that we at Fairfield General Hospital are leading the way with this exciting new technology"

14. Beyond end of life This approach can work for other patients too: Chronic health disease – asthma, diabetes Complex health and social care needs Vulnerable groups – dementia Surgical pre-assessment clinics, children's centres Department of Health (Dec 08): ‘The introduction of the Summary Care Record (SCR) will improve patient care, in particular for those with a long-term condition or requiring urgent care’

15. Mobile Working

16. Lessons learnt

17. Clinical Engagement Absolutely crucial to successful implementation Buy in Cooperation Ideas/input Local knowledge and understanding Ownership Benefits realisation

18. How – locally? A Clinical lead: Provide a link to clinicians Presence on the Project Board Provide clinical advice and input across the project including comms, documents, policy etc Clinical champion – give other clinicians confidence and reassurance, provide clinical ‘credibility’, have local knowledge, understand local demands, pressures and culture Provide a clinical reality check Need to ensure that the clinician offers advice across health providers and communities – not limited to their sphere of reference. GPs & their Practices: Local Medical Committee – have a member of the LMC on your Project Board End users: Walk in Centre teams, OOH clinicians, hospital pharmacists, clinical directors eg OOHs, other areas of potential benefit eg End of Life clinicians, Long term conditions, complex health & social

19. Clinical representation: NHS Care Records Service Board National Clinical Reference Panel – multidisciplinary, professional bodies represented Ongoing involvement by BMA, GMC, RCN etc How – centrally?

20. Implementation Process – NHS South Birmingham Engagement ( raising awareness) Data quality Concept training Technology readiness Public Information Programme ( raising awareness) Business Process design Implementation Benefits Realisation

21. Project Board Engagement with key stakeholders Patients LMC GP leads, Practice Managers A&E OOH Community Nursing, Local Acute trusts, Dental Hospital Connecting for Health SHA representation

22. Planning PIP/Staff Training Practice Toolkit Making sure all information up to date Up to date training & understanding of an ever-changing model initially Sessions with Patient Advisory Liaison Service (PALS) Officers are available at this surgery Call PALS on 0800 389 8391 Plasma screens …………………

23. FAQ’s