Delivering real-time, electronic communication between a patient and a provider.
The Connecting Care system interoperability programme was established to enhance patient pathways and outcomes in Bristol, North Somerset and South Gloucestershire.
The objective was to give clinicians and practitioners secure online access to integrated, up-to-date patient information, which would enable them to provide better coordination of care.
Stage one focused on unplanned and urgent care because, despite clear interdependencies between GPs, minor injuries units, out-of-hours providers, community and social care, emergency care and ambulance trusts, their IT systems remain largely unconnected.
What we delivered
In Bristol, North Somerset and South Gloucestershire (BNSSG) SCW has worked with Orion, the main system supplier for the Connecting Care Programme. The integrated digital care record unifies citizen information from across 18 systems into a single view.
We led the development programme and governance framework, lending expertise in Informatics, Transformation, Finance, Procurement and Communications. Our team directed the work of multiple project workstreams, managed the procurement of a technology partner, and coordinated the input of the participating organisations, which included acute hospital trusts, GPs, local authorities, community health providers and three clinical commissioning groups.
Through the projects we worked flexibly with each organisation’s distinct systems and data management practices, but also to their working preferences and desired level of input.
We delivered the first stage of the Connecting Care record programme so that unplanned and urgent care practitioners now benefit from better patient information at the point of care, including the patient’s medications, allergies, diagnoses, progress notes, radiology and pathology reports, referral history, inpatient and outpatient appointments, and end-of-life plans – all at the touch of a button without having to call the patient’s other practitioners.
Stage one was delivered on schedule and succeeded in providing shared-care records to improve unplanned and urgent care – a QIPP priority for local commissioners. Stage two has included broader clinician access, joint care planning and mobile access.
To encourage wider and continued use of the Local Health and Care Record (LHACR), we monitor and share usage information with key programme stakeholders. Together, we can then identify areas of poor uptake and plan how this should be addressed.
We can also monitor trends, which alert us to areas where, for example, usage was high, but is reducing. This would require a different type of intervention to explore the underlying causes and agree how these obstacles can be overcome. The figure below is an example of the kind of usage information that we share with the Connecting Care programme board in BNSSG on a monthly basis to highlight usage and uptake across partner organisations.
Connecting Care can now be accessed by 3,628 authorised professionals from a wide range of groups from GPs, nurses, occupational therapists, pharmacists, social workers, care of the elderly and out of hours to pathologists, anaesthetists, homeless health service, community discharge and emergency care staff. The number of records viewed per month is steadily growing, hitting 17,596 in January 2018. The programme is constantly adding new functionality and data sets. Initiatives currently underway include consolidated medication history and a Patient Demographic Service Spine cohorts interface to allow demographic changes to be updated in the Enterprise Master Patient Index more quickly.
Being able to draw immediately on a patient’s medical and social care history helps clinicians make quicker, more confident decisions and leads to safer and better care. Patient experience is improved as they no longer have to repeat their own information during what can be a stressful situation.
Early analysis shows that the main reasons for using the Connecting Care portal are to check medications, allergies, current conditions, diagnoses and other agencies providing care. The analysis also indicates that the portal helped prevent many calls to GPs, reducing pressure on primary care.
We successfully co-bid for an award from the NHS ‘Safer Hospitals, Safer Wards’ Technology Fund, which led to our appointment as an exemplar for digital care record integration.
For more information about Connecting Care, visit the Connecting Care website - https://www.connectingcarebnssg.co.uk/
Care Homes on Connecting Care and eRed Bag Information Governance Report
This report outlines the work and the outputs related to Information Governance from the ‘design’ stage of establishing Care Homes as partners within the Connecting Care Programme. The report includes input from key staff from Care Homes, NHS care providers, NHS Digital, Clinical Commissioning Groups, Patient representative groups and others. Much of this was engaged at a workshop in August 2019.
“The introduction of Connecting Care is like the introduction of radios in World War One.”
“I would just like to say how incredibly useful Connecting Care is proving to be… it represents a quantum leap for out of hours.” Clinicians, practitioners and pharmacists involved in stage one.
“It was amazing having this resource over the long weekend. I was able to access information about a patient’s usual insulin regime when she was severely unwell and not able to communicate with us”. Joanna Latimer, Pharmacist, North Bristol Trust