The Go-Between Seasons Greetings! Issue 73 December 2006

http://london.assist.org.uk/resources/resources.htm
The Go-Between
Information for Information Users
Seasons Greetings!
The Go-Between wishes its readers a very happy
Christmas and a prosperous 2007!
The Go-Between would like to hear from potential
contributors. Articles should be on IM&T related matters
and around 250-400 words in length. Copy deadline for
Issue 74 is 20 January 2007.
For contributions etc. please write to the Editor
(address on back page).
____________________________________________________
In This Issue
Care Record Service in London
Care Record Service in the South
Diary
Every Child Matters
News in Brief
Secondary Uses Service Update
____________________________________________________
Every Child Matters
Every Child Matters is a Government initiative aimed at
improving outcomes for children and young people so that
every child achieves their potential. It involves changes to
culture and practice, shifting the focus from dealing with the
consequences of difficulties in children's lives to early
intervention and effective prevention. Every Child Matters
sets out a children's trust model for whole-system change,
with integrated frontline delivery, processes, strategy and
governance.
Issue 73 December 2006
Integrated working focuses on enabling and encouraging
professionals to work together and to adopt common
processes to deliver frontline services coordinated and built
around the needs of children and young people.
To support local change programmes a set of tools has
been developed, including the following:
1. Information sharing
Guidance and case studies for practitioners across
children's services on when, why and how they can share
information, as well as tools to support the development of
a framework for information sharing.
2. Common Assessment Framework
Guidance, training and other supporting materials to help
practitioners assess children's additional needs for services
earlier and more effectively, develop a common
understanding and agree a process for working together
3. Working Together to Safeguard Children
A revised version of clear procedural guidance, setting out
how organisations and individuals should work together to
safeguard and promote the welfare of children
4. Common Core of Skills and Knowledge
A specification of the skills and knowledge required by
practitioners who work with children and young people.
5. Children's trust pathfinders
35 pathfinder authorities have been created to test the
ideas behind children's trusts and to help design the policy.
Progress is being independently evaluated over three
years, covering pathfinder and non-pathfinder areas.
6. Information sharing index
In the longer term, the national information sharing index
will enable practitioners delivering services to children to
identify and contact one another easily and quickly, so they
can share relevant information about children who need
services. This is due to be implemented across all areas of
England by the end of 2008.
7. Information sharing and assessment update
A regular newsletter providing updates on the information
sharing and assessment work programme
8. Supporting integrated working: training materials
An outline strategy and plan for designing and delivering
training on integrated working processes and tools with
details of the core modules which have been developed.
The plan also shows how these materials can be structured
into programmes for different audiences.
An article in the next issue of The Go-Between will focus
on the Information Sharing Index.
More Information:
www.everychildmatters.gov.uk
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Secondary Uses
Service (SUS) Update
undertaking a detailed planning exercise in order to agree
the delivery and implementation of the SUS functionality.
The contract with McKesson for the provision of NWCS
services has been extended to the end of December 2006
in order to support the transition to SUS.
The Secondary Uses Service (SUS) as the name suggests
provides a facility to interrogate data derived from the Care
Record Service and existing patient based systems. The
primary use of the data being to provide care; secondary
uses include commissioning, epidemiology, service
planning, service management, research and development,
financial management and public accountability.
SUS will be the live source for all CDS and PbR data from
January 2007.
The CFH Secondary Uses Service (SUS) was introduced
during 2005/06 and used to pilot the production of 2005/06
Payment by Results (PbR) extracts in shadow mode
alongside the NHS-wide Clearing Service (NWCS). For
2006/07 SUS provides the live source of the PbR extracts
to the NHS.
Care Record Service
in London
Over time SUS will manage and provide access to a wider
range of data in addition to Commissioning Data Sets
(CDS), including demographic data from the Personal
Demographics Service, extracts from Choose and Book
and details of electronic prescriptions. On-line access to
analytical tools and services will also be available to
support research. SUS will also include data from nonpatient based sources (e.g. ONS (Office of National
Statistics), workforce data) and manage data extracted
from the NHS Care Record Service relating to all the care
provided within a care pathway, irrespective of setting.
More information:
www.connectingforhealth.nhs.uk/sus
____________________________________________________
The contract for the Care Record Service in London was let
to BT in 2003, with IDX as the main software partner. The
contract has since been renegotiated to provide a different
portfolio of products.
BT put forward a revised strategic proposal for London
which identified three main suppliers /products for each of
the sectors:
•
Cerner “Millennium” – Acute Services
•
CSE Servelec “RiO” – Community
•
CSE Servelec “RiO” – Mental Health
•
InPractice “INPS Vision 4” – Primary care
The information within SUS will be available in anonymised
or pseudonymised form; rigorous access controls will
enable on-line access to the NHS and to other related
agencies and health organisations. SUS will provide
facilities for quality reporting, standard analyses, user
analysis, and extraction.
This proposal represented a significant move away from
the original vision of a single instance / single solution
across all care settings. To address this, BT will use an
“integration layer” - to be delivered as two separate
releases (IR1 and IR2) - to allow information from the three
“products” to be shared within and across the care settings.
Approval has been given by the Patient Information
Advisory Group (PIAG) under Section 60 (of the Health and
Social Care Act 2001) to operate SUS to store and process
person identifiable data in order to support health care
processes. PIAG set conditions on the use of SUS,
including the scale of use, as well as information
governance including the access and handling of patient
identifiable data.
These conditions will be part of
forthcoming detailed guidance on user access and
information governance.
Two Integration Releases are planned,
components of which are summarised below.
The next release of SUS will replace the NHS-wide
Clearing Service (NWCS).
The release will support
functions currently provided by NWCS, including:
o The provision of all current Commissioning Data Sets
(CDS) to commissioners;
o The provision of Value Added Extracts to authorised
users;
o The creation of the Mental Health Minimum Data Set
(MHMDS) extract to the Department of Health; and
o The creation of the Hospital Episode Statistics (HES)
extract for the Department of Health.
SUS will support future enhanced requirements defined
through Data Set Change Notices (DSCN). Included in the
next release will be the introduction of the Critical Care
Minimum Data Set (CCMDS). It will also enable the
migration of CDS from EDIFACT to XML format and
MHMDS from flat file to XML in line with DSCN 24/2004.
These are the formats for submitting data.
The first priority for SUS for 2006 has been to meet the
requirements to support Payment by Results in 2006/07.
This release is known as 2006-A. Following this, the next
priority is to enable the replacement of NWCS by SUS. To
that end, NHS Connecting for Health and BT have been
the
main
Integration Release 1 (IR1) – End of 2008
The first release supports the following functions:
o Text-based GP Summary style record;
o Single text record prepared and updated by the
patient’s GP;
o Text-based referral, discharge, and assessments;
o Level 2 Decision Support / Alerts;
o Electronic results;
o Electronic scheduling request to other care-settings;
o GP System tracks care setting.
Integration Release 2 (IR2) – End of 2009
IR2 supports:
o Multiple Provision of Care style entries
o SNOMED coding with supporting text where necessary
o Level 3 Decision Support
o Electronic ordering
o Electronic scheduling of requests to other caresettings with coded data
o Integrated Care Pathway Functionality
Key integration issues still to be worked through include:
o Understanding the differences and benefits between
what is being offered via BT’s London integration layer
and what is available through national applications i.e.
the “Spine” and Choose & Book
o Definition and viewing of key event data for community
and mental health across different instances of RiO
o Resolution of confidentiality issues, governing
information-sharing
o Ability to incorporate information (e.g. problem lists)
into the patient record
o Viewing of the longitudinal record
o
o
o
Common look and feel of the applications, and their
alignment with the Common User Interface programme
Clinician review of messaged data prior to
“acceptance” into the patient record
Integrated Care Pathways and scheduling within and
across care setting.
A development path is emerging for the different
applications. Cerner “Millennium” will follow a similar path
for acute trusts as in the Southern Cluster (see below).
RiO (Community) and RiO (Mental Health) will have new
version upgrades in 2007, 2008 and 2010.
Future RiO developments include: electronic prescribing,
the inclusion of Snomed Clinical terms, bed planning and
scheduling, order communications, decision support,
financial management, results receipt and storage, and
Integrated Care Pathways.
More information:
www.connectingforhealth.nhs.uk/regions/london
____________________________________________________
Care Record Service
in the South
The contract for the Care Record Service in the South (the
Southern cluster - stretching from Kent to the Scillies and
as far north as Oxfordshire) was let to Fujitsu in 2003.
Fujitsu since changed its main software partner from IDX to
Cerner.
The approach to building the Care Record Service in the
Southern cluster is to implement the Cerner Millennium
product in all care settings outside of General Practice in a
series of releases, each providing additional functionality
over its predecessor.
Starting at R0, Trusts will
automatically upgrade to R1, R2 and R3 as they become
ready for the new technology.
R0 (Release 0)
This is the foundation for all of the other releases. It meets
the requirements that are necessary to manage patient
records and includes: Choose and Book, patient index,
clinical workstation (PowerChart), partial booking, case
note tracking and clinical coding. The clinical functions of
R0 cover assessments (vital signs), order management
(laboratory and radiology orders), result viewing, discharge
summaries and clinical notes. There are department
modules for Maternity, Accident & Emergency and
Theatres.
R1 (Release 1)
As well as enhancements to the R0 PAS, this release
supports administrative processes in mental health and
community environments, bed management, and
outpatient scheduling. The PAS solution adds statutory
Mental Health data items to the standard PAS such as the
Mental Health Minimum Data Set and basic support for
Mental Health Act Administration.
The clinical functionality in R1 can be used in all settings
delivering a broader range of orders and documentation
including: Allied Health Professionals orders, dietary
orders, nursing orders and additional assessment forms.
This release supports care pathways and is designed to
facilitate comprehensive multidisciplinary planning and
coordination of care for the patient. Features include:
problem-driven plans of care and clinical outcomes. R1
also includes further enhancements to the Theatres
module.
R2 (Release 2)
This release provides for the first stage of compliance to
the National Spine. The patient administration features are
further enhanced including the provision of a full diary and
appointment service and the scheduling of resources
against the care plan. Clinical functionality includes:
o prevention, screening and surveillance
o Caseload Management
o extension of Community content
o more (complex) care pathways supported, and
o decision support driven plan selection
The R2 release includes further enhancements to the
Maternity, Theatres and Accident & Emergency modules.
The Prescribing module will cover the main prescribing and
administration functions and decision support.
R3 (Release 3)
The last release will provide the next stage of compliance
to the National Spine. Clinical functionality in this release
includes:
o rostering
o decision support to determine appropriate care
professional
o graphing of events and numerical data
o notification of assessment event
o risk assessment
o equipment ordering
o bedside medical device Integration
o diabetes screening, scoring and care planning
o cancer screenings and care support
o coronary heart disease patient management
o assessment care planning and care management for
older people.
o Child and Adolescent Mental Health Services
specialist requirements
o care management of renal patients
o extended administration of the Mental Health Act
o professional and carer relationships
In R3 additional access mechanisms will be available to
community health care workers.
Community care
professionals working within acute trust settings will have
access to the same application sets provided to the acute
trust workers, where security allows.
Privileges and
preferences will be configured to accommodate the needs
of community care workers.
On-line access to the community solution set will be
available where there is access to Citrix and the N3
network (e.g. within GP practices, community hospitals and
clinics). The applications accessed in the community
setting will be designed and built to meet the workflow and
content of the community and mental health care workers.
It is feasible that the community solution could be accessed
from the patient’s home where there are appropriate
hardware and network facilities. An offline access - a point
of care solution - will be available for those healthcare
professionals who regularly work in settings that do not
have access to either Citrix or the N3 network. The offline
solution will allow users to download a defined set of
patient data relevant to their caseload for the day. The
care professional will be able to record clinical
documentation and place non-pharmaceutical orders using
mobile devices and synchronise with the live database
overnight.
The Maternity, Theatres and Prescribing modules will be
further enhanced in R3.
More information:
www.connectingforhealth.nhs.uk/regions/southern
____________________________________________________
News in Brief
Forensic Computing Unit
The Forensic Computing Unit provides rapid responses to
fraud investigations as required, and provides a low cost
preview service to allow users to examine files on a
machine in a forensically sound manner. IT staff are often
requested to examine computers or server folders
belonging to a suspected user. They should be aware of
the correct procedures to follow where they are able to
complete the request, and the limitations of what can be
done in a non-forensic manner. See new web site:
http://www.forensic-computing.nhs.uk.
Information Sharing Plan
The Government has announced its plans to bolster
information sharing between public services in order to
increase opportunities for society's most disadvantaged.
The information-sharing statement, which was published by
the Department for Constitutional Affairs, will work
alongside the Social Exclusion Action Plan recently
launched by the government. The statement sets out a
vision for better, more customer-focused services
supported by greater information-sharing which will protect
and support individuals and society as a whole. Next April,
the government will publish a more detailed plan for
information-sharing across public sector agencies.
NICE On-line Health Database
The National Institute for Health and Clinical Excellence
(NICE) has introduced a new on-line health database
designed to provide a forum for public health officials to
discuss their experiences implementing its guidance.
Called “ERNIE” (Evaluation and Review of NICE
Implementation Evidence), the database is available at:
http://www.nice.org.uk/page.aspx?o=ernie.
E-Learning Database
NHS UK Alliance for e-Learning in Healthcare is refreshing
a national e-learning database designed to capture and
share details of e-learning programs that have been
developed and are available for use within the health and
care sector. Local e-learning leads are asked to share
details of any programs which are being developed locally
and which might be shared more widely. The database
can be accessed at: www.nhselearningdatabase.org.uk.
Telemedicine Trial
In an attempt to make use of technology to meet the health
needs of Britain's ageing population, the Department of
Health is trialing home health monitoring systems. Primary
Care Trusts have been given the opportunity to take part in
the telemedicine trial, which is expected to start next year.
It is hoped that the trial will show that elderly or vulnerable
patients can receive good healthcare without having to set
foot in a hospital.
Management Briefing Paper
____________________________________________________
The first of a series of briefing documents was recently
released. Management briefings are designed to highlight
and summarise key issues and provide essential
information on important topics for the busy professional on
related matters. Topics will be varied and will be of
importance to strategic managers and leaders in the NHS.
A new management briefing will be produced
approximately
every
month.
See:
http://www.informatics.nhs.uk/cgi-bin/item.cgi?id=2127
Diary
Health Informatics Collection
The UK's National Health Informatics Collection (NHIC) has
been launched recently. Held at the University of Central
Lancashire, the NHIC is a collection of over 1,000 global
titles and conference papers. The collection, which is
currently being catalogued, includes a wide ranging initial
contribution from the late NHS Information Authority and
from personal donors. The aim of the NHIC is to share
information on good practice and provide information for
health professionals which is reliable, accessible and
secure.
24 Jan 07
Assistive Technology and Telecare
Conference, London
(www.capitaconferences.co.uk)
31 Jan 07
National “Single Assessment Process”
Conference, London
(www.capitaconferences.co.uk)
1 Feb 07
CfH / BMA Conference: “What’s in IT
for me?”, Birmingham
(http://etdevents.connectingforhealth.nhs.uk/d_
book.php?id=478)
19 – 21
Mar 07
HC2007 Healthcare Computing
Conference, Harrogate
(www.healthcare-computing.co.uk)
___________________________________________________________
Informatics Degree Courses
St George’s – University of London and Kingston University
are now offering degree courses in informatics.
St. George’s is offering a full time BSc and MSci in
Biomedical Informatics and Kingston University is offering a
Foundation Degree for those already in work. Students
who complete the foundation degree can opt to transfer
into the BSc course if they want to eventually obtain an
honours or master’s degree. The Foundation Degree is
due to start in September 2007. The course will include a
large element of work based learning and will aim to enable
career progression and development for staff already
working in the NHS.
Address for correspondence:
The Go-Between,
c/o David Green, Head of IM&T,
SW London & St George’s Mental
Health NHS Trust, Springfield
University Hospital, Tooting,
LONDON SW17 7DJ
020 8772 5602
[email protected]
London & South East