Care integration


be able to access a document containing a person’s health or care information from any system where it is appropriate, if every source system structures the data differently, people are going to have to read potentially long documents to find the information they need. Consider it like a keyboard - it is much


easier if every keyboard is a QWERTY keyboard, as the location of any letter is consistent. If every keyboard had their own layout then it would take far longer to find each letter. The same applies to documents, but even more so if the documents are to be consumed by computer systems. Standards are needed for the layout


of the data so that every system communicates using the same data layout. Fortunately, the Professional Records Standards Body (PRSB) has been appointed to develop some of the fundamental standards for the layout of information, and there is an existing standard for some of the content of the information that has been extended for social care. The PRSB has published five draft


standards for health and care integration, and some of these are already starting to be adopted by social care software providers. The first, and most advanced, is ‘About Me’, which contains information that the people who receive care want to share about themselves. About Me will be incorporated into


the Core Information Standard that is defined as ‘a set of information that can potentially be shared between systems in different sites and settings, among professionals and people using the services.’ About Me will also be incorporated into the digital care and support plan standard which has been endorsed by the Royal College of Nursing and the Royal College of GPs, as well as the Care Providers Alliance. The second draft standard that PRSB


has published is for ‘Urgent referral from care home to hospital’. This is based on the information shared in the Sutton Red Bag, sometimes called the eRedBag, which has been implemented by a few social care providers and is actively in use. Another draft standard is the ‘Care


homes view (of shared health and care records)’, which will again be incorporated into the Core Information Standard that is expected to be available this year. The PRSB is looking at the standards for


24


the layout of data, but another standard exists for the content of some of the days, which is the Systematized Nomenclature of Medicine - Clinical Terms, known as SNOMED CT. It currently contains more than 300,000 medical concepts, divided into hierarchies as diverse as body structure, clinical findings, geographic location and pharmaceutical/biological products. Each concept is represented by an individual number and several concepts can be used simultaneously to describe a complex condition. Healthcare has adopted clinical terminology for many years, and for social care to be fully interoperable with healthcare, then a level of common terminology will be necessary. From September, there is a commitment from Health Secretary Matt Hancock for the integration of information between health and social care. The exact words are: ‘NHSX expects all areas will have a basic minimum viable shared care record solution in place by September 2021, focused on the integration of NHS Trusts and GPs, and for use in provision of direct care’. Behind these words there is a massive


amount of work necessary to build systems and create standards for data exchange. The PRSB has created five data standards for sharing data, that are designed to provide common data standards so that software providers can use a common format.


Conclusion The automated communication of information across healthcare will become commonplace in 2021, and social care is included in the plans because the directive given to the PRSB was to ‘create national standards for sharing information between health and social care’. While 2021 will be the year sharing data


gathers pace, it is not going to be the destination for sharing data across all of social care and healthcare. However, the destination has been given a timeframe, and Hancock has again given a very clear expectation of this, saying the NHSX is “aiming to have all social care providers to have access to digitised care records that interoperate with locally Shared Care Records by 2024”. This year is the start of interoperability, and social care will have to adopt digital


care records within the next four years. The pace necessary to reach 2024 with all of social care having implemented digital care systems is a significantly increased rate of adoption of technology. Person Centred Software is leading the


way with shared care, being the first to implement eRedBag and working directly with GP Connect at NHS Digital to bring GP information to English Care Homes via the Access Record: HTML product. We are now in an exciting digital era


that enables interoperability with health services, so that the best quality of care and support can be given to those living in care homes.


Further information 1 Information about NHSX: https://www.nhsx. nhs.uk/.


2 Information about GP Connect: https://digital. nhs.uk/services/gp-connect.


3 NHSX publication explaining the issues of bureaucracy: https://www.gov.uk/ government/consultations/reducing- bureaucracy-in-the-health-and-social- care-system-call-for-evidence/outcome/ busting-bureaucracy-empowering-frontline- staff-by-reducing-excess-bureaucracy-in- the-health-and-care-system-in-england.


4 Information about NRL: https://digital.nhs.uk/ services/national-record-locator.


5 The PRSB five standards: https://theprsb.org/ standards/healthandcareintegration/.


TCHE


Jonathan Papworth


Jonathan Papworth is the co-founder and director of Person Centred Software, a market leading digital care technology pioneer. Founded in 2013 with the objective of helping to improve standards in social care, Person Centred Software has become an award-winning global company with over 2,000 care homes in the UK alone using their digital care system.


www.thecarehomeenvironment.com • March 2021


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