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Emergency Care Summary
SCIMP Conference - Dunblane 7th November 2007
Agenda
• ECS Definition• Progress to Date• NHS24• Security and Audit• Gold Standards Framework• Future Developments
What is ECS?
• Emergency Care Summary• Patient information is extracted
from GP Practice computer systems• Sent to ECS store twice daily• Explicit Consent to view ECS
record• The information is ‘Read only’ and
available to Emergency Care clinicians
Agreed Dataset
• Patient demographics (address, telephone, CHI number)
• Allergies and Adverse Reactions to medications
• Medication history - Repeat prescriptions and - Acute prescriptions in past 30 days• Consent Flag
– Patients can opt out
Progress to Date
• 95% of GP Practices connected– GPASS, EMIS, InPS live – iSoft and Ascribe due shortly
• NHS24 linked in directly • OOH Rollout Complete• Some A+E Departments• Cross Border Access switched on
Progress to Date
• Over 5 Million Patient Records extracted
• 1025 patients have ‘opted out’• 340,000 accesses to date
– c.220,000 NHS24– c.35,000 A+E
• Expected increase in use over Christmas period
NHS24 Call Process
NHS24 – Call handler
NHS24 – Call handler
NHS24 – Nurse Advisor
ECS Security and Audit• Access and security controls with
passwords and log on for all clinicians • Patients must give permission for the
clinician to view their records• Practices can check who has accessed
their patients’ records• Audit controls run regularly:
– Practice Reporting– Health Board Audit– Cross Border Audit– National Audit
ECS Access Report
Palliative Care Summary• MacMillan Nurses led initiative• Palliative Care Forms
– Based on Gold Standards Framework Scotland (GSFS)
– Paper process already in place in many GP Practices
– IT Development to assist with key patient group
GSFS Solution
• Extension to ECS dataset to include more detailed information to send to OOH for Palliative Care patients (known as PCS)
• Move from paper to electronic information• Reduction in faxes from GP Practices to
OOH Centres
• Consent Model•ECS – Implied to send, Explicit to view•PCS – Explicit to send, Implied to view
Palliative Care OOH Summary
Palliative Care Dataset
• Captured within GP system – some already pre-populated:
– Palliative care register flag (Read code) consent
– Carer details and key professionals– Diagnosis and current treatment– Preferred place of care– Current care arrangements– Patients and Carers Awareness of
Conditions– Advice for OOH care– Review date
Current Progress of GSFS
• 4 out of 5 GP Suppliers have completed SEF testing
• ECS – central ECS development complete
• NHS24 / Adastra / Taycare – development ongoing
• Communication materials to follow• Rollout to start early 2008
Future Developments
• Practice Pack ECS Information• Integration with National A+E System• Scottish Ambulance Service
• Preparation of Outline Business Case– Patient Access– Extension of Users– Extension of Data Set
• NO DEVELOPMENT WITHOUT CONSULTATION
RCGP and SCR in England
• RCGP published UK wide recommendations on the GP Summary
• Arising from Ministerial Taskforce• Automated extract the same as ECS in
Scotland• Configurable use of significant medical
history in England• Patient Preferences if requested• HealthSpace in development
Summary
• Good progress with use of ECS• Security built in with fully integrated
solutions• Audit at all levels including Cross
Border• Palliative Care Summary development
well underway• Consultation and communications in
planning
