NHS Connecting for Health A National Framework For Implementing

Electronic SAP

Summary of Recommendations

Project Outline• Initiated by NHS Connecting for Health (CFH).

• Reporting to Electronic Social Care Records Board, Care Records Development Board & National Programme Board of NHS CFH.

• Project Board representation from NHS, social services, DH, and Cabinet Office.

• To develop an implementation plan and business case for electronic SAP for England.

• First stage to define and evaluate options for electronic SAP by end June

• Subsequently to develop an implementation plan and business case.

• Focus on SAP/CAF, but seeking solution which could support other multi agency information sharing needs

Consultation Process• On-line questionnaire on SAP websites of Centre for Policy On

Ageing and NHS Connecting for Health – 272 registrations and 166 responses

• Meetings with established forums (ADSS, Better Government for Older People (BGOP), Cluster Expert Reference Groups, etc.)

• Meetings with SAP leads & NHS/social services IT managers.

• Meetings with suppliers – Local Service Providers & partners, social services systems, SAP systems

• Meetings with DH CAF lead, NHS Connecting for Health, Children’s Index, e-CAF and Government Connect

e-SAP Requirements• Person-centred processes and records.

• Available to health, social care and other workers, providing care to individuals at diverse locations.

• Available to service users and carers.

• Each item of information entered once only wherever possible and subsequently validated or updated by other users.

• Seamless access to assessment, care planning and review information and output of multi-agency management information.

• All relevant SAP information available to system users when and where needed (including mobile working).

• Users having access only to the information in which they have a legitimate interest.

• All updates to SAP information being notified to users in a timely manner.

• Separate but linked carer’s assessments.

e-SAP Principles

• Information that is shared will be subject to individual consent.

• Information governance standards across NHS and social services.

• Systems from different suppliers interoperate using standards

• Commonality of process from SAP to the Common Assessment Framework ( ‘Our Health, Our Care, Our Say’).

• Support evolution of both the process and information associated with it.

• Build on existing systems

Potential e-SAP Benefits

• Reducing length of stay and delayed transfers of care• Reducing unscheduled admissions• Improved management of care for people with long-term conditions• Improved quality of care• Resource savings for professional staff• Improving the referral process• Improving public health information• Contributing to strategic planning and commissioning

Current Situation

Survey of e-SAP implementation in 27 communities:• Substantial gap between SAP requirements and current e-SAP

implementation• Lack of integration between

- SAP and other LSP systems- NHS and Social Services systems and consequent dual data

entry• Lack of standards around functionality and information sets with

different solutions developing in different communities• Small-scale adoption of mobile devices with consequent dual

recording

Information Sharing ModelFUNCTIONALITY DESCRIPTION

E-SAP application Assessment, care planning and review functionality, including associated management reporting provided as an integral part of electronic care records so that they are seamless to the user.

Index Index of service users or patients, used to identify individuals uniquely.

Services Directory index of care professionals and the organisations by which they are employed.

Security broker Services used to authenticate users and control their access to information, taking account of individual consent, user role and their relationship with the individual

Messaging Services to support the exchange of information between systems.

Publish Services to enable assessments, care plans and other updates to an individual’s electronic record to be published to a central store where they can be accessed by other care professionals involved in their care.

Subscribe/notify Services to identify users who are working with an individual and have a legitimate interest in updates to their record.

Services to notify these users of changes to an individual’s record.

Citizen access Services to enable individuals (and agreed carers or family members) to access their electronic SAP records directly, including self assessment

Information Governance & Exchange Standards• Level 3 e-GIF standards recommended for

confidentiality and integrity of information

• HL7 v3 Provision of Care messages for information exchange

• Need to publish compliance regime and accreditation of systems to meet the above standards

Deployment of e-SAP SolutionOptions:

• National approach (standards, application and integration• Local approach (no standards, local application and integration)• Hybrid

Recommendation: Hybrid Deployment• Local e-SAP implementations, agreed by local ‘care

communities’• Operating to national information governance standards• Employing national standards for information exchange• Using national services for cross-community exchange

National Services To Support Local ImplementationFUNCTIONALITY SERVICE

Personal demographics index

NHS CRS Personal Demographics Service

Services directory NHS Spine Directory Service

Security broker NHS Spine Security Broker

Messaging NHS Transaction Messaging Service

Publish NHS Personal Care Information Service

Subscribe/notify Secure email (NHS & CJIT email)

Citizen access Healthspace if extended to support SAP, but also investigate links with Gov Connect Citizen Account.

Implementation To implement electronic SAP a national work programme is needed including:

• Joint governance encompassing the NHS and social services

• Co-ordination with other related initiatives (e.g. e-CAF, Children’s Index & Gov Connect)

• An implementation plan and business case, including procurement strategy

• National enabling work:

- Definition of national information exchange standards for e-SAP

- Definition of national information governance standards for NHS and social services information sharing

- Definition of national reporting requirements to ensure standard reporting definitions across agencies

- Definition of consistent electronic record retention policies.

- Deployment of national information sharing services, including accreditation process

Implementation (Continued) To implement electronic SAP the following will be needed:

Local implementations:

• Local business cases

• Deployment of e-SAP solutions

- change management and process change

- education and training

- hardware implementation

- project resourcing, etc.

Potential Phasing

• Health and social care first, then other users over time

• Electronic information sharing phased (documents first)

• SAP first, evolving into CAF over time

Next Steps

By October:

• Implementation Plan• Business Case