Briefing: NIB Priority Domains Update on the Roadmaps June 2015 Following the publication of the Five Year Forward View and the Framework Personalised Health and Care 2020, the National Information Board (NIB) have published a series of work streams and associated roadmaps which set out evidence-based plans for how proposals for service transformation though data and technology will be delivered and their expected benefits. These work streams have now been formed into six priority domains for delivery. These six core priority domains for delivery are intended to become programmes that will help transform health and care services through data and technology. Initial modelling by the NIB indicates that technology could contribute to potential savings opportunities of 8.3-13.7 billion a year by 2020/21, of which 1.8-3.4 billion could be achieved through enabling citizens to make the right health and care choices. This briefing: Summarises the six key priority NIB domains: 1. Enable me to make the right health and care choices 2. Transforming general practice 3. Out of hospital care and integration with social care 4. Acute and hospital services 5. Paper-free healthcare and system transactions 6. Data for outcomes and research Provides a timetable of national requirements for local action and implementation Includes an overview table of the six priorities NHS South, Central and West Commissioning Support Unit Page 1
Domain one: Enable me to make the right health and care choices This domain contributes to the efficiency/productivity challenge and transforms the patient s digital experience of and access to health and care services and transactions. Programmes will include: nhs.uk, including access to personal health records (PHR) Digital primary care services Digital 111 Digital applications library Support for self-care Support for digital inclusion nhs.uk will be developed into a new integrated health and care digital platform. Citizens will be able to: Communicate with clinicians/practices via email, secure video links and complete pre-consultation questionnaire; Include data from their personal applications and wearable devices in their personal record Access a set of (NHS assessed and approved) health and care digital applications Digital transactions will be offered: ordering/paying for prescriptions, registering with GPs, claiming funds for treatment abroad, registering as an organ/blood donor and reporting the side effects of drugs. nhs.uk will also enable citizens to create their own PHR from information stored in the electronic health records in primary and secondary care. Where appropriate, PHRs will be linked to care accounts to help people manage their personal budgets. The MyNHS data service on nhs.uk will be expanded to include new scorecards, expanded coverage of patient experience. NHS South, Central and West Commissioning Support Unit Page 2
Domain two: Transforming general practice This will include: General Practice Systems of Choice (GPSoC) GPIT GP2GP Prime Minister s Challenge Fund (PMCF) Further procurement under the GPSoC will be used to stimulate the supply of new systems and the GPSoC framework will be reviewed as a vehicle for change before it ends in April 2018. To support 7-day services citizens will be able to communicate with their GP via online communications, including the ability to register securely or change their primary care provider online. Domain three: Out of hospital care and integration with social care Programmes in this domain will cover: eprescribing epharmacy Urgent and emergency care Integration with social care online Care Accounts Local Authorities Patients and carers will able to: choose how/where they get their prescriptions, without the need for paper check information about their medicines, through simple barcodes Connecting data to other digital applications will also remind people when to take their medicines. 111 and 111 digital (part of nhs.uk) will deliver an online triage and consultation service for patients with urgent needs, fully integrated with local services. The personal use of digital applications to record their health and care preferences in advance of them needing urgent and emergency care will be actively encouraged. NHS South, Central and West Commissioning Support Unit Page 3
There will be a programme to improve self-care and the use of telehealth, to enable citizens to plan and manage their care and finances and to connect to carers and peers. The programme will support the work of local government, and also involve the independent and voluntary sectors, and carers. Domain four: Acute and hospital services Programmes in this domain will cover: Elective/non-elective care ehospitals Summary Care Record Electronic Health Record Barcodes Supplier-side efficiencies Digital initiatives like: providing a single source of information on referrals and bookings; supporting national standards of integration and interoperability; and exploring the use of digital channels for pre and post-operative assessments, will all contribute to driving greater efficiency in hospital settings. For example, asset tracking is an effective way of addressing inefficiencies. It enables a hospital s wireless infrastructure to actively track assets through the use of Radio Frequency Identification (RFID) tags and can reduce the financial impact of inefficiencies in equipment utilisation; patient care and safety, and staff productivity. NIB is proposing a set of common digital and information standards including the use of the NHS Number as primary identifier of patients, adoption of the GS1 barcoding standard and SNOMED- CT. NHS South, Central and West Commissioning Support Unit Page 4
Domain five: Paper-free healthcare and system transactions This domain will include programmes that will support interoperability around common digital and information standards including: Automation of system transactions Electronic Health Record Summary Care Record Electronic medicines supply chain Digital diagnostics Back office transactions, e.g. BSA, pensions Wider system access dentistry, defence etc By April 2016, local health and care economies will publish local digital roadmaps for delivery against the paper-free targets for 2018 and 2020. By March 2016, it will be a core requirement for all providers to have enabled access to SCRs and the information available to clinicians in the SCR will be extended to include whether a patient has learning disabilities or suffers from dementia. Work will also begin on the commitment to have 100% of pharmacies with access to the SCR by March 2017. By 2018 clinicians in primary, urgent and emergency care will be working without paper records, and by 2020 all patient and care records will be digital, real time and interoperable. To ensure transparency a Digital Maturity Index (DMI) is being co-produced with the health and care sector to enable individual providers and health and care economies to baseline and benchmark their current position and mark progress. It will assist local organisations and economies identify solutions to address the gap between their current reality and what making best use of digital technology delivers. The first DMI will be published in the autumn of 2015. Core content of the DMI can be found NIB Work Stream roadmap 2.1 Appendix B. NHS South, Central and West Commissioning Support Unit Page 5
Domain six: Data for outcomes and research The programmes will seek to address the issues of fragmented, incomplete and inaccessible health and care data: Data platform/strategy System-wide consistency of data capture at point of care Transparency Genomics Subject to patient consent, high quality standardised data will be extracted from all parts of the NHS and care services. A standardised record will be generated at the end of every episode of care with a copy being made available to a patient s GP. Major national genomics projects such as the 100,000 genomes programme, laboratory reconfiguration and wider National Institute for Health Research (NIHR) are already underway. A National Genome Informatics Network will be created to align and create a detailed assessment of how NHS genomic and pathology services can share genome or molecular data for the benefit of patients and research. The NIB plan on the delivery programme for Personalised Healthcare 2020 can be found here: www.gov.uk/government/uploads/system/uploads/attachment_data/file/437067/nib-delivering.pdf Next steps The NIB is currently consulting on the draft roadmaps/content of the programmes within the domains, before publishing final roadmaps in September 2015 The NIB is seeking wider views on the proposals and four regional events aimed at local commissioners, managers, NHS chief information officers, social services, local government and voluntary/community are being held in Reading, Bristol Sheffield and Manchester between 15-18 July. Register to attend: www.eventbrite.co.uk/e/nib-regional-eventsreading-tickets-17652515148?access=nib28715 NIB is due to publish guidance for CCGs outlining the core content to be included in their local digital roadmaps Co-created tools and resources on developing digital roadmaps as part of a package of learning and support will be made available from September 2015 NHS South, Central and West Commissioning Support Unit Page 6
Timetable for implementation and local action Project/element Description Deadline Local Action and Impact E-discharge Community Pharmacy Access to SCR Electronic Prescription Service All NHS providers must send discharge summaries to GPs electronically only email and e-messaging will be acceptable under standard NHS contract Roll out due to start in Autumn 2015 Roll out EPS to community pharmacy 1 October 2015 Ensure that local providers are equipped to provide e- discharge summaries Ensure that all GPs are aware that discharge summaries should not be accepted via post or fax. If they continue to receive alternative discharge summaries this should be escalated appropriately. Communicate changes to patients March 2017 Locally identify which pharmacies are involved and their local practices Training for local pharmacists Communication with, pharmacies, practices and patients March 2016 Communication to patients SCR updated data All GP practices must ensure March 2016 Ensure all practices are and all providers that SCRs include information aware of the deadline and enabled access to on whether patient has SCRs updated accordingly SCRs dementia or learning disability Communicate changes to patients to ensure they are aware of changes to data recorded and shared SCR All GP practices must provide April 2016 Communication with Comprehensive access to a comprehensive patients Record record Training for GPs NHS South, Central and West Commissioning Support Unit Page 7
Publication of Local commissioners will create April 2016 Comply with standards local roadmaps and publish local roadmaps to published by NIB (Appendix for delivery of support introduction of fully A work stream 2.1) interoperable interoperable digital health Comply with core content health records records, including specialized guidance (due for care. publication July 2015) The roadmaps will describe the CCGs will coordinate current digital capabilities of roadmap development in local areas and outline plans for conjunction with providers, progress towards paper-free local authorities, and the over the next five years. They voluntary and community will be supported by self- sectors. Given the assessment and peer review; significance of the Better plans refreshed annually in line Care Fund, Health and with the NHS Planning Wellbeing Boards will have a Framework. central role in local sign-off. NIB will assure the content of local digital roadmaps to check that individual and health and care economy proposals are harmonised and realistic. Replacement of Read codes replaced with End of 2016 All GP systems, QoF and Read codes Snomed CT pathology reporting systems compliant with Snomed CT and records not affected Training for GPs Secondary Care All secondary care outpatient September 2017 Training in use of e-referrals Outpatient referrals will use e-referrals system e-referrals service Communication to patients Emergency Emergency services End 2018 Compliant with plans laid out services real time (ambulance, 111 and OOH) will in published local roadmap access to full have access to fully Communications to patients digital health interoperable comprehensive alerting them to who will record patient records have access to their records Fully All healthcare providers have End 2020 Communication to patients interoperable access to fully interoperable, Training for all healthcare comprehensive comprehensive patient records. providers and users of patient records, including IG NHS South, Central and West Commissioning Support Unit Page 8
Overview of the six NIB priority domains NHS South, Central and West Commissioning Support Unit Page 9