Access to critical patient information within the emergency department

Emergency clinicians at Royal Surrey NHS Foundation Trust are using the TVS Care Record, powered by Graphnet Health, to access vital patient information directly within the Emergency Department, helping teams make faster, more informed clinical decisions and support continuity of care.

The TVS Care Record enables authorised clinicians across Surrey and the wider Thames Valley and Surrey region to securely access relevant information from multiple health and care organisations. At Royal Surrey Hospital, clinicians access the platform through a single sign-on connection embedded within the Oracle Cerner Millennium electronic patient record (EPR), allowing them to open a patient's record directly in context without switching systems or logging into separate applications.

For emergency teams working in a fast-paced, high-pressure environment, having rapid access to information from across the wider health and care system is proving increasingly valuable.

GP Connect integration described as a "game changer"

For Emergency Physician and Chief of Service, Dr Will Niven, one of the most valuable developments has been GP Connect integration, which provides a real-time view of GP data, including GP Encounters within the TVS Care Record.

"The GP Encounters element has been a game changer," he explained. "Being able to see exactly what the GP has said, rather than relying on paper referrals or limited summaries, has made a huge difference in the Emergency Department."

The integration enables emergency clinicians to view detailed information recorded by GP practices, including consultations, referrals and previous primary care interactions, helping provide valuable clinical context when patients arrive at hospital.

Dr Niven said the functionality has significantly reduced reliance on paper referrals and fragmented communication, while supporting quicker clinical decision-making and more efficient triage.

The ability to see what has happened previously within GP surgeries, alongside information from hospitals and community services, helps clinicians build a much more complete understanding of the patient in front of them.

Building a more complete picture of the patient

Within the Emergency Department, clinicians use the TVS Care Record alongside their local EPR to bring together information from primary care, community services, mental health, ambulance services, out-of-hours providers and adult and children's social care teams.

The platform provides access to medication histories, correspondence from other acute hospitals where patients have previously received treatment, externally completed test results, GP Connect information and ReSPECT Care Plans that may not otherwise be available within the local hospital record.

"Having access to a patient's wider context helps clinicians make better decisions," said Dr Niven. "The ability to quickly see previous encounters, correspondence and planning information gives us a much clearer picture of the patient in front of us."

The additional visibility is particularly valuable in emergency medicine, where clinicians often need to make rapid decisions with incomplete information. Access to information from across different care settings can help reduce duplication, avoid unnecessary delays and support safer, more informed care.

Between March 2025 and February 2026, Royal Surrey Acute recorded an average of 1,685 users accessing the TVS Care Record each month, with more than 13,000 patient record views every month, demonstrating how embedded the platform has become within frontline clinical workflows.

Alongside accessing information through the platform, Royal Surrey also contributes data feeds into the TVS Care Record and Population Health platform, supporting information sharing and regional analysis across Surrey. Current feeds include ADT (Admissions, Discharges and Transfers) data covering inpatient, outpatient and appointment activity. A dedicated community data feed from Royal Surrey Community teams is also now live within the TVS Care Record and Population Health platform, providing clinicians with an even more comprehensive view of patient care across acute and community services.

Surrey first began working with Graphnet in 2019 through the Surrey Care Record programme. In March 2025, Surrey migrated onto the consolidated TVS Care Record platform, bringing together Surrey with the wider Thames Valley and Surrey shared care record.

Expanding digital care planning

The TVS Care Record now provides access to ReSPECT Care Plans across Surrey, enabling clinicians working in different care settings to view consistent information about a patient's wishes, priorities and recommended approaches to care.

Making this information available through a shared platform helps clinicians better understand patient preferences, supports more coordinated decision-making across organisational boundaries and ensures important care planning information is available wherever patients receive treatment.

Supporting population health

Alongside supporting frontline clinical care, Surrey also uses the TVS Population Health platform to support wider analytical, operational and transformation activity across the health and care system.

Incoming data from partner organisations is consolidated within the platform to provide insight into patient cohorts, service demand and system pressures. Dashboards support both primary and secondary care teams, helping organisations identify trends, inform operational planning and target interventions more effectively.

Graphnet provides a range of core dashboards through the platform, while additional local dashboards can be developed to support regional priorities and transformation programmes.

The combination of shared clinical information and population health analytics is helping create a more connected and collaborative approach to care across Surrey.

Looking ahead: towards more actionable transfer of care

Looking ahead, Dr Niven believes the next stage of development is moving beyond information sharing towards more coordinated transfer of care between hospital and community services.

"We would love to see it progress further into actionable transfer of care back into the community," he said. "Being able to redirect or stream patients appropriately and ensure actions are picked up elsewhere in the system would be incredibly valuable. Sometimes the right answer is not here, not now, but making sure the next step is properly actioned."

As shared care records continue to evolve, the ambition is increasingly shifting beyond providing visibility of information towards enabling more proactive, coordinated models of care across organisational boundaries.