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Digital Shared Care Records in Context: The National Strategy

The drive to integrate health and social care, reduce costs and improve services to patients means that hospitals, GPs, mental health trusts, community trusts, councils and other providers all need to work together effectively on joined up care pathways. Integrated record systems are a key tool in facilitating these new ways of delivering care and in driving and managing the process of change.

Nationally, the case for shared care records is increasingly well-documented.

Shared care records also dovetail with other significant government policies. They support the use of the NHS number as the key patient identifier, for example, and data matching across organisations ensures that a valid NHS number is used throughout healthcare communities. Shared care records also directly support Health Secretary Jeremy Hunt’s target of a paperless NHS by 2018.

What is a Digital Shared Care Record?

Over recent years the NHS has moved away from plans to provide national "one size fits all" systems for healthcare organisations. Proven systems and technical advances have shown that it is much better to share records between organisations delivering care in a particular geographic area, perhaps covered by one or more Clinical Commissioning Groups, or across an entire county or local authority area.

One organisation in an area can host a shared care record, which will collect data from the care records systems used by all of the care providers in that area, including GPs, hospitals, community and mental health trusts, and providers of social care. Feeds will include the following:

The result is a full multi-agency record of key data covering the provision of care from primary to secondary and community care. It supports assessments, care plans and pathways which are multi-agency and multidisciplinary.

The digital shared care record is available to clinicians and care professionals across a health community, whenever and wherever they need it. It should be accessible not only in care provider facilities, but also in patient homes, nursing and care homes, ambulances, treatment centres and hospices. Mobile technologies ensure that the shared record can be accessed anywhere care or treatment is provided.

Shared care records have processes in place to ensure the correct records are matched, that patient consent is addressed, that records can only be viewed by clinicians and care professionals with the right authority to view and that data is secure and safe.

However, shared care systems should also go beyond simple record viewing. They should include the workflow, alerting and data collection facilities required to support the multi-disciplinary and multi-agency care pathways which are essential for the NHS of the future.

What Does a Shared Care Record Do?

A shared care record will have four primary functions:

To be really effective, access to the shared record should be possible from within a clinician or care professional’s usual system, so there is no need to remember passwords and processes to find the right patient or the right information. The easier it is to use, the more information will be entered into it and therefore the richer and more useful the record will become.

However, the shared care record is independent from primary and secondary care system providers – this provides a system which is not viewed as being "owned" by a particular care sector. Instead it is a truly shared record, hosted by one organisation, but available to all, and accessible using familiar systems and processes, with shared passwords, enabling more comprehensive use of shared care plans and pathways across organisational boundaries.

Example uses of a Digital Shared Care Record

The following examples show how shared care records can positively impact the quality of patient care provided and the efficiency of services:

Benefits of using a Digital Share Care Record

Clinical Benefits

A shared care records system across a health and social care community will deliver significant clinical benefits which are summarised below:

Cost Savings and Productivity Benefits

A community wide shared care record will also deliver cost savings, for example:

Studies in England have shown that shared care systems which support End of Life care, allowing patients to record their wishes about where and how they wish to die, enable a significant increase in Deaths in the Usual Place of residence (DIUPR), resulting in net saved costs of hospital care of at least £38,900 per 200,000 population.

Other Quantifiable Benefits

Other quantifiable benefits are likely to include the following:

In primary care:

In secondary care: