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Integrating care pathways using the National Record Locator

Thanks to integration between the National Record Locator and shared care records, including the Cheshire Care Record, ambulance services across the country can see whether their patients have a mental health crisis plan regardless of geographical location, and will soon be able to retrieve this plan directly, enabling them to direct these patients to more appropriate care settings.


What is the National Record Locator?
The National Record Locator (NRL) is an award-winning programme that provides a national index of pointers to patient records. It enables an authorised clinician, care worker and/or administrator across health and care settings, to access a patient’s information to support that patient’s direct care.


Sharing mental health crisis plans
The NRL’s first use case was mental health crisis plans. Using FHIR API integration, the NRL seamlessly uses the Cheshire Care Record to identify patients who have a referral or crisis plan with CWP to the Cheshire and Wirral Partnership NHS Foundation Trust (CWP), a mental health and community service provider.

Ambulance services, accessing the NRL and Cheshire Care Record from their tough books, control centres or clinical hubs, can then decide whether the patient should be transported to a more appropriate care setting than Emergency Departments (ED), for example directing them to community-based care as indicated in the patient’s crisis plan.

Having access to this vital information in real-time improves the safety of patients and staff and reduces costs across the health and care system.

How it works

NRL diagram

Benefits for patients and care providers 

  • Improved care pathways: Improved integration of care pathways across providers, including timely communication and collaboration between acute trusts, mental health providers, ambulance services, primary care, social care and public health (drug/alcohol services)

  • Informed decision making: Improving data quality and recording of mental health need in ED. Possible prevention of unnecessary conveyances to ED by giving paramedics more information about the individual when making my clinical decisions 

  • Improved patient experience: Reducing distress and enabling more appropriate care at the point of crisis and averting emergency care

  • Patient safety: Supporting safeguarding by sharing alerts across multiple care settings and responding to significant risks identified in a crisis plan

  • Time savings: Saving time by reducing the need to manually request information about the patient by either ambulance crews or dispatch and reducing avoidable pressures on emergency services.


Next steps
Future phases will enable record retrieval and extend to other record types such as the Healthy Child Record, End of Life Plans and Digital Maternity Record.

By combining patient record access across the NHS without dictating where those records might be stored, the NRL realises a level of national interoperability across the health and care system.

A benefits programme has been agreed between Graphnet, the Cheshire Care Record and NHS Digital to report on realised benefits to clinical users of the NRL and their patients. The joint report in will be available early 2021. Please contact us if you would like to receive a copy of the report.


For more information on the National Record Locator programme:
NHS Digital website
- National Record Locator Service wins digital innovation award
- FHIR APIs link Graphnet’s shared care record to new National Record Locator Service

Ambulance image

“The addition of mental health information to the record locator is a giant step forward in terms of integrating care models and I am delighted with how the NHS Digital team, Graphnet and Cheshire Wirral Partnership worked so well together to get the record locator integration over the line. The degree of commitment and energy expended has been colossal.”

Dr Adrian Burke, Consultant Psychiatrist, Cheshire and Wirral Partnership NHS Mental Health Trust

“Having access to the contact details for a patient and knowing a care plan exists and who I can speak to for more information has saved me time when triaging patients”

Mental Health Nurse, North West Ambulance Service

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