Summary Care Record

Summary Care Records Action Plan

Wrafton House Surgery October 2014

Background

The Public Information Programme has been completed and lasted for 12 weeks in 2010. By March 2013 more than 24 million SCRs had been created across the UK. The introduction is being continued with SCRs containing essential information that could be necessary in an emergency.

Summary information now contains: patient medication, allergies, adverse drug reactions and additional information that may be requested by the patient, as well as patient’s name, address, date of birth and NHS number.

Benefits

Benefits to patients include:

• Improved safety
• Increased efficiency
• Increased effectiveness
• Better patient experience

More patient information can be found on the website: digital.nhs.uk/services/summary-care-records-scr

Summary Care Record Implementation Programme

The practice is contractually obliged to publish on the practice website and within the practice plans to:

• Promote and offer the facility for patients to view online, export or print any summary information from their records relating to medications, allergies, adverse reactions and any other items agreed with the patient.
• Upload information daily to the Summary Care Record
• Use GP2GP transfer facility to transfer patient records

Promotion and Information for Patients

The Public Information Programme was completed and lasted a minimum of 12 weeks.

The practice will continue to provide information concerning Summary Care Records including:

• Posters within the surgery informing patients about SCRs
• Opt out forms for patients
• To provide help with queries
• Plans for new patients registrations

Patient Choice

• Patients can choose whether or not to have an SCR
• Patients can change their mind at any time by informing their GP practice
• Patients can choose whether they want additional information added to their SCR
• Patients can choose which additional information can be added to their SCR
• Patients are asked for their permission every time healthcare staff need to view their record
• Permission to view can be asked and granted for a group of healthcare staff e.g. an Emergency Department clinical team.
• If a patient is unable to grant permission to view e.g. they are unconscious, a Clinician may choose to use emergency access to view the SCR if they believe it to be in the patient’s best interests.

Security of the Summary Care Records

In order to maintain the security of the SCR security measures are in place to control access.

Technology security measures:

• Secure NHS Network (N3)
• Smartcards - are needed to view and update SCRs
• Role Based Access Controls (RBAC) - ensures that only appropriate staff can view and create records
• Legitimate Relationships – ensure that only healthcare staff involved in the patient’s care can view their record
• Permission to View - gives patients control of access to their record at the point of care

Organisational security measures:

• Legislation e.g. Data Protection Act
• Caldicott Principles
• Care Record Guarantee
• Local Information Governance policies and procedures
• Contractual measures e.g. confidentiality clauses in employment contracts
• Training

Individual user based security measures:

• Adherence to Smartcard usage policy
• Existence of legitimate relationships
• Asking for permission to view (where applicable)
• NHS duty to patient confidentiality
• Professional codes of conduct
• Contractual requirements
• Adherence to organisational security measures

What happens before we go live?

Within the practice there will be an SCR lead who will work with to ensure:

• All of the appropriate technical checks are carried out
• All of the staff within the practice are trained
• All of the staff within the practice have received the information to enable them to deal with any queries patients may have about SCR
• All staff are compliant with local best practice e.g. Patient Demographic (PDS) information management
• The appropriate data quality standard is reached
• The new patient process is operational

What happens when we go live?

• There will be an “initial upload” of the three key core data items (allergies, adverse reactions & current medications) for each eligible patient who has not opted out of having an SCR

What happens after we go live?

• Staff must follow all of the processes that were explained during the training e.g. using smartcards
• If staff believe that the system is not working as it should be then they should follow normal escalation processes
• Always ensure that there are patient packs with opt outs, on site to give to patients that register with the practice
• Should practice staff receive a query that they cannot answer they should contact the Health Organisation

How are SCRs updated?

After the initial upload, SCRs are updated every time:

• a change is made to the core data set
• an additional data item is marked to be included or excluded from the patient’s SCR e.g. a diagnosis (This only results in an SCR update if the patient is set to explicit consent)

Updates are only made if the user is authenticated with their smartcard and the patient’s local demographic details are matched to the PDS

The SCR is date and time stamped so that anyone viewing the SCR knows the date and time it was last updated

Practice Activities

The following activities need to be considered when implementing the SCR:

• Nominating a Practice Expert
• Managing Data Quality
• Managing PDS Information
• Consistent use of Smartcards
• Managing Patients Preferences
• Supporting Children and Vulnerable Adults
• Viewing SCR for Temporary Resident Patients
• Dealing with SCR Deletion Requests
• New Patient Registration