Social care workers, community midwives and health visitors will be able to access and contribute to patients’ full digital health record by March 2025, the Government has announced.
A new plan for digital health and social care published by the Department of Health and Social Care (DHSC) today said that non-clinical social care staff will also be able to access patients’ electronic ‘life-long, joined-up health and social care record’ and input data.
And it also said that some GP practices will have online triage and ‘message-based consultation’ from June this year.
The plan said: ‘By March 2025, all clinical teams in an ICS will have appropriate access to a complete view of a person’s health and social care record that they can contribute to.
‘Non-clinical staff in social care settings will also be able to access appropriate information and input data into digital records in real time.’
It added that digital record-sharing ‘should be available to relevant staff in all settings, including community midwives and health visitors’ and that implementing the digital record will ‘help to achieve ambitions set out in the Fuller stocktake report’ on integrating general practice in new ICSs.
It said: ‘In particular, primary care networks (PCNs), including their partners in third-sector organisations, pharmacies, high-street optometrists and community diagnostic centres (CDCs), will benefit from the seamless flow of data between frontline teams.’
And it added that ‘individuals, their approved caregivers and their care team’ should have the ‘ability to view and contribute to the record’ by 2024.
The DHSC plan added that patients will be able to access their ‘GP’s online triage and message-based consultation offer’ from June 2022 ‘if enabled for [their] practice’.
It also set out Government plans to ‘strengthen’ NHS 111 as the ‘entry point’ to urgent care and said it would achieve this by ‘supporting better integration’ of primary care and urgent emergency care by March 2025.
The plan also said:
- Primary care will ‘use technology to streamline routine tasks’ and pilot automation of ‘appointment management tasks’ by March 2025 such as telephone-answering, letter-writing and document-scanning
- Data will be used for ‘real-time management’ of primary care by commissioners by March 2025
- GP digital records must use ‘cloud native architecture’, with the Government to ensure that modern, integrated, secure and user-friendly digital systems are available to primary care through the GPIT Operating Model and Digital Care Services catalogue by March 2025.
- A March 2028 ‘vision’ includes carers being ‘notified’ of changes in care when it is updated on the record, patients adding data to their own record and accessing test results ahead of follow-up appointments, patients tracking changes in their condition via ‘support tools’ that feed into their record and digital health checks
- Advice and guidance (A&G) will be expanded by March 2023 and GP referrals will be triaged ‘by urgency’
- Patients will be able to track their GP prescriptions by December this year
- They will be able to see new information on their GP record and request ‘historical information’ from their practice from December 2022
- They will also be able to view all test results and link wearable devices and ‘other health-related data’ to their online NHS profile by March 2025
- The Government will scale up ‘digital self-help, diagnostics and therapies’
- The focus ‘this summer and autumn’ is on giving NHS app users access to their health records and the ability to receive ‘notifications and messages’ from their GP practice from September 2022
- The NHS app will do blood pressure management to be shared with GPs from March 2023, as well as vaccine bookings and reminders, followed by ‘targeted digital health checks’
- Those with severe mental illness will have ‘tech-enabled’ annual physical health checks from March 2023
- Implementation will allow frontline healthcare staff to ‘spend less time on administrative tasks’ and ‘reduce the load’ for them
- The Government will use ‘regulatory levers’ in partnership with NHS England and the CQC to ‘monitor and support compliance’
- It will ‘explore’ how AI and machine learning can ‘supplement’ decision support systems already used for urgent and emergency care triage
- The plans will be backed by national funding, with £2 billion ‘earmarked’ from the spending review to ‘help digitise the NHS and social care’
- The Government will embed ‘digital skills development’ into academic curricula from 2022
However, it set out the caveat that many of the actions it describes ‘still require business cases that require HM Treasury approval’.
Health secretary Sajid Javid said: ‘We are embarking on a radical programme of modernisation that will make sure the NHS is set up to meet the challenges of 2048 – not 1948, when it was first established.
‘This plan builds on our data strategy to revolutionise digital health and care, which will enable patients to manage hospital appointments from the NHS App and take more control of their own care at home, picking up problems sooner and seeking help earlier.
‘Ensuring more personalisation and better join-up of the system will benefit patients, free up clinician time, and help us to bust the Covid backlogs.’
Speaking at the Policy Exchange today, he added that we ‘must look at the huge advances of the pandemic, not just as a quirk of history, but the start of a new era of digital transformation, and a platform upon which to build’.
The report said digital transformation of health and social care is a ‘top priority’ for the DHSC and NHS England and that ‘the system’s long-term sustainability depends on it’.
Dr Claire Fuller’s landmark stocktake recommended last month that urgent same-day appointments should be dealt with by ‘single, urgent care teams’ across larger populations.
Earlier this month, the DHSC’s new data strategy said it is considering ‘mandating’ access for patients to their GP records, as is done in the United States.
It also indicated that patient access to GP records on the NHS App is again delayed until November, following rumours it would launch in July this year.
NHS Digital had announced in October that patients whose practices use TPP would be first to have access to new entries in their GP notes through the NHS app from December 2021 – with EMIS practices to follow this year.
But the launch date was delayed until April 2022 for both systems, after the BMA wrote to NHSX expressing its concerns about the timing of the rollout.
It was then delayed again, with NHS England recognising concerns around ‘safeguarding’, but it remained unclear when the launch would finally take place.
READERS' COMMENTS [4]
Please note, only GPs are permitted to add comments to articles
Whislt integrated notes sounds great some of the allied professions write reams and reams of irrelevant negative finding making important information difficult to find in all the noise. At least in systmone you can set filters to remove the DNs leg wound notes that often duplicate information and seem like they are aiming to write war and peace. So yes but cna they have their own jounal section please
Back in 2003, they trialled this with the paper notes of hospital patients when I was a house officer.
It meant that detailed and complicated medical management notes would be interleaved with thinks like “Bowels opened, normal consistency” and detailed medical consults from other teams would be bookended by similarly detailed accounts of patients going to the shower. It made following a clinical narrative virtually impossible.
Hopefully filters etc can avoid this as above, but let’s be honest we all know that the records will be filled with garbage.
1. All sense of narrative will be lost as the notes become an information dump.
2. Clinical risk will be heaped on the GP. Entry on notes = ‘doctor informed’ = ‘no longer my problems’.
3. Opening up the notes this way will essentially end privacy of the medical record.
4. I personally do not want this. I think the downside of the loss of privacy far outweighs any real clinical benefit – though it does potentially allow far more ‘command and control’ by the state of an individual’s life. I will either opt out, or seek a private GP with whom I can have difficult conversations without 3m people having open access to the record of the conversation.
5. In my opinion, we are betraying the trust of our patients by doing this. In many other countries – Germany, for example – the medical record is held as being absolutely private between doctor and patient, as it used to be here. We should resist being agents of the state – no good has come of this in the past, and medical records have been very badly misused. I cannot understand the lack of RCGP/BMA resistance.
Perhaps a good test of this is: will the Queen’s NHS record also be freely available to such large numbers of people? Boris’s trips to the GUM clinic, perhaps?
If there needs to be a different system for the rich and powerful we should reflect on why what is proposed is good enough for any citizen.