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Thames Valley and Care Records Partnership www.thamesvalleysurreycarerecords.net May 2020 TVS Care Records partnership update

1 URGENCY 2 WIDER ACCESS 3 ACCELERATION By the end of June During the COVID 19 pandemic Surrey, clinicians across up‐to‐date patient information and Berkshire West, becomes even more important Milton Keynes Frimley and across Valley and speeding up work Surrey. to get will have access information into to patient the platform as information across soon as possible. those areas.

4 AMBULANCES 5 FURTHER ACCELERATION 6 ACROSS BOUNDARIES We are looking where the Ambulance service SCAS and We are aiming to programme can be accelerated to subsequently SECAMB will share patient data help patients (for example, those access the care record. across ICS boundaries with cancer) ASAP. We will only accelerate if we can do it safely.

5/27/2020 4 TVS Care Records partnership update

Given the COVID 19 pandemic the programme will require: • A more flexible approach, as staff may be deployed to support COVID‐19 related activities. • Each local area across & Surrey to take greater ownership of their TVS Care Records activity and our collective opportunities.

LEADERSHIP We are delighted that Jane Hogg will be joining the programme as the new SRO for the TVS Partnership. Jane is currently the Integration and Transformation Director for Frimley Integrated Care System (ICS) and will be leading the work of the partnership alongside her Frimley ICS role.

5/27/2020 5 Who?: the Thames Valley and Surrey (TVS) Care Records Partnership

The TVS area covers 3.8m residents and: • 13 NHS trusts • 334 GP practices and multiple Primary Care Networks • 15 councils

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5/27/2020 6 Partnership: Organisations in TVS

10 ACUTE 15 LOCAL AUTHORITIES TRUSTS Reading Borough

Rushmoor Borough Council Royal Berkshire 3 C/MH Council Council NHS FT TRUSTS Buckinghamshire Borough Council Council Buckinghamshire Surrey and Borders Healthcare NHS Trust Partnership NHSFT Borough Forest Waverley Borough Council Council Council

Frimley Health Berkshire Healthcare NHS FT NHSFT RB Windsor and County BERKSHIRE WEST ICP Council Council Milton Keynes University Hospital Health Guildford Borough Oxfordshire County NHS FT NHS FT Council Council Borough Oxford University Surrey County Council

2 AMBULANCE TVS CARE RECORDS Council Hospitals NHS FT SERVICES Ashford and St Peter’s SOUTH CENTRAL 334 GP 9 OOH 3,800,000 Hospitals NHS FT AMBULANCE SERVICE 7 CCGs PRACTICES SERVICES CITIZENS Epsom and St Helier University Hospitals S.E.COAST GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP NHST AMBULANCE SERVICE GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP Royal Surrey County 2 CHILDRENS GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP Hospital NHS FT SERVICES GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP Surrey and GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP Healthcare NHST SCW CSU CHIS GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP Frimley Health NHS FT Surrey CHIS (CSH) (Wexham) GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP GP

5/27/2020 7 Why?: around 20% of acute care for patients in the TVS area is provided outside their home area

This example shows the number of patients that received care outside of their ‘home area’ in 2018.

This care does not currently benefit from shared health and care records, so health and care professionals do not have a complete picture of the patients’ needs’. 20% of all patients 21% of all patients 18 % of all patients visiting an A&E having out‐patient care having in‐patient care

140,333 people 336,317 people 125,413 people

1,814,981 people 18 % of all episodes of acute care

5/27/2020 8 Aim: sharing patient information to support health & care across TVS

1 SHARING 2 BETTER DECISIONS To enable sharing of patient information ‐ such By sharing this information safely, quickly and as diagnosis, hospital admissions and treatments securely using the TVS Care Records, health and with health and care staff involved in the care of care workers will be able to access the most patients wherever they are seen in current details about a patient to make the best Buckinghamshire, Berkshire West, Frimley, choices about their care. Milton Keynes, Oxfordshire and Surrey.

5/27/2020 9 Local Care Records: What’s happening in my area? Buckinghamshire

• Patient data from Buckinghamshire is already in the TVS Care Records.

• Sharing of patient data in the TVS Care Records for clinical use is planned by the end of June.

• Patient data will then be available for supporting the health and care of patients.

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5/27/2020 11 Berkshire West & Frimley

• Patient data from Berkshire West and Frimley is already in the TVS Care Records.

• Sharing of patient data in the TVS Care Records for clinical use is planned for the end of June.

• Patient data will then be available for supporting the actual health and care of patients across Buckinghamshire, Berkshire West and Frimley.

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5/27/2020 12 Surrey

• In June the Surrey Care Record will go live for clinical use.

• Proposals will be developed for patient data from Surrey to connect into TVS Care Records.

• Intent is to enable patient data to be available for supporting the health and care of patients across Surrey, Buckinghamshire, Berkshire West and Frimley.

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5/27/2020 13 Milton Keynes

BERKSHIRE WEST ICP • Plans are being made for local care records in Milton Keynes to connect with the TVS Care Records.

5/27/2020 14 Oxfordshire

• The local care records in Oxfordshire ‐ Health Information Exchange (HIE) ‐ went live on 8 April 2020.

• Plans are being made for patient data in Oxfordshire to connect with the TVS Care Records.

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5/27/2020 15 Planned Population Coverage

Percentage of TVS population covered by the platform as areas go live with data use

Buckinghamshire

Surrey Milton Keynes Oxfordshire Berkshire West & Frimley

May June July TBA TBA

5/27/2020 16 Ambulance services across the TVS partnership

• During the COVID‐19 emergency it is critical for ambulance staff to be able to access the care records of patients in their care South Central Ambulance • Service (SCAS) Plans are being made for SCAS and subsequently SECAMB to be able to access the TVS care record

• We are working with ambulance services to enable paramedics and call staff to have access to the information

South East Coast Ambulance Service (SECAMB)

5/27/2020 17 Case study scenario: Emily Parsons

THE PATIENT THE HISTORY Emily Parsons is an 86‐year‐old lady living in Padbury, Buckinghamshire Emily has a familial history of hypertension (high blood pressure) and is taking amlodipine. She has paroxysmal Atrial Fibrillation and suffered a Transient Ischaemic Attack 5 years ago. She is taking a low dose of apixaban.

ALLERGIES THE EPISODE Emily is allergic to aspirin. Emily is an independent lady but recently had a fall and was admitted to A&E at MKUH. She is now receiving physiotherapy from Buckinghamshire Healthcare Trust (BHT).

5/27/2020 18 What happened in A&E : clinician’s perspective

1 On arrival at A&E Mrs Parsons is able to tell the team about the trip that caused the fall 2 and that she is on “two yellow tablets” but Mrs Parsons has low blood she is “not sure what they are”. She takes pressure, has extensive them because her “GP thinks it is best after bruising and is in she had a funny turn”. considerable pain on movement but X rays do not show any fracture.

3 4 The A&E team are able to consult Mrs Parsons Careful judgement has to be made about her medication. Both Shared Care Record and find out about her her drugs are temporarily stopped, and she is given a short iv previous TIA and her current medication. On saline infusion and encouraged to drink. She is given paracetamol, further thought she does seem to be rather dry avoiding non‐steroidal anti‐inflammatories, and stays overnight and blood tests are taken which do show a degree but is rapidly mobilised with the help of in‐patient physiotherapy of renal failure. She has no overt evidence of any with a referral to community physio for a home visit. cerebrovascular event.

Information about Mrs Parsons medication and past history has been crucial in avoiding problems arising from her medication. The speedy notification of her admission to her GP allows her practice carefully to restart her medication once her condition has stabilised in order to manage her risk of a stroke.

5/27/2020 19 For more information

Website: www.thamesvalleysurreycarerecords.net

Email: [email protected]

TVS animation: https://www.youtube.com/watch?v=0CpvMUh6w7

Twitter: https://twitter.com/TVSpartnership

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