DCCR briefing February March 2023

A new system that aims to transform the way information is shared among health and care organisations has been launched in Devon and Cornwall.

The Devon and Cornwall Care Record (DCCR) enables authorised health and care staff to see details held by a wide range of providers across Devon, Cornwall and the Isle of Scilly in a single record. It gives professionals a more complete view of a patient’s history and is part of a national programme.

Phase 2 and beyond

The programme team has been developing a plan to take the DCCR forward over the next year to improve its capability and usefulness to health and care professionals. It has been proposed that, subject to funding, the following data and features will be added to the system:

Admission, discharge and transfer information from Royal Devon University Foundation Trust and Torbay and South Devon Healthcare Trust

• Documents – initially discharge summaries, but care plans and clinic letters are also being discussed
• Echocardiogram results
• ED admission, discharge and transfer messages from University Hospitals Plymouth
• Engage Portal (linked to forms, which are mentioned below)
• IAPTUS data from Cornwall Foundation Trust
• Multi-factor authentication (to allow access via mobiles phones/tablets)
• Radiology results.

In addition, we are aiming to build some multi-disciplinary and cross-organisational forms. Work on the Treatment Escalation Plan has also started (see below) and other forms for consideration include frailty assessment, mental health framework and personal care plans.

We are also always keen to get feedback from the users on how the system could be improved, and the type of information that would be useful to see. While we can’t always deal with all requests – due mainly to the age of some systems that are in use – we will look into all suggestions, and where integration is technically possible, add this to the forward plan.

Roll-out

The roll-out to new organisations and staff groups within existing organisations is picking up pace. As more information is made available, especially from Royal Devon University Healthcare NHS Foundation Trust and Torbay and South Devon NHS Foundation Trust, as well as the remaining GP practices in Devon, we are confident that the benefit to users will increase.

In Cornwall, 100% of GP practices are signed-up and the aim is to have all practices live within the next two months. With data being surfaced by Royal Cornwall Hospitals Trust (RCHT) and

Cornwall Foundation Trust, we will be looking to roll the system out to more user groups over the summer.
Initial engagement with social care providers has begun and we hope some early adopters will have access to the system and be sharing data during the summer months.

New capability

Data is now available from Devon’s hospices. This can be accessed via the Clinical Document Viewer.

Alerts will be live from Royal Cornwall Hospitals Trust from April 18. Initially, these will be limited to anaesthetics, special requirements (such as sign language) and a military veteran flag.

We will increase the range of alerts from RCHT and engage with other stakeholder organisations over the coming months to widen the scope of the information available. However, while we build up the alerts information – the absence of an alert does not mean that the patient does not have an alert recorded on a system somewhere. If in doubt, check your local system for alert information.

Future capability

Two new dashboard cards will be appearing soon. These are ‘Organisations Involved’ and ‘People Involved’. This will show at a glance the last five people to access a record, and the organisation that they work for. The organisations card will show any organisations that are currently involved in the care of the patient or client.

Treatment Escalation Plan (TEP)

The Devon system end of life care steering group and partner stakeholders have been working with Orion to develop an electronic TEP form that will be hosted within the DCCR system.

Core development has been completed and functionality will now be tested by a range of partners within the Devon and Cornwall health and care systems.

The aim of the project is to increase the availability of TEP information to health and care professionals involved in their care. This will significantly improve continuity of care for individuals and help speed-up decision making around their treatment options and preferences.

In parallel, the One South West programme is working with the South West Ambulance Trust (SWAST) and NHS England to make this document available to controllers and front-line ambulance staff.
For additional information, email James Boult at james.boult@nhs.net

GP data

From late spring or early summer, we will surface data using the national GP Connect system. Since the system went live, this has been done via the Medical Interoperability Gateway (MIG).

This change will allow us to bring some critical information to the fore and add relevant alerts from the GP record to the Alerts dashboard card so that they are readily viewable from the main patient screen.

EMIS issues

EMIS users have been experiencing issues with ‘Launch in Context’. This is due to interoperability between the DCCR and EMIS as a result of some Microsoft software becoming outdated.

Working with shared care record teams who experienced similar issues, the DCCR support team have identified a solution and asked all the GP practice IT support providers to make a small change to the configuration of Microsoft Windows for all the PCs and laptops they support.

While most users have the fix in place, some are still reporting problems. If you use EMIS and find that Launch in Context does not work, contact the organisation that provides your IT support. They should already know how to fix the issue, but if they have any questions, please refer them to the DCCR support team using the e-mail below.

The national picture

The Health Tech Newspaper recently reported on the key findings of the Hewitt Review – an independent review of integrated care systems.

It stated that “The Shared Care Record (ShCR) should be a priority for further development”, and that there is an “urgent need” to enable social care providers, voluntary providers of community and mental health services and local authorities to access the ShCR on an equal basis with NHS partners.

It added that “as soon as possible, the ShCR should enable individuals (and their carers where appropriate) to access as much as possible for their own data and allow them to add information about their own health and wellbeing.”

At the recent Shared Care Record summit in Leeds, Tim Ferris (National Director of Transformation at NHS England) committed to the programme and challenged all shared care record programmes in England to allow the sharing of information between the various programmes.

In the South West this work is being led by the One South West programme. Shared care records factor into the national programme and the DCCR programme will continue to develop the system to meet both local needs and that of the wider national agenda.

Find out more about the DCCR

The programme team has also produced a range of resources to help staff and patients find out more about the DCCR. These include a:

Quick guide to the DCCR – basic details about the programme.

• Patient communication toolkit – a suite of marketing materials to help organisations inform their patients and service users about the DCCR and its benefits. (download the quick guide and patent toolkit from the DCCR resource)
• Website – information about the DCCR for patients and health and care staff. The site can be found at https://devonandcornwallcarerecord.nhs.uk/
• Training website – supports staff of participating organisations in the use of the DCCR platform. The site includes user guides and short videos and can be found here