children's health digital strategy 2016 - an introduction
TRANSCRIPT
www.england.nhs.uk
Children’s
Health
Digital
Strategy
2016 An Introduction
November 2015
www.england.nhs.uk
What is the Digital Strategy? • A roadmap which explores the options for transforming the way
children’s health information is gathered and used over the next 5
years.
• Currently child health information services (CHIS) comprise:
Child Health Record Departments (CHRDs)
Child Health Information Service Systems (CHISS)
Personal Child Health Records (PCHR or ‘red book’)
• Child health information services liaise across care settings and
agencies and regions to ensure that children and young people in
their local population are offered the universal services available –
the ‘Healthy Child Programme’ – and that key information on
children’s health is available to parents and professionals and for
public health purposes.
www.england.nhs.uk
Children and Young People
Parents, Families, Carers
Health Professionals
in all care settings
. . . Primary, Urgent, Acute, Mental Health, Community,
Voluntary
Social Care Professionals
Public Health Professionals
Education Professionals
Strategy aim: Appropriate access to child
health information for all involved in the
care of children
www.england.nhs.uk
Why a new digital strategy now? • In recent years there has been a new emphasis on ways of
improving children’s health:
Focusing on the importance of early interventions and preventive measures in improving health
The idea of proportionate universalism – improving the lives of all, with proportionately greater resources targeted at the more disadvantaged groups
The need for more coordinated approaches to child health and wellbeing if outcomes are to be improved
Thinking of investing in the current and future health of children and young people rather than focusing purely on spend
Needing to listen to children and young people and families if we are to develop effective strategies
• But the way we manage and inform parents and professionals
about the health of children has not changed in over 20 years
and cannot support the new vision.
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• Changing perceptions about organisational boundaries to provide
joined-up care
• Overcoming technical constraints to provide information when it is
needed, in easily understandable formats
• More information sharing across care settings within health
• More information sharing with partners outside of the NHS who are also
responsible for the health and wellbeing of children
• Online access for children, parents and families to their own health
records
• Using the potential of new technologies to enhance health and wellbeing
Significant change is needed:
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The existing model of CHIS will not scale
to meet current and future challenges
NHS and
Public Health
Communities
Non-NHS
Communities
Children,
Young People
& Families
? CHRDS
CH Info Systems
PCHR (Red book)
www.england.nhs.uk
• Is fragmented – partial records in several different systems – Maternity,
GP, Child Health Information Systems, Acute
• No single picture of a child’s health interventions
• Is complex - disparate systems with very little interoperability
• Very limited access to information for our partners outside the NHS, for
example, Social Services or Education
• Information still largely recorded on paper and sent from care-setting to
care-setting
• Information re-keyed from systems to system creating large
administrative burden
• Possible for children’s information to be mislaid/delayed when they
move to a new area
• Impossible to easily view a child’s history and determine how healthy
they are
Current Information Landscape
www.england.nhs.uk
NIP
E
Blo
od
sp
ot
He
ari
ng
Ne
w B
ab
y
Re
vie
w
6-8
We
ek
Ex
am
8/1
2/1
6 w
k Im
ms
12
mth
Re
vie
w
12
/13
mth
Im
ms
2/2
.5 y
r In
teg
Re
vie
w
3yr
4m
th Im
ms
4-5
yr
eye
sig
ht
ch
ec
k
Sc
ho
ol E
ntr
y C
hk
Ye
ar
6 C
he
ck
Ye
ar
8 H
PV
Bo
os
ter
Imm
s
Mate
rnity I
S
0d 5d 8d 11d 7w 9w 12m 13m 24m 40m 4y
5y
5y
Public Health & MDS
Acute & Mental
Health
e e
Primary Care IS
Child Health IS
CP-
IS
PDS & Summary Care Record
Screening
Local Authority Lab
Complexity of current systems interaction
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Working and thinking in silos creates
access issues
www.england.nhs.uk
The challenge is to simplify and standardise
Population Management &
Population Definitions
Access & Information Governance
Interoperability & Centralised vs
Distributed systems
Lack of National Data Standards
Variability of local practice &
procedures
Accountability
&
Responsibility
Inclusivity &
Working
Without
Boundaries
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• Imagination and intelligence need to be applied to use information in
ways that enhance professional practice and personal/parental
responsibility for the health of children and young people
• We need to inquire into why we do things in certain ways and ask
whether there are better ideas and models available.
• We need to change our perspective to truly see and deliver integrated
care, no more working and thinking in silos.
• We need to do things differently
We need to think differently
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• We had a simple, almost real time, single view of whether the healthy child
programme had been delivered to a child?
• It acted as failsafe for the population and the child and the parents?
• It could be used easily by parents and children – what interventions should
my child be having, at what age, have they had them?
• It could be used by professionals managing a population cohort (or
caseload)
Health Visitors
School Nurses
GPs
Practice Nurses
Commissioners
What if. . .
www.england.nhs.uk
NIP
E
Blo
od
sp
ot
Heari
ng
New
Bab
y
Revie
w
6-8
Week E
xam
8/1
2/1
6 w
k Im
ms
12 m
th R
evie
w
12/1
3 m
th Im
ms
2/2
.5 y
r In
teg
Revie
w
3yr
4m
th I
mm
s
4-5
yr
eyesig
ht
ch
eck
Sch
oo
l E
ntr
y C
hk
Year
6 C
heck
Year
8 H
PV
Bo
os
ter
Imm
s
0 5 8 11 7 9 12 13 24 40 - -
Age in days In months In weeks
NHS Number Issued Registered with GP Y N
Admitted, UCL, 01/10/2014
Discharged, UCL, 05/10/2014
A&E, Whittington, 03/12/2014
A&E, Royal Free, 03/12/2014
No transactions
Timeline and Health Status for Child
www.england.nhs.uk
• This is only an initial idea, one among may, a beginning
But what if. . .
What if you decided to contribute your ideas for how we can better use information and digital services to improve healthcare for children? f
www.england.nhs.uk
We are seeking consultation with:
Children
Service Users Parents Families
Info Services
for Parents
Architecture
HSCIC Interoperability
Standards
CHIS Maternity
System Suppliers Neo-natal Screening
GP
Health Promotion
PHE Screening
Imms
Innovation & Best Practice
Sites
Social Services
Local Authority Education
Justice
Midwives Paediatricians
NHS Clinical Health Visitors School Nurses
GPs
Psychiatrists
CPNs/CMHNs
Royal Colleges & Prof. Bodies
Nurses
CHRDS Commissioning
NHS Non-Clinical Operational
P&I Digital Tech
NHS England Interoperability
PHR
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Birth and Neo-Natal Care
Healthy Child Programme
0-5 Years
Primary and Community
Care
Acute Paediatric
Care, including Urgent Care
Child & Adolescent
Mental Health and Learning
Difficulties
Safeguarding
School Health
The following services are in scope for the
strategy:
www.england.nhs.uk
Personal Child Health Record
Summary Care Record
Primary Care Records
NHS Trust Health
Records
Health Records in
NHS Partner Organisations
Public Health Information
Minimum Datasets and
Secondary Use Services
The following information types are
included:
www.england.nhs.uk
Child Health Information
Systems
(CHIS)
Summary Care Record & Personal
Demographic Service
Maternity Systems
National Screening
Systems and CP-IS
Primary Care Systems
Acute & Mental Health
Systems
Electronic Personal Health
Records (PHRs)
We will be looking at these digital systems:
www.england.nhs.uk
And how systems should interoperate:
N3 Boundary
Voluntary
Organisations
Educational
Systems
Personal
Health
Records
Local
Authority
Systems Non
-NH
S
Syste
ms
National
Screening
Systems
Personal
Demographic
Service
Summary
Care Record
Child
Protection
Information
Sharing Na
tio
na
l
Syste
ms
Maternity
Systems Lo
ca
l
Syste
ms
Primary
Care
Systems
CHIS
Acute &
Emergency
Systems
Mental
Health
Systems
Secondary
Use Services
inc. MDS &
GPES
www.england.nhs.uk
• Work began September 2015
• Consultation interviews started in October and continue through to
February 2016
• A first design workshop was held 2nd November 2015
• Further workshops being planned for January and February 2016.
• Estimated publication date Spring/Summer 2016
• The strategy will cover the strategic direction for child health information
to 2020
Timeline
www.england.nhs.uk
• Tracey Grainger, Head of Digital Primary Care Development, Digital
Technology Directorate, NHS England
• Dr David Low, Clinical Advisor, HSCIC
• Andy Smith, Programme Manager, Cross-Government Programmes,
HSCIC
• Alison and Shona Golightly, Child Health Information Consultants, NHS
England
Digital Strategy Core Team
www.england.nhs.uk
• Email [email protected] to be included on our contact
lists for information and events.
• Then:
• Contribute your ideas for the strategy via our online feedback form – we
will send you the link for this by email.
• Attend one of the workshops we will be planning for 2016.
• If you represent an organisation, invite us to attend one of your regular
forums to discuss the strategy.
• Or let us know you’d like a call to discuss your ideas.
How to contribute to the strategy