Orion Health’s UK and Ireland Customer Conference 2022 is taking place in Bristol; which is the home of one of the longest-running and most successful shared care record programmes in England: Connecting Care. Tracey O’Brien, digital consultant at NHS South, Central and West Commissioning Support Unit, has just told the conference that it has been running for nine years – which has benefits and disadvantages. “We are ahead, but also there is lots of new technology available for how we do things.”

The scope of Connecting Care

Connecting Care started with a proof of concept, but now works with two hospitals, a mental health trust, three local authorities, community providers, specialist services such as substance misuse and triage, care homes and hospices. Technically, the systems in use at these organisations feed into the Orion Health platform, Amadeus, from where it can be made available to clinicians with patient consent.

Connecting Care can also share documents, such as hospital discharge summaries with GPs, and is working on personal health records, liaising with the My Medical Record team at Southampton’s university hospital. In fact, it is constantly expanding the range of information that it can share – it has just added IAPT summaries – and the range of sites that it can share it with – one care home has just started sharing information into the record.

Tracey said that, coming from a social care background, “I am also pushing to share more information, particularly children’s information, into our record.” But, she said, “there is still so much more to do; after almost ten years, there is still a lot on our roadmap” and there are some organisations that the record is still looking to reach. “Like a lot of people in this room, we are waiting for the ambulance service to come on board,” she said. “We are still working with the prison service. And like a lot of you, we want to be sharing care plans.”

Working with care homes

A recent focus for the Connecting Care programme has been on rolling-out access to care homes; which is a national priority, given the policy imperative to join up health and social care and support population health management approaches.

“We were given funding from NHS Digital to connect Connecting Care into care homes,” Tracey explained. “As many of you know, until now they have used letters and faxes and more recently NHSmail to share information, but now we have set up a VPN to allow them to access the Connecting Care platform, as long as [the meet] security standards. We have also been working with the Public Standards Record Body on standards and we have provided our care homes with the PRSB care home view.”

Tracey said this has made a big difference to care homes. “The comments that we have got remind me of what people said ten years ago, when we started on this journey,” she said. “They want information about their residents’ care, and their medications, because that is a source of anxiety for residents and their families. Care homes also need to make decisions about admitting residents from hospitals.

“They are becoming experts in making decisions about where to admit, and they are using Connecting Care to make sure that nothing is missed. We are also hearing things we didn’t expect. We are being told care homes are becoming more expert in wound management, and making sure that patients have the right food for their needs.”

Lessons and the future

Connecting Care has been on a long journey, and has inspired many integrated care systems that are still putting their ‘basic’ shared care records in place. Reflecting on this, Tracey said that some of the things she had learned were: “We have spent a lot of time discussing what information to share, and going at the pace of the slowest, but if you keep going, you will get there.”

Tackling concerns about information governance, sorting out onboarding and user access, and addressing the technicalities of information sharing had all been essential, she said. “And on the technical side, there are still things to do. We have had to map our terminology to social care, and agree a local information standard. Now, we have [the PRSB] core information standard, it will make a big difference. We have had to address our UX, and to move to using FHIR standards where we can. Luckily, Orion Health is an exceptional supplier and uses those standards.”

Going forward, she said there was still a requirement for Connecting Care to take more control over what can be shared from system suppliers; and to find a new way to discuss whether to include sensitive information, such as concerns about domestic violence. However, after almost ten years, there is no doubt that Connecting Care is delivering on its vision to not just join-up health and care, but to support clinicians, patients, vulnerable individuals and their loved-ones across the region.
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