Children's Health Digital Strategy 2016 - An introduction
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NHS England is leading in the development of a new digital strategy which will transform the way children's health information is gathered and used over the next five years. The current information landscape is fragmented with partial records spread across different clinical systems. One child will have separate profiles across maternity, general practice, child health information and acute systems. This complex picture is difficult to access by professionals outside of the health system, such as education or social care. There's also still a high volume of paper records going back and forth between different settings, which, aside from being bad for the environment, is error prone and time-consuming. When you consider the commitment made that health and care services will be paper-free at the point of care by 2020, it is crucial that we address child health with a new digital strategy if we are to meet that commitment and improve the care that children receive by providing an information service which knows where every child is and how healthy they are as well as appropriate access to child health information for all involved in the care of children.
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Children's Health Digital Strategy 2016 - An introduction
- 2. 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.
- 3. 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
- 4. 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.
- 5. www.england.nhs.uk • 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:
- 6. www.england.nhs.uk 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)
- 7. 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
- 8. www.england.nhs.uk NIPE Bloodspot Hearing NewBaby Review 6-8WeekExam 8/12/16wkImms 12mthReview 12/13mthImms 2/2.5yrInteg Review 3yr4mthImms 4-5yreyesight check SchoolEntryChk Year6Check Year8HPV Booster Imms MaternityIS 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 AuthorityLab Complexity of current systems interaction
- 9. www.england.nhs.uk Working and thinking in silos creates access issues
- 10. 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
- 11. www.england.nhs.uk • 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
- 12. www.england.nhs.uk • 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. . .
- 13. www.england.nhs.uk NIPE Bloodspot Hearing NewBaby Review 6-8WeekExam 8/12/16wkImms 12mthReview 12/13mthImms 2/2.5yrInteg Review 3yr4mthImms 4-5yreyesight check SchoolEntryChk Year6Check Year8HPV Booster Imms 0 5 8 11 7 9 12 13 24 40 - - Age in days In monthsIn weeks NHS Number Issued Registered with GPY 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
- 14. 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
- 15. 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
- 16. www.england.nhs.uk 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:
- 17. 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:
- 18. 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:
- 19. www.england.nhs.uk And how systems should interoperate: N3 Boundary Voluntary Organisations Educational Systems Personal Health Records Local Authority Systems Non-NHS Systems National Screening Systems Personal Demographic Service Summary Care Record Child Protection Information Sharing National Systems Maternity Systems Local Systems Primary Care Systems CHIS Acute & Emergency Systems Mental Health Systems Secondary Use Services inc. MDS & GPES
- 20. 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
- 21. 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
- 22. www.england.nhs.uk • Email alison@golightlyandgolightly.com 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