Life-saving information to help treat patients during the COVID-19 emergency
COVID-19 has shown just how powerful access to the right information at the right time is. During the first wave of the pandemic, many NHS staff were redeployed, patients were often seen virtually, by an unfamiliar healthcare professional or in an unfamiliar setting. Whole health populations needed to work differently and shared information was absolutely key to the success of this.
To ensure that those providing care for patients and service users had access to up-to-date information, an enhanced comprehensive medical summary from an individual’s GP records was made available to other GP practices, NHS 111 and other health and care services. At the start of the pandemic just over 3 million people had an enhanced Summary Care Record (SCR-AI). By the end of May 2021 over 56 million people had such a record and that figure continues to creep up. This has revolutionised the speed at which clinicians and care providers can make timely, accurate plans for patients - many of which cannot imagine ever having to go back to working without this life line of information. Controls are in place to ensure that only those caring for patients or share how service users have access.
The experience of a chief nurse information officer and clinical safety officer
Claire Lambie, a registered nurse and chief nurse information officer and clinical safety officer at NHS Gloucestershire Clinical Commissioning Group said:
“Prior to the pandemic, access to a person’s health records or care plans would vary and was dependent on a number of factors. Even in an emergency, staff might not have had access to up to date information on the person needing care in front of them.
“Thankfully, local shared care records are becoming more readily available, but there are a few issues with relying on these. For example, if a person does not live in the area or has only just moved to that area, their record may not currently be accessible and not all health and care staff get access to these records.
“During the pandemic, the Summary Care Record with Additional Information (SCR-AI) was set up for people in England who had not opted out of sharing their information. This meant that 92% of the population now had a health record that could be accessed by health and care staff, wherever they may be in England (with their permission).
“For the patient, it means no longer having to go over their medical history, listing conditions, treatments or personal preferences as it’s all held securely online. For me and my colleagues, access to this data is vital and can in fact be lifesaving, especially for those who may have suffered a trauma or are unable to communicate their medical history. Accessing SCR-AI means quicker diagnosis, treatment and care. During the pandemic, this meant that those ‘at risk’ patients were identified quickly and given the right advice or treatment.
“The call for this information to be made widely available is led by clinicians who know that having the right information enables them to prescribe the right medication, give the right advice and correct treatment. It enables the clinician and patient to make informed choices. For instance, if the person has been in an accident and cannot communicate their preferences, the clinician can find this information in their record.
“Reverting back to little or no information is unconscionable. If a person chooses not to share their information, then provided it’s a fully informed choice with the implications fully understood, that’s their decision. However, the majority of people expect their healthcare record to be available at the point of care (with robust data security and access control in place).
“The six domains of healthcare quality are that care is patient-centred, safe, effective, efficient, equitable and timely. My clinical colleagues regularly tell me that having the right information, in the right place, at the right time is critical. SCR-AI delivers across all organisational and regional boundaries - we cannot go backwards; maintaining and enhancing this flow of information has to stay. In my opinion, not making data available in this way poses a risk to patient care and safety, an opinion shared by my clinical colleagues.”
The experience of an ambulance paramedic
Rhys Hancock, registered paramedic and Senior Clinical Lead with the South Western Ambulance Service NHS Foundation Trust said:
“As a paramedic, me and my fellow ambulance crews now have access to a wealth of critical information about our patients through the SCR-AI. This includes medical history, reasons for medication, care plans, respect forms and end of life information and more. It’s available for nearly everyone unless they have opted out.
"Often I see patients unable to remember their full medical history or who don’t have their care plans to hand. Having instant access makes it a hundred times easier to provide more effective and efficient care. This is especially true for older patients, those for whom English is a second language and it's particularly useful for patients with long term or complex conditions, including dementia or learning disabilities. On occasion, additional information means we can avoid a hospital admission. It’s also beneficial for end of life patients who can use it to share information about their preferences, Lasting Power of Attorney and advance decisions, allowing us to make the best decisions with regards to their care and wishes.
"Furthermore, it’s helpful to look up specific COVID-19 information such as whether the patient is shielding, confirmed or suspected of having COVID-19. This is truly amazing for ambulance crews and paramedics up and down the country. It is a unanimous conclusion from me and my frontline colleagues, SCR-AI has to become a permanent feature beyond the pandemic. It allows me and my colleagues to give care which is personal and consistent with each patient’s personal wishes. It simply cannot be removed.”