Platforms

We developed an online GP registration service for patients, shifting the process of GP registration from paper to digital for the first time. Initially launched across 34 practices, it has proved extremely popular with both patients and practices, who benefit from a quicker process with more accurate information. This helped reduce practice administration time by at least 15 minutes per registration and, with 6 million registrations annually, this promises significant time savings across primary care. We will be expanding from 50 to 500 practices and integrating with GP systems in the coming year.

We also made changes to support the COVID-19 vaccination programme as the pandemic evolved. This included supporting the accelerated booster rollout for the various cohorts and the logging of vaccines administered outside the NHS. We introduced the national COVID-19 vaccination invitation preference service, which allows people to choose how they want to be contacted by the NHS to book a COVID-19 vaccination. The service has enabled people to opt out of certain communications, allowing the NHS to target its resources more effectively.

In addition, we improved the quality and timeliness of mortality reporting, using data from the General Register Office, Office for National Statistics and our Personal Demographics Service (PDS). Through this work, we reduced the average time to record a death in PDS from 20 days to 9 days and reduced the need for manual resolution from 10% of registered deaths to 0.1%.

The NHS Spine responds to service demands across all platforms, allowing secure information sharing in the health and care system. It supports the transfer of vital vaccine information, pathology results, referrals and prescriptions. In December 2021, the Spine reached a record high of 1.8 billion transactions, with a 40% increase in transactions year-on year. This was handled through proactive hardware scaling and by upgrading the datastore to achieve increased performance and reliability. A significant percentage of the traffic increase has been through the internet, reaching a peak of 14% of total transactions. This growth has been driven by increased use of PDS and the Message Exchange for Social Care and Health (MESH), the secure large file transfer service used across health and social care organisations. These services were used to support the COVID-19 vaccination programme, Test and Trace, and the National Booking Service. Release 1 of our MESH to Cloud service is now complete, meaning files over 2GB are held on Amazon Web Services. This increases our ability to handle large files and reduces risk to the service.

We are continuing to make integration easier and have expanded our application programming interface (API) platform, with more than 50 APIs now live on the portal. We have 33 point-of-care and patient-facing applications using these APIs and have processed more than 1.4 billion transactions since January 2021– around half of which were in support of the response to COVID-19. Our new digital onboarding service went live in January 2022 and is making it quicker and easier for applications to get connected to our production environment. We have introduced API lifecycle management, with obsolete APIs being deprecated and eventually retired.

Our APIs use the global standard for health care data exchange, Fast Healthcare Interoperability Resources (FHIR). This year, new demographic services based on the latest FHIR 4 standard were used. Population of key fields such as email address and mobile number has improved from 36.2% to 47.9% and 84.9% to 88.3%, respectively, supporting digital communications from local and national programmes.

In 2021-22 we established a UK FHIR governance structure. This will enable the development of common standards that can be agreed by the 4 nations, supporting interoperability across the UK.

To support the fight against COVID-19, our Risk Stratification team built a platform that allows high-risk, non-hospitalised patients with COVID-19 to have access to therapeutics. The digital pathway provides a route for COVID Medicine Delivery Units (CMDUs) to reach out to patients who are vulnerable, testing positive, and digitally identifiable. These patients are clinically triaged and, if eligible, given treatment, reducing their risk of severe outcomes from the virus. To reduce the burden on patients, all patients identified in this way have been provided with priority PCR and lateral flow tests ready for use. These patients are also contacted by text message and email on testing positive to ensure they are aware of the pathway. The platform has identified more than 170,000 eligible patients for clinical triage.

We also supported the national PANORAMIC Trial, which investigated whether new antiviral treatments for COVID-19 in the community reduced the need for hospital admission and helped people get better sooner. Our Risk Stratification team built a digital cohort system that gives GPs access to a list of their patients who have tested positive for COVID-19 and might be eligible for the study. GPs use this information to contact patients and offer information about taking part. The trial has exceeded expectations: due to effective patient identification, nearly 23,000 patients have been recruited, compared to the original target of 10,000. Since automated SMS enablement in February 2022, participation rates have doubled, significantly improving the rate of clinical evidence collection from the trial. This work will provide the clinical basis for offering these therapeutics to the wider population.

The COVID-19 pandemic highlighted the need for better information sharing between care settings and localities, as well as between professionals and patients. We have continued to build on the success of the Summary Care Record application (SCRa), which gives authorised clinicians access to key information from a patient’s GP record. With information on around 52 million people, it is a vital national resource. 50% of ambulance trusts are now accessing the new version of SCRa in order to provide better care to patients and reduce unnecessary hospital admissions. In addition, more than 4,500 paramedics are accessing SCRa using fingerprint verification, speeding up access to vital information. Pilots are also taking place in NHS trusts, care homes and pharmacies. Use of the Summary Care Record (SCR) has increased by 26%, with 290,000 views per week.

The National Record Locator (NRL) helps clinicians find patient information held in other parts of the NHS, alerting users when records exist and pointing to where they are held. In 2021-22, the number of pointers on the NRL’s index has increased 10-fold, from 40,000 in March 2021 to 400,000 in March 2022. More than 13,000 healthcare professionals can now access 5 different types of records from other care settings, including mental health crisis plans, end-of-life plans and urgent care plans.

We have also expanded the use of the National Event Management Service (NEMS), which improves the sharing of information about children’s contacts with healthcare. It now covers 80% of child health information services and health visiting services and handles about 85,000 messages per day.

The Electronic Prescription Service (EPS) offers a safe and secure way to digitally prescribe, dispense, track and sign for prescriptions from any care setting. Digital prescribing rates rose to 90% in 2021-22. During the year, we piloted support for digital prescribing in secondary care settings.