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How is additional information in Summary Care Records being used?
As the coronavirus hit us in March, the Government made a significant change to the sharing of patient information for those working on the frontline in the NHS. Tamara Farrar, a user researcher at NHS Digital, looked at what that extra information meant for professionals in a wide range of different health and care settings.
17 December 2020
The Summary Care Record (SCR) is the main way that vital facts from a patient’s GP record are shared with other clinical professionals who are involved in a person’s health and care. The basic SCR includes what medication people are taking, their allergies and known adverse reactions to treatments.
My day-to-day role is part of the Spine Team in the Platforms directorate of NHS Digital, and we are in the process of delivering a re-designed version of the Summary Care Record Application. This is one of the ways a user can view a SCR. Having worked in this area for 18 months, I gained insight and knowledge regarding what our users need from a healthcare record. Past research has told me that whilst knowing about a patient’s medication and allergies are important, it’s often not enough.
The SCR also has an option to add additional information such as the patient’s long-term conditions, immunisations, and greater depth on their medical history. But this additional information had, until the coronavirus crisis, only been included for patients who had specifically opted in.
I was really conscious that people were already up against it and dealing with huge pressures.
As hospital admissions spiked in the spring, the Government changed to an ‘opt-out’ model under what is known as a Control of Patient Information (COPI) notice. Additional information is now present in the SCR and shared with health and care professionals by default – except for those patients who have previously told the NHS they don’t want their information sharing.
This has been a temporary measure, originally scheduled to end in September but now extended until March 2021 due to the continued impact of coronavirus.
As a user researcher, I was asked to find out how the additional information in the SCR was being used and the impact this had on healthcare professionals and their patients.
The first thing I did was identify who I needed to speak to and recruit them for my interview sessions. The groups I sought were located across many different health settings – not just in general practice and hospitals, but also in mental health services, prison healthcare and social care.
As we were in the midst of the first wave, I was really conscious that these people were already up against it and dealing with huge pressures, so I had to change the approach I would usually take. Most of my recruitment was through messages on social media and shared by the medical community – I made sure that my intent was clear and that the sessions would be short, with minimal time away from caring for patients.
During this recruitment and the subsequent interviews, what impressed me the most, was how passionate our users are, and the fact that they took the time to be involved will always be a reminder of how important this work is. We research and design around user needs, collaborating to identify solutions. These are some of the things I learned and stood out for me within the following settings:
What I saw during these shifts were crews having to turn detective.
In the past, I have carried out ethnographic research with ambulance crews, which meant that I observed them on their shifts – riding in the ambulance and assessing patients in their homes, which is one of the highlights of my career. During these shifts I saw a lot of crews having to ‘turn detective’ and look for medication packets, discharge letters and other evidence of the patient’s medical background.
Access to additional information now enables them to see this information easily and quickly. They can also find out a lot of other history (medical and social) and use this to build up a picture of the patient in front of them and have a basis for probing further with the patient if they need to.