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This means you will have more accurate and up to date patient information available to give to the paramedic team or clinical hub. The clinical hub may be able to see this information through their own EPR or a paramedic team may also be able to see this information through their MDT or portable tablet device.

A patient with a crisis plan for example available through NRL may be of benefit as a clinician/ paramedic can see the details of their crisis care plan when they are being treated. For example, the crisis care plan may include information about how to spot signs of when the patient may become distressed or what to do in the event of a crisis.

The NRL will allow ambulance services/systems to see any information a participating mental health trust has agreed to share, for example a patient care plan.  

As part of phase one of the NRL project when a patient’s care plan is created by a mental health care professional it will be saved on their computer (their local health care record system) and a pointer to that record (bookmark) will also be saved to the NRL. This means if the patient contacts the ambulance service, at a later date or time the ambulance service will know there is a care plan for the patient and where it is held.  

Later phases of the NRL will enable ambulance services to access actual care plan information through viewing a copy of the care plan or being given contact details to the care plan owner.

We have included an example of a patient in crisis who has rung for an ambulance.  

Example of care without the NRL

This example shows what happens now and what could happen if NRL is integrated into your IT system.

1. A mental health professional creates a care plan for a patient. 
2. The patient rings 999 or 111 because they need support for a mental health issue. 
3. The call handler asks the patient questions to assess what help is required. 
4. If the call is deemed to be urgent the call handler dispatches an ambulance.
5. If the call is decided to be not urgent the patient receives a non specific hear and treat from the call handler. 
6. The call handler is unaware there is a careplan in place for the patient. Unless there is an arrangement through a local shared care records. 
7. If an ambulance is required the paramedic will treat the patient and attempt to find out if there is a careplan in place. The patient may end up having to go to Accident and Emergency and other health care organisations may be involved. 

Example of care with the NRL 

This example shows what could happen if NRL is integrated into your health care system.

1. A mental health professional creates a care plan for a patient. 
2. A pointer is created on NRL that references the care plan. The existence of the pointer allows the ambulance to know there is a care plan in place for this patient. 
3. The patient rings 999 or 111 because they need support for a mental health issue. 
4. The call handler asks the patient questions to assess what help is required.  
5. NRL will allow the service to view specific care plan information meaning that the treatment can be more patient specific and timely.  
6. If the call is deemed to be urgent the call handler dispatches an ambulance.
7. The call handler can use NRL to check if there is a care plan in place and pass that information on to the paramedic. 
8. NRL will allow the paramedic to see the care plan information so the care can be more patient specific and timely. 

NRL will work with your current IT systems without the need to alter your day to day tasks.  We have created some fictitious examples of systems to show what NRL will look like when it is used through existing IT systems and how it can be displayed next to a patient’s information.  

The IT system automatically makes a request to the NRL to locate a specific patient's pointers. These pointers are then displayed within the IT system and can tell you if any care plans exist in other IT systems, what type they are and where they exist.

The screen helps to show patient information as it might normally be displayed after completing a search for a patient. The screen also demonstrates how NRL pointer results can be shown alongside this information.

Once published onto the NRL these pointer results may be able to return patient information such as care plans as created by mental health professionals for example. 

These care plans are created separately from the NRL at the point of care by the care professional and are stored in local IT systems. Why not also take a look at how NRL can work for mental health trusts to learn more about NRL pointers created for care plans. 

NRL pointers in an example of the SCRa

We have created a fictitious version of the SCRa to demonstrate how NRL pointers (bookmarks) look in the SCRa. 

View this demonstration.  

NRL pointers in an example clinical hub system

We have created a fictitious version of a clinical hub to demonstrate how NRL pointers (bookmarks) look in a clinical hub system.

View this demonstration.  

NRL pointers on an example paramedic mobile device

We have created a fictitious version of a paramedic mobile device to demonstrate how NRL pointers (bookmarks) look in a paramedic mobile device. 

View this demonstration.