National Record Locator for mental health trusts

This means an ambulance service may 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 when they are treating a patient.  

The NRL will allow ambulance services or 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.  

The result is the patient's care plan can be viewed to enable direct care. This is informed care and will help and support the delivery of care and treatment to your patient in a more timely manner.

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, before 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 IT 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. 

The NRL will allow trusts to treat patients with a greater understanding of their needs. 

As a mental health professional such as a care coordinator, your role will not change as a result of the NRL. You will create care plans as usual for the patients you are co-ordinating care.

The role of care co-ordination will be defined by individual mental health trusts in line with the CPA policy and procedures

Once you have created a care plan an NRL pointer will be produced automatically. This is either created directly from your local health care system to the NRL or with your local health and care record exemplar. These pointers can be seen and read by other organisations and will point the authorised users to the patient's care plan. They will be used by authorised users to see the care plan information. 

Most users within a mental health trust may never need to see a NRL pointer or even interact with the NRL directly.  Your organisation's ICT and business intelligence departments, along with your information governance lead and CCIO, will help to define and scope which care plan field or sections will be included. 

Why not also take a look at how NRL can work with ambulance services to learn more about what NRL pointers look like in their health care system.  

1. Pointer development and generation 

Your ICT, business intelligence, information governance lead and other departments will help you to decide and scope what fields to include in your care plan. 

2. Your electronic patient record 

3. Pointer production

Once you have created the care plan, a pointer will be produced. This is created either directly through the NRL or with your local health care record. The pointers can be seen and read by other organisations which will point the users towards the patient's care plan.

Pointer consumption

The care plan you have created will allow authorised users to view the care plan information. Open the NRL for ambulance services to see an example of a pointer.