Community services: improving access to clinical information

Each year, community health services have about 100 million patient contacts, accounts for around £10 billion of the NHS budget and one-fifth of the total NHS workforce. Providers of community services include NHS trusts, social enterprises, and private companies.  

Community health covers a wide range of services and provides care for people from birth to the end of their life. Community health teams play a vital role in supporting people with complex health and care needs, to live independently in their own home for as long as possible.  

Community health services are delivered through partnership working across health and social care teams made up of various professionals including GPs, community nurses, allied health professionals, district nurses, mental health nurses, therapists and social care workers. Services are mainly delivered in people’s homes (including care homes) and in community hospitals, intermediate care facilities, clinics and schools.   

User research undertaken by the PODAC programme has identified that many community health services lack sufficient access to appropriate and accurate clinical information about their patients from the point of referral to the point of care. This is crucial for staff working in community settings.

We've identified that community health providers should aim to access clinical information through a shared care record, normally achieved with support from local shared care record programmes. This allows people involved in a patient's care to access their health and care records safely and securely so that they can provide better joined-up care as a patient moves between different parts of the health and social care system.

However, these are at varying stages of maturity, and to speed up access to primary care data, we've identified GP Connect as a more immediate solution. Making information that community health providers tell us is key to their decision-making available for the first time to some providers.

Access to clinical information will benefit community healthcare services through:

• reduced risk of errors and harm to patients 
• improved patient experience (accessibility and convenience)
• better outcomes for individuals and improved population health
• greater convenience for staff
• increased productivity of clinical and administrative tasks

These benefits are particularly significant for urgent community response services that provide crisis response, typically through a multidisciplinary team, to adults in their usual residence within two hours.

Through a recent baselining exercise, the NHS PODAC team has identified community health providers who have an electronic patient record system that is already compliant with GP Connect, but the provider is not accessing that data for a number of reasons. This group of providers will form the initial cohort of a programme to speed up access to this information whilst shared care records programmes mature.

The Future Enterprise Architecture for community health is a conceptual service blueprint to inform the development plans for IT system suppliers. It was developed through extensive strategic stakeholder, service user and supplier research during 2021 and 2022. It supports technology providers to define their product roadmaps to address user priorities. It also supports them to maximise the benefits from current and developing technologies and standards in the market. 

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