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Summary Care Records with Additional Information – user research report

Use cases for Additional Information

Our research identified the following areas that have particular use cases for Additional Information and would value it continuing to be available in Summary Care Records after the pandemic-related Control of Patient Information (COPI) regulations expire.

Out of hours health care services

During out of hours services, Summary Care Record allows for more robust messaging between settings and across systems.

Out of hours GP services

An out of hours GP needs to build a wider picture of their patient’s needs than just medication and allergies. They need to know if they:

  • are frail or housebound
  • have palliative care needs
  • have seen the GP recently, and if so, what was discussed

Having access to Additional Information in this setting makes a huge difference to the quality and effectiveness of care, especially in complex cases where the patient is unable to piece together a full picture of their medical history.

Summary Care Record access allows me to see a patient’s history and medication, rather than relying on their often-imperfect recollection. The Additional Information over the last few months has been a real boon, particularly dealing with older patients and their complex co-morbidities. It would be a real loss for OOHs GPs to go back to limited SCR access this winter.

Out of hours psychiatry services

Psychiatric services are often busier from Friday evening and over the weekend.  Having access to Additional Information means staff can prescribe vital medication at weekends, rather than having to wait until they can check details with a GP.

Access also allows mental health services to assess whether their users are taking their medications as they’ve been advised, and to understand if that is the reason for a relapse of their psychosis, or if there is something else going on.

Paramedics and call handlers

Paramedics and call handlers told us that:

  • they often have little to no information about a patient when they attend the scene – only details that come through with the call, such as ‘chest pains’
  • they need to make the safest decisions quickly
  • patients can be scared and confused, and are often unable or unwilling to provide information about their medical and social history
  • clinicians need to know people’s baselines, for example is the patient’s blood pressure normally low, or are they usually out of breath

Survey respondents felt that access to more information in Summary Care Record will drive up its use by paramedics and call handlers. Many said that Summary Care Record in its previous format was not worth the effort of accessing it.
They also felt that Additional Information helps paramedics to assess if they can provide alternative care, other than just conveying the patient to A&E. For example, can they provide self-care advice, or seek care options in the community?

The Additional Information really helps us even more than the basic details.  From our perspective it fills in a lot of blanks, where the patient either doesn’t know, doesn’t want to tell us, or can’t remember their past medical history and is a good time saver on each job when we can access it there and then. I really hope it continues.

 

Prison service

Our users in the prison service identified several use cases for Additional Information.

In the reception phase, a couple of hours after arriving, prison staff need to know the medication prisoners are on – and if not having it immediately will cause risk to life. It’s also good to know about substance abuse, mental health and cardiac conditions.

In the second phase, it is good to be able to take advantage of a captive audience and use it as an opportunity to look at prisoners’ longer-term healthcare needs. Access to lifestyle, and family history information would be most useful here.
Summary Care Records with Additional Information could be used to corroborate what patients are telling them.

Having access to vaccination records would stop duplication of childhood vaccines in Young Offender Institutes.

I would argue that it is absolutely essential for us to have access to that information in the prison estate, because we don’t have anything else.”

Last edited: 16 December 2020 5:27 pm

Publication chapters

  1. Summary Care Records with Additional Information – user research report
  2. What Summary Care Records are
  3. User research remit and approach
  4. The survey
  1. Research findings

  2. Use cases for Additional Information

  3. Potential disadvantages of keeping Additional Information