Transfer of Care Initiative

Summary

To support the delivery of high quality care, there's an increasing need to share information more efficiently and consistently across health and social care.

Top tasks

Transfer of Care Initiative resource library
A resource library of downloadable implementation guidance and supporting materials

Implementing eDischarge summaries in England
As part of the NHS England Standard Contract, providers must have aligned their eDischarge summaries with the nationally published specification.

Implementing Emergency Care discharge summaries in England
As part of the NHS England Standard Contract, providers must have aligned their Emergency Care discharges with the nationally published specification.

Implementing Outpatient clinic letters in England
As part of the NHS England Standard Contract, providers must have aligned their Outpatient clinic letters with the nationally published specification.

The Transfer of Care Initiative aims to improve patient care by promoting and encouraging the use of professional and technical document standards.

Professional standards

Professional record standards for electronic record keeping are a fundamental element of successful IT enabled care and interoperability.

In order to record, share and access health data consistently across care settings, the structure and content of electronic health records needs to be standardised. The Professional Record Standards Body (PRSB) produce standards for the way care records should be structured.

The PRSB has published the PRSB Standards for the Structure and Content of Health and Care Records which replaces the Academy of Medical Royal Colleges publication ‘Standards for the Clinical Structure and Content of Patient Records’ published in 2013.

The PRSB standards have been updated to reflect current professional practice and incorporate new or changed structured content resulting from the development of detailed transfer of care standards. They have been developed with input from thousands of professionals from all health and social care specialties, carers and people who access services. They agreed what information is essential to share in order to provide timely, high-quality care efficiently that is well-coordinated and meets an individual’s needs.

This is the first major release since 2013 and PRSB has produced guidance, FAQs and other materials to help organisations and system suppliers replace previous versions of the standards in their information systems.

Technical standards

The long-term strategy is to send Transfer of Care documents by direct electronic transmission, nationwide, including SNOMED CT encoded diagnosis, procedures, allergies and dm+d encoded medication information.

Providers are reminded that as detailed in the NHS England Standard Contract (technical guidance section 39.22) that by 1 October 2018, they must have aligned their acute inpatient and day case discharges, Emergency Care discharges, Mental Health discharges and OutPatient Clinic Letters with the nationally published specifications and be sending these by electronic transmission using a structured message specification.

NHS Digital has taken the decision to move directly to Fast Healthcare Interoperability Resources (FHIR) based structured document standards for Transfer of Care.

FHIR has become the international industry standard so the decision has been taken to migrate to FHIR now to prevent a more complex migration in the future which would result in greater clinical risk and higher costs for NHS providers and NHS clinical system suppliers.

The Transfer of Care FHIR messages will use the ITK3 (Interoperability Toolkit) specification available here:  https://developer.nhs.uk/interoperability-tool-kit-itk-specification-versions/

For further advice and support, contact information.standards@nhs.net.

Clinical Safety Case

NHS Digital in collaboration with INTEROPen has produced the following documents:

  • Clinical Safety Case  for the Curation of National CareConnect FHIR Interoperability Standards as used in Transfer of Care and GP Connect
  • Hazard Log - Identified risks and issues for development and implementation of FHIR Resources for Transfer of Care and GP Connect.
  • Clinical safety group endorsement - This endorses the clinical safety management approach following by NHS Digital Integration Projects in support of development and planned deployment of FHIR Interoperability Standards as used in Transfer of Care and GP Connect.

Benefits of standards

Using standards in electronic healthcare records allows clinical information to be recorded, exchanged and accessed consistently to deliver high quality care to patients. Other benefits include:

  • improved patient care and safety due to the availability of complete, accurate and timely information
  • reduction in the risk of missing or inappropriate critical clinical information
  • reduction in costs by removing the administrative task of correcting information

Video - why the Transfer of Care Initiative matters

Latest news and updates

August 2018

Transfer of Care BETA Technical Specifications now published

The BETA versions of the Transfer of Care message specifications are now published; these are sufficiently mature to enable suppliers to development against. There are no plans to change the specifications other than to react to defects reported by implementers. The specifications can be found here: https://developer.nhs.uk/transfer-care-specification-versions/

The Transfer of Care FHIR messages will use the ITK3 (Interoperability Toolkit) specification available here: https://developer.nhs.uk/interoperability-tool-kit-itk-specification-versions/

Contact details

For more information, or to register on our mailing list, contact information.standards@nhs.net.

Join our NHS Interoperability Toolkit group on LinkedIn.

Further information

  1. internal

    Outpatient Clinic Letter

    Find out about Outpatient Clinic Letters including advice on how they should be implemented in England.

  2. internal

    eDischarge summaries

    Find out about eDischarge summaries, along with advice on how to implement them.