Test of Change

We are living and working in an inter-connected environment. The use of email for sending messages, exchanging information and assisting with workflow is common place across the public sector. There are many links between the health and care system, but it’s often difficult for health and care professionals to share information. Access to the right information about patients and users of services at the right time is essential to ensure continuity of care.

When patients are discharged from hospital, care homes are still receiving information about that individual by fax, in person or post. Often, key pieces of information are not received at all. This makes it difficult for care homes to prepare for a new patient’s/resident’s arrival or the return of a resident who has been in hospital. As well as being inefficient and slow, paper-based communication is not a secure delivery method.

Lothian Unscheduled Care Board have agreed to fund costs for a one year test of change –Secure emails access for all care independent care homes (circa 103) in Lothian. Each care home will be provided with up to three nhs.net accounts for a period of one year. Care homes coming on stream during the next few months have also been included in this test of change.

CEO’s or equivalent of each individual independent care home must sign the Data Sharing Contract, as must the staff identified as secure email recipients. Following on from this each identified recipient must sign a NHS Lothian User ID Request Form

The provision of secure emails to all care homes in Lothian will markedly improve communications between care homes general practice and social work. Specifically, it will enable faster discharge of patients through the electronic communication of patient assessments and subsequent discussions rather than this being by post.

Secure email will transform how healthcare organizations in Lothian share and work collectively to provide coherent joined up services for the people concerned the public. Good timeous information underpins good care and on-going support.

Care homes will benefit greatly from having a consistent electronic transfer of medical discharge summaries (typically sent to a GP within 24 hours). This will enable the care home to fully prepare their service for supporting people discharged from hospital by preparing for the persons needs well in advance of their arrival.

Pre admission assessments will be carried out and shared timeously thus supporting early discharge to the care home and help improve the efficiency of the discharge process generally.

Secure emails offers the potential to share Anticipatory Care Plans from statutory services. E.g Person moving into a care home. Referrals, assessments, multidisciplinary review summaries, flu vaccine consent forms will be immediately accessible to care homes. Opportunities for Tissue Viability, Health Protection, Care Home Liaison, CPN’s and pharmacy specialists instant ability to network and support and safely communicate sensitive information with care home staff.

Other benefits are the ability to send and receive patient/resident information quickly and securely. No confusion from messages taken over the phone or illegible writing on faxes. Improved awareness of care home staff in relation to  information governance rules on handling patient information. Secure paper trail in place for example, time emails were sent, removal of fax machines which are costly and require maintenance. Costs of postage for partnership reduced. Reciprocal communication time by health and social care professionals markedly reduced and this initiative supports positive change in service.

This test of change Secure e-mail access for care homes in Lothian should seek to demonstrate measurable improvement in outcomes either directly to individuals or indirectly through improved service design and delivery. There will be on going monitoring to make sure the project is achieving the desired results and to demonstrate the impact of the project to others; as well as to identify issues or problems as they arise within the project so that actions can be taken to change or redesign the project while it is in progress.

 

Rene Rigby

Local Integration Lead, Edinburgh City