Integrated health system needed for Scotland’s young

NHS Scotland should be working towards a single integrated information system to support improvements in the health of children and young people, according to a new consultation document issued by the Scottish Executive.

In the interim, there are a number of systems which could be brought together or interfaced and this work needs to be progressed, says the document, Delivering a Healthy Future in a section on e-health and telemedicine.

Stating the basis for changes in the service, the document says: “Information concerning children’s health, well being and development is gathered at various points throughout their life, with some components collected universally and others on an episodic basis. However it is often disjointed and is of variable quality. This becomes particularly apparent and problematic where the complexity of a child’s healthcare involves several sectors or services.

“In practice, information systems need to facilitate seamless packages of care which include not only specialist hospital care, but also the patient’s outpatient care and their primary care and community based needs. These issues become all the more pertinent in situations where children require to access services outwith their local area or across traditional agency boundaries.

“Information therefore has to reflect this integrated care, so that for the individual patient, communication between professionals from different services, disciplines and agencies is facilitated. There is a requirement for properly integrated information across the child’s pathway of care which also links, in the longer term, with information from social services and education departments. Some aspects of this process may require not only electronic solutions and local protocols but also legislative change.”

The consultation document refers to four eCare project which has pilots underway in Glasgow, Aberdeen, Lanarkshire and Dumfries & Galloway. The project is a partnership between the Scottish Executive and local authority, health and other agencies across Scotland to develop information sharing systems and processes for a number of client groups, including children.

“Recent interest in child protection issues has forced multi-agency information-sharing to the top of the political agenda and it is anticipated that eCare offers a potential solution to some of the difficulties involved,” says the consultation document.

It adds that new systems need to recognise the rights of children and young people in matters such as consent and confidentiality and be responsive to the changes that occur with maturity and increasing autonomy.

A section on telemedicine reinforces earlier proposals for the improvement of services to people in Scotland’s remote and rural areas.

“It is inevitable that staff caring for children in remote and rural settings will need the capacity to be able to easily access specialist support and advice across the range of clinical disciplines. Telemedicine offers precisely that capacity and the provision not only of the necessary technical infrastructure but also the response capability within the specialist centres, both on an elective and an emergency basis, must be a key element of planning services for such communities.”

The consultation is open until 7 July 2006. Online responses can be made at http://www.scotland.gov.uk/consultations/health/dhf.asp