Birmingham reboots central care record

A “proof of concept” trial for a Birmingham central care record is underway, following an overhaul of the troubled project.

EHI revealed last October http://www.ehi.co.uk/news/EHI/9719/birmingham-rethinks-failed-record-plan that plans for the record to share patient information across health and social care had been cut back after GP leaders raised concerns.

The aim of the original project, which was being run by NHS Central Midlands Commissioning Support Unit on behalf of local clinical commissioning groups, NHS trusts and local councils, was for information to be recorded once and shared between provider systems via a central data warehouse.

Leadership of the project was transferred from the CSU to the Birmingham CrossCity Clinical Commissioning Group as part of the revamp, while a number of changes were also made to the scope of the record.

Approximately 120,000 patients from eight GP practices are now taking part in a pilot of the revised project, which began this week.

University Hospitals Birmingham NHS Foundation Trust, Sandwell and West Birmingham Hospitals NHS Trust, Heart of England NHS Foundation Trust, and Birmingham and Solihull Mental Health NHS Foundation Trust are also participating in the pilot.

And a survey of residents has shown support for the idea in principle. The survey of 1,000 patients carried out by the project team found that more than 90% agreed that medical professionals should be able to view their GP medical records when treating them in hospital.

Dr Gavin Ralston, the chairman of the CCG, told EHI the purpose of the trial is to ensure the record can be safely rolled out to all 1.5 million people in Birmingham, Sandwell and Solihull, while also achieving the expected benefits.

“Inevitably there will be a few teething problems before we roll it out more widely…and we want to make sure it does lead to quicker and better decision-making to help patients, doctors and nurses.”

Ralston said each of the patients asked to take part have received a “comprehensive” information pack, explaining the project and including an opt-out form for those who did not want their information shared.

The NHS trusts have also been heavily involved in the technical details of the project, as well as ensuring an appropriate consent scheme is in place.

The Birmingham Local Medical Committee expressed serious concerns last year about the project, including patients being unable to give informed consent and which organisations would be given access to the record.

As part of the overhaul of the project, a proposal to hold data for the record in a central warehouse was scrapped and replaced with on a “look up and view” system for “appropriate health professionals” based on patient consent at the point of care.

Ralston said the change was made to reflect concerns about the wisdom of establishing a “large data repository”, with the LMC, the BMA’s ethics committee and a barrister who provided legal advice all expressing their doubts.

“No data will be shared, just looked at, and everyone is much happier with [the revised project] now.”

Moving leadership of the project from the CSU to the CCG was intended to “help drive the project forward”, he said.

Ralston said the revised proposal will still provide clinicians with valuable information, including a patient summary and information on medications and allergies among other data.

The pilot will take about three months, with an externally approved evaluation and audit process running alongside to avoid unnecessary delays in rolling it out further if it is deemed a success.