Presenter name Presenter title Social care viewing and

Presenter name Presenter title Social care viewing and connecting on the Health Information Exchange COVID-19 viewer and integrated projects

Vision for the Great North Care Record “Professionals and carers to have legitimate access to the right information at the point of need, ensuring our population get better, safer care regardless of setting or organisation. ” Great North Care Record Vision 2016

Health Information Exchange roadmap Mar 2020 GP data live Apr 2020 NUTH lab results, radiology reports, radiology May 2020 NUTH appointments and correspondence Jul 2020 NUTH remaining data, CNTW and STSFT. Social care viewers (NCL, S’land, G’head, Durham) Aug 2020 NCIC Infoflex, Gateshead FT, Northumbria demographics, NEAS Sep 2020 Sunderland City Council – integrated viewer and connector goes live Oct 2020 CDDFT, TEWV, NTH, South Tees live

Use case #1 Amy is a frail older person currently in hospital. She has multiple health and social care services involved. There is a concern amongst the MDT about the level of care she will need upon her discharge, and whether she will be able to manage in her own home. Status (POA, Housing): This helps us establish who can make decisions for Amy and who we should involve in any future assessment or care Family dynamics/connection: This helps us establish Amy's support networks and who we should involve in any future assessment or care How will accessing HIE transform care for Amy? Identify risks – To enable the safety of Amy and any care workers Formal Carers: This helps us establish Amy's support networks and who we should involve in any future assessment or care Planned future health interventions: This helps us establish whethere may be any future admissions Amy’s social worker Involvement (acute, community, social care) : This helps us establish who we need to speak with in order to learn as much about Amy and how she was before she came to hospital Actions taken: This helps us understand whether Amy may have been in a stable or unstable position prior to admission Discharge letters/plans: This helps us understand whethere any ongoing medical issues Current medical info (Treatment, meds, appts, diagnosis) : This helps us understand Amy’s potential longer term needs Care plans: This helps us understand the support she already has in place and whether this has been successful

Use case #2 Amy needs a Mental Health Act Assessment. She is known to the NHS Trust crisis team but not known to Adult Social Care Status (POA, Housing): This helps us establish who can make decisions for Amy and who we should involve in any future assessment or care Family dynamics/connections: This helps us establish Amy's support networks and who we should involve in any future assessment or care How will accessing HIE transform care for Amy? Formal carers: This helps us establish Amy's support networks and who we should involve in any future assessment or care Legal status (S 117): This helps us understand Amy's access to ongoing support Amy’s social worker Identified risks: To enable the safety of Amy and any care workers Planned future health interventions: This helps us establish whethere may be any future admissions Involvements (acute, community, social care): This helps us establish other professionals involved who will be part of a plan for her care Current medical info (Treatment, meds, appts, diagnosis): This helps us understand Amy potential longer term needs

Use cases: For all cases some information will be relevant to share Basic demographic information – Name, address, telephone number, family/support network Professional involvements to understand who needs to support be part of any care planning Primary need allows correct allocation of the team There are times when we simply don’t have the information we need to be able to locate someone to begin providing support Legal status POA etc ensures we know who makes decisions and any ongoing support There are occasions when people are incapacitated for a number of reasons and so they are unable to give us relevant history themselves Basic medical information (medications, appointments, diagnosis) live information only By understanding what has happened in the past, we are less likely to repeat making offers of support that might have been tried previously and failed By understanding who else is involved, we are better able to work as a team where this is necessary to achieve resolution of presenting issues The more information we can gather in advance, the more we are able to prepare and the quicker we can move towards resolving the presenting issues By understanding when the person might be involved with other services, we are less likely to waste time contacting them when they are not at home

Social care integration: Two projects 1. Providing view only access via web portal to all councils to support information flows in response to COVID-19 using HIE web portal, known as COVID-19 viewer. Newcastle, Gateshead, Durham and Sunderland agreed, remaining councils under discussion. 2. Longer-term connections so that data flows both ways and is integrated in the social care case management application. Sunderland Durham confirmed, remaining councils under discussion

Examples from Sunderland Council

Proposed data items to be shared from adult social care (draft from Sunderland) • Person data (including demographics) • Related persons • Referral records • Practitioner Involvements • Assessment • Primary Support Reasons • Safeguarding • Deprivation of Liberty DRAFT • Risks and Special Factors • Disabilities • Care plan needs and outcomes • Service provision

Data social care would like to see (draft from Sunderland) • • Demographic Information Diagnosis of any pre-existing medical conditions Information relating to any current investigation for undiagnosed medical conditions Current medication GP/consultant/s Any other acute or community health professionals involved with the customer either now or in the last 12 months Planned discharge date where the customer is residing in an acute health setting • Detail of any current observations/assessments regarding functional ability, breathing, mobility, cognition Live DOLS, safeguarding or risk issues DNR or Emergency Healthcare plans Substance misuse issues Specialist equipment issued Information relating to any history of falls DRAFT • • • Information provided courtesy of Sunderland City Council

Safeguards • Information governance approach agreed and signed off by SIGN members • Any additional data sharing on HIE is reviewed by regional clinical safety officer, GP IT Governance Group, Professional Advisory Group and HIE Project Board • Integrated only - only data from patients on the existing case management system can be accessed where there is a legitimate relationship

Safeguards • • Sunderland City Council Adult Social Care fully comply with GDPR and seek consent to gather, use and share information on individuals throughout each referral and event completed. This is not a one-off process but continues through the lifetime of our involvement with the customer. Each individual who accesses the case management system is required to be aligned to a profile which gives them rights to see certain parts of the system linked to the profile they hold e. g. Social Worker. Security in terms of information you are able to access is managed through the profiles within the system Information provided courtesy of Sunderland City Council

Safeguards • • Access to the case management system is only given on formal request through an appropriate delegate once staff have been fully trained and signed the data protection agreement. Monthly access audits are undertaken across all teams to validate the reasons for accessing individual customer cases are valid and appropriate. Access to the system is expected to be maintained by the users, if someone does not access the system for over 30 days access is removed and needs to be reinstated via ICT. Monthly practitioner audits are undertaken across all teams and this reviews the information gathered, recorded, accuracy, GDPR, capacity and consent throughout the lifetime of the case for each customer. Information provided courtesy of Sunderland City Council

Any questions • Mark. walsh@ahsn-nenc. org. uk • 07752 411 013

Information governance approach • • SIGN engaged and working in collaboration with the project team Developing appropriate information governance assurance and processes once COPI notice expires Data Sharing Agreements (DSAs) to be signed by all data controllers (trusts and GP practices) before end of September when the COPI notice expires/first local authority connection DSAs refer to all local authorities and all data items available on HIE

HIE data categories inc’ the COVID-19 viewer HIE data category Allergies Clinical correspondence Vital signs Appointments Medication GP records Lab results Additional GP records Microbiology Social care Cellular pathology Community and Mental Health Problems Physical examination Diagnoses Family history Procedures Visits Immunisations Social history Radiology COVID-19 viewer