Digital technology and innovation can help us to transform the way we provide health and care and offer new ways to support people to stay well.

Across Humber, Coast and Vale we are looking for ways to harness the latest digital technology and innovation to transform the way we deliver health and care services.

This includes finding new ways to share information between different health and care providers to enable safer, more joined-up care. It also means using digital technology to create new ways for patients to access advice, support and care.

It involves supporting our clinicians and other professionals to work together across organisations and our large geographies. In addition, as a Partnership we are supporting innovation in our local health and care economy through initiatives such as the Humber Care Tech Challenge.

Our Priorities and Programmes

Sharing Information to Improve Care

Supporting Innovation to Improve Care

Working Together to Improve Care

In Humber, Coast and Vale we are working together to develop a digital strategy for our Partnership. The strategy will identify an overarching vision for digital transformation in Humber, Coast and Vale.

If you would like to get involved in helping to shape our future digital strategy, you can join the conversation on twitter #HCVDigitalFutures or get in touch to find out more.

Read our Digital technology in Humber, Coast and Vale (July 2019) progress report

Shared Care Records

The Problem

There are hundreds of clinical computer systems across our region. They all hold clinical information about patients who have used services provided by their GP, at a local hospital, community healthcare, social services or mental health teams. Each record may hold slightly different information about a patient or individual using a particular service.

When patients move between different organisations for different aspects of their care their records don’t automatically travel with them, and so clinical teams spend a lot of time checking vital information such as current and past treatments, test results and allergies with patients themselves or with other care providers. This also creates the potential for important information to be missed making it harder to provide good quality, safe care.

What we are doing about it

Our partners are working together on a number of different programmes to enable the sharing of critical health and care information between clinical teams who need to see it so that they can provide safe and effective care for patients. We are also looking at how we can support individuals to view and add information into their own health and care records directly, enabling them to have greater control over their own health.

To support this work, we have asked local people what they think about how their information should be shared. You can read the Joined Up Yorkshire and Humber report here.

We will continue to involve local people in this work and welcome views and ideas.

Get in touch

More about our programmes

System-Led Interoperability Pilot (SLIP)

Thanks to the roll-out of a new initiative, patients across the Humber region are now benefiting from more joined-up healthcare. Healthcare professionals in GP practices, community and mental health services can now see up-to-date information about their patients, even if they’ve been treated somewhere else.

Read the whole story

Yorkshire and Humber Care Records

Yorkshire and Humber Care Record

The Yorkshire and Humber Care Record is being rolled out across the Humber, Coast and Vale area with the aim of improving care for people who use NHS and social care services.

Programme Updates

February 2019

Read about out engagement work

What is it?

There are hundreds of clinical computer systems across Yorkshire and Humber. They all hold clinical information about patients who have used services provided by their GP, at a local hospital, community healthcare, social services or mental health teams. Each record may hold slightly different information.

The Yorkshire and Humber Care Record will bring together certain important information from all of these systems so that medical and care information held about a patient or service user can be centralised into one easy-to-use system.

All of your records will still be strictly confidential. They will only be looked at by clinical care staff who are directly involved in your care.

Find out more

What difference will it make?

The Yorkshire and Humber Care Record will support people working in health and social care services to provide you with better and more joined-up care. It will make care safer because everyone involved in treating you will have access to the most up-to-date and accurate information about the medicines you are taking and any allergies that you have, for example.

It will also help to avoid unnecessary or duplicate tests and procedures, and reduce paperwork for doctors, nurses and other staff, giving them more time to spend on patient care.

You can choose not to have a Yorkshire and Humber Care Record. It is your choice but sharing your medical and social care information through a Yorkshire and Humber Care Record will make it easier to provide the best quality care and support for you. Read more about how to object in the FAQs section below.

Frequently Asked Questions

What is the Yorkshire and Humber Care Record?

At the moment, every health and social care organisation that you use has a different set of patient or service user records for you. These records may duplicate information or one record might hold information about your treatment, care and support that another one doesn’t. To provide the best care to you as a patient or service user, it is essential that health and social care professionals have access to the most up-to-date information.

It will be a secure virtual health and social care record. It will pull key information from different health and social care records and store it in one combined record. This enables health and social care professionals to find all the key information for your care in one place.

Why do you need to share my information?

To provide the best treatment, care and support to you as a patient or service user, it is essential that health and social care professionals have access to the most up-to-date information.

Information is already shared between health and social care organisations by phone and through paper records. Sharing health records allows this sharing process to happen more efficiently, enabling better care for you.

Healthcare organisations across Yorkshire and Humber are working together to further improve health and social care across the region. Health and social care professionals have a duty to share relevant information between them if they are involved in providing you with care:

Types of information that may be shared include:

  • Address and telephone numbers
  • Problem diagnosis list
  • Medications prescribed
  • Recorded allergies
  • Care plans, outpatient appointments, inpatient stays and clinical contacts
  • Referrals, clinic letters and discharge information
  • Test results
  • Community treatment orders
  • Contact details of care professionals

How do I know my records are kept secure?

By law, everyone working in, or on behalf of, the NHS and social care must follow strict information governance rules designed to respect your privacy and keep all information about you safe. Information is held on secure, encrypted systems which keep a record of everyone who has accessed a patient record, the time and date when they accessed it and the information they were viewing. The laws on data protection are clear and we take them very seriously. We regularly check to make sure that only people who need to see your patient record are viewing it.

Can anybody see my records?

Your medical records will still be confidential. They will only be looked at by people who are directly involved in your care. Your information isn’t shared with anyone who doesn’t need it to provide treatment, care and support to you. Your details will be kept safe and won’t be made public, passed on to a third party who is not directly involved in your care, used for advertising or sold.

Accessing your own health and care records?

Patients have the right under Section 7 of the Data Protection Act (1998) to request access to any information that an organisation holds about them. Each individual organisation that contributes information to your Yorkshire and Humber Care Record has a responsibility to handle these “Subject Access Requests”.

Should you wish to access your records this way, contact the organisation who holds the part of the record you are interested in directly, for example: your GP, hospital, mental health trust or social care team.

Can I object to my records being shared?

Yes. You have the right to object to your health and care records being shared. However, if staff require access to the information shared on the Yorkshire and Humber Care Record to provide safe individual care they are legally allowed access.

For further information, contact the Access to Health Records team at Leeds Teaching Hospitals NHS Trust:

T: 0113 20 65824

Access to Health Records
Leeds Teaching Hospitals NHS Trust
St James University Hospital
Lincoln Wing / Chancellor Wing Link Corridor
Becket Street
Leeds
LS9 7TF

What do I do if I would like to make a complaint about improper use?

Please contact the care provider alleged of improper use directly to register a complaint.

Which organisations are involved

Nine GP practices in Humber, Coast and Vale started using the Leeds Care Record technology as part of the phase one pilot from 29th March 2019.

These practices are:

  • Ampleforth and Hovingham Surgeries
    (Ampleforth Surgery), Scarborough and Ryedale
  • Ancora Medical Practice, North Lincolnshire
  • Dr Chalmers and Meier, North East Lincolnshire
  • Haxby Group (Haxby and Wigginton Surgery), Vale of York
  • Hunmanby Surgery, Scarborough and Ryedale
  • Scarborough Medical Group
    (Danes Dyke Surgery), Scarborough and Ryedale
  • Sherburn Group Practice, Vale of York
  • Tadcaster Medical Centre, Vale of York
  • Wolseley Medical Centre, Hull

Wave two practices

  • Riverside Surgery, North Lincolnshire
  • Winterton Medical Practice, North Lincolnshire
  • South Axholme Practice, North Lincolnshire
  • Kirton Lindsey and Scotter Practices, North Lincolnshire
  • Riding Medical Practice, East Riding of Yorkshire
  • The Killingholme Surgery, North Lincolnshire
  • Priory Medical Group (nine sites), Vale of York
  • Scott Road Medical Centre, Vale of York
  • Roxton Practice and Roxton at Weelsby View (two sites), North East Lincolnshire
  • Posterngate Surgery, Vale of York
  • Pickering Medical Practice, Vale of York
  • Haxby Group Hull (five sites), Hull
  • Cambridge Avenue Medical Centre, North Lincolnshire

Wave three practices

  • Chestnuts Surgery, East Riding of Yorkshire
  • Field House Surgery, East Riding of Yorkshire
  • Hallgate Surgery, East Riding of Yorkshire
  • Market Weighton Group Practice, East Riding of Yorkshire
  • Northpoint Medical Practice, Hull
  • Peeler House Surgery, East Riding of Yorkshire
  • Princes Medical Centre, Hull
  • Manor House Surgery, East Riding of Yorkshire
  • Modality Partnership Hull Practices
    • Springhead Medical Centre (all Hull)
    • New Hall Surgery
    • Diadem Medical Practice
    • Faith House Surgery
    • Newland Group Practice
  • Bridge Street Practice, North Lincolnshire
  • Open Door Health Centre, North East Lincolnshire
  • Quayside Medical Practice, North East Lincolnshire
  • Pelham Medical Group, North East Lincolnshire
  • Humberview Surgery, North East Lincolnshire
  • Derwent Practice, Scarborough and Ryedale
  • Dr A Kumar Surgery, North East Lincolnshire
  • Cedar Medical Practice, North Lincolnshire
  • Front Street Surgery, Vale of York
  • Millfield Surgery, Vale of York
  • Trent View Medical Practice, North Lincolnshire

Wave four practices

  • York Medical Group, Vale of York
  • Hackness Road Surgery, Scarborough and Ryedale
  • The Old School Medical Practice, Vale of York
  • Field View Surgery, Hull
  • Jorvik Gillygate Practice, Vale of York
  • The Oswald Road Medical Centre, North Lincolnshire
  • The Birches Medical Practice, North Lincolnshire
  • Market Hill 8 to 8 Centre, North Lincolnshire
  • West Common Lane Teaching Practice, North Lincolnshire
  • Barnetby Medical Centre, North Lincolnshire
  • West Town Surgery, North Lincolnshire

You can find out more about the other organisations who are part of the Leeds Care Record here

Electronic Palliative Care Co-ordination System (EPaCCS)

The Challenge

Patients who are at the end of life come into contact with many health and care professionals. The challenge has been in enabling different care providers to share information about an individual patient’s care and end-of-life preferences in a safe, up-to-date and efficient way.

Treatment choices, how and where care is delivered and the preferred place of death are at the heart of end-of-life care. Patient choices are not static and often change during the last weeks and months of life. Typically, preferences for end-of-life care are collected by GPs and inputted into their GP system. However, this may not always reflect the latest wishes of the patient and may not be available to all of a patient’s health and care providers.

The emphasis being placed on improving end-of-life care is also reflected within the contractual standards being implemented for health and care providers. Electronic Palliative Care Co-ordination System (EPaCCS) can support health and social care providers in meeting end-of-life contractual standards as part of the improvement of the full end-of-life care management process.

What is Electronic Palliative Care Co-ordination System (EPaCCS)?

EPaCCS enables the recording and sharing of a patient’s care preferences and key details about their care at the end-of-life.  As it is electronic it can easily be shared 24/7 between all of the clinicians and carers involved in the patient’s care across organisational and geographical boundaries.

An EPaCCS record can be created, updated and shared by any member of a patient’s health and care team, subject to locally-determined pathway and user administration settings. The EPaCCS record is a summary record, intended to provide an easily accessible view of the information that carers need in an end-of-life setting.

Some of the data that populates the EPaCCS record is pre-populated from the GP record, for example, patient demographics, GP practice details, current repeat medications and diagnoses/problems. Other mandatory fields can be filled collaboratively by different health and care providers, including primary end of care diagnosis, CPR decision, preferred place of care, details on anticipatory medication and preferred place of death.

When will EPaCCS will introduced in Humber, Coast and Vale?

An initial pilot will be rolled-out from August in Vale of York and Scarborough and Ryedale CCGs. The pilot will include GPs, community providers, a local hospice, YAS, Vocare and York Hospital.

During the three-month pilot, we will work with participating organisations to understand the patient, clinical and efficiency benefits and to ascertain if any changes are needed to the forms to meet local needs.  The pilot will be followed by a full roll-out of the EPaCCS solution across Humber, Coast and Vale from November.

How can my organisation get involved?

To find out more about the roll-out of EPaCCS please contact Tara Athanasiou ([email protected]).

More information for clinicians

The roll-out of EPaCCS is part of our vision for the Yorkshire & Humber Care Record to provide a joined-up electronic record for our patients, that is accessible by and can be inputted into by all of the services involved in their care.

EPaCCS enables the recording and sharing of a patient’s care preferences and key details about their care at the end-of-life. In this section health and care organisations can download further information about the EPaCCS roll-out in Humber, Coast and Vale and access all training and on-boarding materials.

EPaCCS pilot overview WebEx presentation

GP practice implementation guide

Acute and community clinician implementation guide

Frequently Asked Questions

General

What is EPaCCS?

EPaCCS (Electronic Palliative Care Co-ordination System) enables the recording and sharing of a patient’s care preferences and key details about their care at the end-of-life.  As it is electronic it can easily be shared 24/7 between all of the clinicians and carers involved in the patient’s care across organisational and geographical boundaries.

EPaCCS supports appropriate treatment decisions to allow more people to experience a “good death”, in the place that they wish and with the appropriate level of intervention.

An EPaCCS record can be created, updated and shared by any member of a patient’s health and care team, subject to locally-determined pathway and user administration settings.  The EPaCCS record is a summary record, intended to provide an easily accessible view of the key information that health professionals and carers need in an end-of-life setting.  Some of the data that populates the EPaCCS record is pre-populated from the GP record, for example, patient demographics, GP practice details, current repeat medications and diagnoses/problems. On creation of a new EPaCCS record, three mandatory fields are completed:

  • Informing the patient their record is to be shared (wording TBC)
  • Primary end of life care diagnosis
  • CPR decision

Why is a digital (IT) system needed?

The EPaCCS digital system supports effective end of life care planning as it enables sharing of patient’s wishes and preferences with all clinicians who come into contact with the patient. It aids assessment, pro-active identification of patients and supports clinical decision-making. Information is shared across health care boundaries and is available 24hrs a day.

What about patient confidentiality?

As with the YHCR, the legal basis for sharing end-of-life information between the carers and clinicians involved in a patient’s care is ‘direct care’ and NOT consent. This is in line with the recommendations of Caldicott Reviews of 1997, 2013, the provisions of the Data Protection Act (DPA) 2018 and the General Data Protection Regulation (EU) 2016/679 (GDPR).

To be part of the EPaCCS project, you will be asked to sign up to an Information Sharing Agreement. You will be legally required to make your patients aware of the Yorkshire & Humber Care Record. All participating organisations will receive patient information leaflets and posters, that include reference to sharing patient preferences, as well as wording to update their Fair Processing Notices on their websites.

The EPaCCS form begins with a mandatory section, the completion of which indicates that the carer or clinician has informed the patient that they are creating and EPaCCS form that will be shared, viewed and amended with other individual’s involved in their direct care.

Who Will Access EPaCCS?

An EPaCCS administrator in each organisation is responsible for applying for their teams to be licensed.

Access may allow full access i.e. the creation / editing /viewing an EPaCCS record; read/write access or read-only, as appropriate. They will apply for their users to be licensed, details can be found in the implementation bulletins.

The following clinicians will have access to EPaCCS:

  • GPs, nurse practitioners and members of the administrative team
  • Practice nurses
  • Community nurses
  • Community palliative care teams
  • Hospice clinicians and end of life administrators
  • Hospital end of life leads
  • NHS111/out of hours

How does this fit into the Yorkshire & Humber Care Record?

The roll-out of EPaCCS is part of our vision for the Yorkshire & Humber Care Record to provide a joined-up electronic record for our patients, that is accessible by and can be inputted into by all of the services involved in their care.

As with the Yorkshire & Humber Care Record, the EPaCCS solution will not replace the existing clinical and administrative systems you already have. Instead, it will enable you to access a joined-up view from your current IT systems. The EPaCCS solution is funded through GPSoC, which means there are no financial implications for health and care providers to benefit from the solution.

When will EPaCCS be rolled-out in Humber, Coast and Vale?

The system will be rolled out from August 2019 across health and care providers in HCV. An initial three-month pilot will take place in Vale of York and Scarborough Ryedale CCGs, with the following organisations:

  • York Acute Hospital
  • York Community Services (community nursing for Vale of York)
  • Humber Community Services (community nursing for Scarborough Ryedale)
  • St Catherine’s Hospice
  • YAS
  • Vocare
  • GP Practices:
    • Haxby Group Practice
    • Filey Practice
    • Priory Medical Group – User Acceptance Testing
    • Sherburn Group Practice
    • Pickering Practice
    • Millfield Surgery
    • Derwent Surgery – User Acceptance Testing
    • Ampleforth Surgery

During the three-month pilot, we will work with participating organisations to understand the patient, clinical and efficiency benefits and to ascertain if any changes are needed to the EPaCCS record to meet local needs.  The pilot will be followed by a full roll-out of the EPaCCS solution across Humber, Coast and Vale from November 2019.

What are the benefits?

EPaCCS is intended to improve the service provided to people approaching the end of life their families, carers and the clinicians that look after them.  Anticipated benefits include:

  • Improved patient experience – end of life care delivered in their preferred place and preferred place of death are in line with patient preferences
  • More patients die in their preferred place of death
  • Improved communication between health and social care professionals – enables integrated care provision
  • Clinical decisions made on up-to-date information – patient information available in one place
  • Reduction in number of unnecessary/avoidable ambulance journeys and hospital admissions
  • Efficiency savings – reduction in paper forms and duplication, less time chasing information
  • Supports health and social care providers in meeting end-of-life contractual standards e.g. QOF indicators QI003 and QI004 in the new GP Contract.
  • Details on anticipatory medication

Clinical

How have clinicians been involved in EPaCCs?

We have chosen to work with Black Pear to deliver the EPaCCS solution. Black Pear has worked collaboratively with GPs, Macmillan GPs, Hospice Palliative Care Consultants and Community Palliative Care Consultants to develop a clinically-focused EPaCCS form.

After an initial clinical workshop, we have convened a Clinical Design Authority with representatives across the health and care providers involved in end-of-life care.  This Clinical Design Authority is responsible for ensuring that the EPaCCS solution meets our local priorities and pathways and will make any local changes required to the forms.  After the pilot, a full clinical review will take place, at which point any further changes will be made before the full roll-out of the solution across Humber, Coast and Vale.

I am a GP. Do I have to fill out everything in the End of life Plan?

No, it is expected that the GP will initiate the plan and complete they key mandatory fields e.g. primary end of life care diagnosis, CPR decision if known. Other organisations will contribute to the EPaCCS record over time e.g. community teams, hospices etc. The GP practice will be notified of any updates to the EPaCCS record.

The EPaCCS record on creation is pre-populated with relevant data from the patient’s GP practice record such as demographics, current acute/repeat medications; allergies and adverse reactions and other data items (agreed with the local team) that may be in the patient’s record e.g. interpreter needed.

User

How does the information get into EPaCCS?

Some of the data is automatically populated from that already stored in the patient’s GP record. Examples include patient demographics, GP Practice details, current repeat medications and diagnoses / problems. This saves time and improves the accuracy of health information.

More data can be added when appropriate (e.g. ceiling of care, prognosis, advance care planning information, anticipatory medication details, main carer / care worker details). Data entry is easy and straightforward. The rationale being that the register information is built up over time.

Will I find EPaCCS on my GP system?

Yes. As soon as you are licensed to use the EPaCCS App and the Pyrusium software has been installed on your workstation you will be ready to use EPaCCS. First, log onto your GP clinical system, find the patient you wish to record information about, click on the pyrusium icon in your ‘start’ menu and choose the ‘EPaCCS’ app. The app is intuitive and easy to use.

My GP practice already uses end-of-life templates. How will these work with EPaCCS?

Some practices may use existing templates to record end of life information. If there is one to one mapping between the codes captured in the GP record and the EPaCCS form AND you have requested for those terms to be uploaded then this can happen.

However, the EPaCCS record is a) a summary of the end of life discussions (not a detailed care plan) b) all users will use the same common user interface i.e. the EPaCCS record c) uses natural language to ensure clarity/understanding and increase the quality of the information recorded. NB: terms can be and are defined (see ‘i’ denoting information text next to some of the terms) d) not all clinicians use the same clinical terms to mean the same thing.

Once an EPaCCS record has been created, that record should be used each time there are additions/amendments to the EPaCCS record.

For SystmOne practices, GPs do not have to use a ‘standardised TPP template’ first. All they need to do is find the patient’s record, access Pyrusium, click create an EPaCCS record, fill in the three mandatory fields and save. The form is then available for others outside the GP practice to use and amend.

How does EPaCCS differ from the end-of-life information sharing in the enhanced Summary Care Record?

  • EPaCCS is complimentary to the Enhanced Summary Care Record. Some key data items captured in EPaCCS is written-back into the GP system and will automatically be uploaded to SCR, provided the patient has explicitly consented to SCR AI.
  • EPaCCS provides more detail that the SCR and enables the meeting of national end-of-life standards. Unlike the SCR, EPaCCS includes the primary end-of-life diagnosis, which supports effective clinician-patient engagement and helps minimise the need for difficult conversations.
  • EPaCCS is a read/write system, that enables details to be updated by all authorised health and care professionals. This means that the latest information is available within all settings in real-time.
  • EPaCCS is designed to improve the quality and safety of care by facilitating communication and coordination between health professionals and informing best clinical practice.
  • Semantic issues have been considered in the design and implementation of a shared EPaCCS record so that meaning is preserved.
  • EPaCCS record is the single source of truth about a patient in the last year of life.