Digitising processes to improve care…....

An innovative technical solution (Local Person Record Exchange Service – or LPRES for short!) is being implemented in Blackburn with Darwen Borough Council. LPRES supports the safe and secure exchange of information between health and social care and will also eventually be used to facilitate the digitisation of the hospital discharge process.  It is already used by other Local Authorities and hospital trusts across Lancashire and South Cumbria, covering a population of 1.7 million people; the next phase is to integrate LPRES with our adults social care system, Mosaic. Our first implementation step is to automate the inclusion of NHS numbers in our social care system, then we’ll enable NHS record availability in social care and finally enable NHS teams to access social care information digitally. We aim to complete this first stage before Summer 2020, carrying everything out in accordance with our robust Information Governance frameworks and GDPR. Many months of design and analysis have taken place to get us to this stage. 

ADW stands for Assessment, Discharge & Withdrawal and is a digital discharge process which integrates health and social care data/information - so once an electronic assessment/discharge document has been completed by ward staff in the hospital, social care will be aware and able to act upon it.  This document will have mandatory fields to ensure the right information is received the first time, freeing up more time to see the patient and arrange their discharge.  Each year demand for services increases yet the way that patient discharges are managed has not been revolutionary enough to keep up, which means more and more resource time is required each year as demand increases.  The current processes are paper-driven, laborious and result in patients being asked to repeat their medical history by various professionals. Our work to digitise ADW will be completed in Blackburn in 2021. 

It’s good to talk.…. But not always necessary!

The role of a clinician in a hospital can be a hectic one, somewhat intensified by the amount of paperwork and discussion which takes place between themselves and adults social care when preparing for a patient to be assessed and discharged from hospital.  This discussion can be by way of numerous telephone calls and emails spanning over a number of days, in order to ensure adults social care have all the necessary information required for the patient to be assessed and discharged from hospital.

Joined-up data. What will this mean for you?

The sharing of care records between health and social care will allow clinicians and social workers to have access to real-time information about a person’s care, resulting in a more joined-up and unified approach. “I had to keep repeating myself” is a complaint often heard from people, however, by digitising the discharge process this will mean fewer forms to be filled in by clinicians and social workers alike, which will mean less time spent by patients and their families repeating themselves and answering the same questions.  

Putting the person at the heart of what we do…....

Improving the experience of people and their family members is central to what we do and delays in discharge can be distressing for all those affected and can be detrimental to a person’s health, reducing their chances of returning to an independent life.  Some people need to be there for medical reasons but many remain in hospital when they’re well enough to go home but can’t do so without extra support or due to disjointed processes between health and social care.  With ADW this will all change! 

Extensive liaison with people, their families, social workers and clinician’s was undertaken and user-stories created which offered great insight into what a person’s journey between hospital and social care looked like in the Blackburn with Darwen area (see Doreen's story).  This understanding allowed us to predict what their journey could have looked like if their discharge was managed through digital channels and by doing so, it was clear that there were some real high-quality benefits which would [directly and indirectly] improve the patient’s overall care experience. 

Below are just some of the key benefits:

• Continuity of care
• Improve patient care by freeing up valuable clinician resource time due to reduced administration
• Social Care notified quicker that a patient is ready to be discharged, resulting in a quicker discharge
• Improved data security
• Reducing the need to keep asking patients for recent medical histories
• Reducing the cost of existing administrative processes to share records (letters etc.)
• Reducing duplicate data entry
• Avoidance of prescribing errors
• Quicker diagnosis and treatment 
• Reducing unnecessary and invasive tests