The document discusses interoperability strategies for health and care in Hampshire, England. It describes current systems like the Hampshire Health Record, areas for improvement, and future needs. Key priorities include building on existing records, improving usability and access, and supporting integrated digital care and emerging models. Lessons focus on centralizing governance, stakeholder engagement, and reviewing existing solutions to transform care through expanded interoperability.

1. Interoperability
Indi Singh, Head of Enterprise Architecture, NHS England, inderjitsingh@nhs.net
Barbara Rushton barbara.rushton@nhs.net
Nigel Watson Nigel.watson@wessexlmcs.org.uk
Tim Cotton tim.cotton@westhampshireccg.nhs.uk
Joseph Stepney Joseph.Stepney1@nhs.net
Peter Cambouropoulos Peter.Cambouropoulos@SouthCSU.nhs.uk
Mark Pugh mark.pugh@iow.nhs.uk

2. Taking Forward Personalised Health and
Care 2020: Interoperability Strategy
Indi Singh
Head of Enterprise Architecture, NHS England

3. As a Clinician, Paper-Free Health and Care
will Mean I Can:

4. The Ambition Will be About Improving High
Priority Care Pathways

5. Delivering Integrated Digital Care
How do I get there? Interoperability Strategy
Where am I going? Where am I now?

6. Interoperability Strategy
the development of an open environment
for information sharing supporting
emerging models of care based on open
interfaces and open standards.
Transfers
of Care
NHS
Number
Key Priorities
Procurement
Guide
Interoperability
Handbook
Tools

7. Interoperability – The Offers

8. Introduction to Hampshire Vanguards
• Better Local Care – South Hampshire (MCP)
• North East Hants and Farnham (PACS)

9. Introduction to Hampshire Vanguards
East Hampshire
 10 practices / 70k patients
 Semi-rural “new town”
Gosport
 11 practices / 80k patients
 Urban deprived
New Forest
 7 practices / 70k patients
 Rural – older demographic

10. DoctorsStuffthey’regoodat
Stuffthey’renotgoodat
Remembering
206 bones in the
human body
Remembering
206 Usernames
and passwords
Patience with
patients
Patience with
technology

11. Where we are now
Hampshire Health Record (HHR)
• Started in 2004, now covers around 1.9 million patient records
• Holds 20 million documents including discharge letters and pathology tests
• Approximately 85% of GP practices upload daily extracts in HHR
• It has seen increasing usage and derived improved clinical and business outcomes
• Usability, ease of access,IG issues and changing requirements mean the system
is underutilised
Prime Minister’s Challenge Fund:
• Using TPP and EMIS in primary care to interoperate
Care.data in West Hampshire

12. HHR Diagram
Medicines
Note:
Ambulance
services and
OOH also able
to see record

13. Preliminary Conclusions - HHR use in AE &
Inpatients setting
Use of HHR is associated with:
• Increasing complexity of patient presentation
• Statistically significant reduction in decision to admit patients to hospital
– 9% reduction
• Statistically significant reduction in the number of pathology and radiology tests
– ReducedX-ray exposure
• Statistically significant reduction in average length of stay in hospital
– 1.7 days average
nb evidence of association may not be evidence of cause

14. What are the future needs
• Support the evolving needs of the extended primary care team
– Flexibility to support changing models of care
• Extended teams working on a single version of the truth
– Seamless two way integration
• Greater engagement with the patient and their extended support network
– Self service, proactive care
• A usable solution supporting the future Digital transformation
– A platform/backbone for developing applications and integration

15. Expanding and Improving Interoperability
• Build on the HHR repositoryas a foundation
• New Care and Health Interoperability Programme (CHIP)
– Focussed on the requirements from stakeholders across the wider care system
– Supporting key future information sharing and Digital needs

16. Lessons learnt so far
• Centralise governance as soon as possible
• The right level of stakeholder engagement
• Start with the future requirements rather than the current issues and focus
on transformation
• Review all existing solutions or plans in place
• Consider the implications/impact for providers
• Engage with suppliers early and build confidence in the market

17. Getting IT right in Rushcliffe
Dr Stephen Shortt
Stephen Murdock
Andy Evans

18. TPP DistrictNursing Community Unit
NEMSOOH
GP practicesx 3
Primary Care Connectivity for
Prime Minister’s Challenge Fund
GP Practicesx 9
Medical InteroperabilityGateway
(MIG)
Read
&
Write

19. Primary Care Connectivity
TPP DistrictNursing Community Unit
Rushcliffe CCG TPP OrganisationGroup
Groupwide recalls using SMSwhere possible
Groupwide reporting and feedback
Central appointmentbooking and management
Federationof back office functionse.g. secretarial,scanning
Standardisedand centralised templates,forms,letters etc..

20. Primary Care Data Sharing
EDSM
MIG
PATIENTCONSENT
96% of eligible
Rushcliffe GP records
are now shared

21. Information Distribution and Management
Information,news, documents,pathwaysetc.held and maintained centrally
NurseGP Managers
& Staff
All information targetedtosubscribed groups
Accessible direct from SystmOne

22. Patient Online Access
Personalisedaccess to online services, information & health data
Standardand simplified interface acrossplatforms and organisations

23. Pharmacy
Access to Care Records
Access to SystmOnerecords for care home nursing staff
Record viewing
Medicationrequesting
Tasks to clinical staff
Care plansCare Homes
Access to SystmOnemedication screens only
Medicationrequesting
Tasks to clinical staff
Rushcliffe Care Professionals
e.g. Community Geriatrician
Access to SystmOnerecords acrossCCG via shared admin
Ability to report on cohorts of patients
Write into recordsand task clinicians for actions