2. • Interest in improving quality of care by better use of our information systems
• Passionate about General Practice
Who Am I?
3. • Remind ourselves about the standard
• Look at some of the data from my practice and what this means
• Opportunity to discuss around the tables
• Consider some process redesign for your practice
• Look at Ideas in development
• Finally look at practical solutions with suppliers
Aim and format for workshop
4. • Highlight in patients records that they have communication needs, and
explain how those needs should be met
• Share those needs with other organisations with consent
• Ensure patients have information in accessible way and communication
support if they need it
Accessible Information Standard
7. • Where do we start?
• How do we identify patients ?
• What processes do we need for new patients?
• What do we do for existing patients?
Table Discussion
9. • Need for verification of use of codes
• Establishment of “disease registers”
• Clarification of use of codes
• Communication with patients
• Sharing information with other organisations
Use of Standard
10. • How could your practice implement this standard?
• What difficulties can you foresee?
Table Discussion 2
11. 1. Run reports to identify patients who may be appropriate
2. Training staff about standard
3. Design a process which works for the practice
4. Send out letters to identify if there is a need for additional information
requirements
5. Act on the letters
Where Do You Start?
13. Dear _______________,
At this Medical Practice we want to make sure that we give you information in a way that is clear to you.
Our records show that you may have a disability that means you find it difficult to read or understand the information that you are given
by the Bentham Medical Practice.
Is this correct?
Yes No
Please can you tell us how we need to communicate with you?
By phone
I use a hearing aid I do not use a hearing aid
With a British Sign Language interpreter
By email
I use a screen reader I do not use a screen reader
By text message
I use a text to speak app I do not use a text to speak app
With Easy Read pictures and words
By letter using large type
If you need anything that is not on the list above, please tell our receptionist when you come in for your next appointment and we will do
our best to meet your needs.
Yours sincerely,
Letter to Patients
15. • Developed by Clinical Support Unit
– Tested in four local practices
– Developed by
• Lucy Speller
• Barry Clarke
• Des Carter – here today
Yorkshire & Humber Prompt
17. • Training requirements regarding coding
• All staff aware of the standard
• Understanding SCR and additional consent
Create templateUse status markersCreate a view
Possible Solutions
22. • Understanding coding issues with this standard
• What should be recorded in a medical summary
• England and Wales partially sighted certification = 0
• Gaining consent for additional information to be shared with SCR
SCR
23. What resources do I need to be able to address the patient information needs?
• How do I convert to braille?
• Use of email from notes?
• Text type
• Patient online access - results of tests, letters etc.
What other solutions do I need?
Completing the Circle
24. • Letter to patients
• Update to new patient questionnaire
• Clinical system support
• List of appropriate codes
• Consent of patients to share this information
• Practical provision of services to patient
What additional assistance do you need?
Practical Support
GP in Derby –
working or 22yrs full time
Practice has 18,000 patients over 2 sites
GP trainer and appraiser
Co-founded the national SystmOne user group
I’m no expert but interested in improving patient care
We don’t always record
Who has hearing aid
Who is registered deaf
Who requires a sign language interpreter
Who can lip read
I had request early Feb from a patient who I have email correspondence with who required a counsellor with BLS skills, the local counselling service did not provide this
Here are more figures about the disease registers we have and the possible patient who will need to be contacted
Interestingly despite never knowingly used the “patient information status code” apart from one patient which I have been using for testing things out, we have 12 patients with this code, 10 who do not have any problems with AIS , and the code has been added by previous practices
One code added with record of marriage certificate – proof of change of name, another patient had entry 8 x in record but no free text as to why code had been added, other 8 patients no indication for why code added
The way we record and use information , has implications for how we use that information and to what end
Hearing loss may be part of the standard but if patients have hearing aids and don’t need BSL interpreter how do we use the codes
Some patients can lip read , but require email correspondence to book and arrange appointments
Consent for sharing with other organisations , about not only their communication needs but also the health and social information
Identifying patients and consider improved coding for this issues
All staff need to be aware of changes an implications for records .. What does all this mean
Think carefully about process in practice, if reception and admin are trained properly …may be clinicians will not need to be heavily involved in this
You can design your own processes if you want however Yorkshire in its normal proactive manor has been proactive in trying to assist practices
Prepared by clinical support team , which I believe is about to be disbanded .
When we have information from patients
we need to know how to record this information –
which codes
where is the records is this going to be so we can find it easily and
act on it appropriately
Yorkshire and Humber Clinical Support team have developed a protocol which put a free text reminder on to the home page
This informs you of the way in which the patient should communicated
It depends how the practice likes to work ……. Whether you like coded information …… whether you would like to search in future fore more detail on patients or happy with high level code in records .
It does not therefore offer the opportunity to add a detailed code which would need to be added as well if we are all going to learn how to share this information with other organisations
What have I been up to in our practice ?
Looking through things in preparation there was a code for
What information belongs in a medical summary – there is no national agreement over contents of medical summary
I recently reviewed new patients registering with practice and only 20 % would have an up to date good quality summary .
England and Wales partially sighted certification – how many have used this code ? Which means there is re-coding of existing patients
There is a process around gaining consent to share information, which will need to be tackled by the practice.
Our local area is proposing a process of implied consent – I don’t think this is acceptable
What do I need to be able to deliver this standard ?
I’m still learning how to do all this , and trying to find solutions
Printers with A3 paper? Able to convert to Braille? Simplified language and use of pictures?
How can we email from notes and record information back into records?
How is patient on line going to help facilitate sharing some of this information so patients can see and enlarge type electronically
Copy of letter to patients
Notification containing protocol and templates
Lists of codes
Details of suppliers of services