Slides from the Regional event launch for the Welcome to the Digital Child Health

1. Welcome to the
Digital Child Health
Launch Events
Hosted by:
Claire Walker - North
James Bolt – South
Pam Hall – Mids and East

2. • Share work to date on the publication of ‘Healthy Children’
• Give an overview of the vision of Healthy Children
• Share scope and approach of the Digital Child Health Transformation programme
and its ambitions
• Explore the opportunities and challenges for new service models in response to
the vision
• Agree next steps
Objectives

3. Timings Agenda
13:00 - 13.10 Welcome to the Digital Child Health Launch Event –
House Keeping and Introductions
13.10 - 13:20 Healthy Children: Transforming Child Health Information an Overview
13:20 - 13:40 The Clinical Perspective –
“what this means for parents, young people and professionals”
13:40 – 14:00 Q&A Session
14:00-14:45 Breakout Sessions – Redesigning our Services
14.45 – 15:00 Coffee Break and Networking Opportunities
(make use of flip charts to record comments etc?)
15:00 -15:30 Digital Child Health Transformation Programme Introduction
15-30 -15-45 Q&A Session
15:45-1600 Wrap up & Next steps

4. Healthy Children:
Transforming Child
Health Information
an overview
Jo Gander
Senior Programme Lead
Digital Child Health NHS
England

5. Why focus on children’s health and
information?
 Public Health England and the NHS Outcomes Framework 2015/16 stress that a focus on
children’s health is essential and that we should be striving to provide the best start in life
possible for our children.
 The recent National Maternity Review has highlighted that this begins not just with the
newborn child but with the mother’s experiences in pregnancy and the birth itself.
 The importance of ensuring this good start for the future health of children for the
sustainability of the NHS and the economic prosperity of Britain is one of the key themes of
the Five Year Forward View.
 We need to redesign information services to support the new emphasis on:
• the importance of early interventions and preventive measures
• integration across different care settings, particularly joining up maternity and newborn care
• the need to enfranchise children, young people and parents as equal partners in their care.
 We also need to take on the challenges posed by the current organisation of information services.

6. CHIS Evolution
Section 7A (NHSE)
Commissioned by PCT
2011
-
2013
2013
-
2015
2015
-
2016
Delivered by: New Providers LSP
?
LA Delivered by: Provider Trusts LSP CSU
Section 7A (NHSE) LA Delivered by: Provider Trusts AQP
£ ?

7. "Our ambition is to know
where every child is and how
healthy they are and which
give appropriate access to
information for all involved in
the care of children”
“The importance of ensuring
this good start for the
future health of children
for the sustainability of the
NHS and the economic
prosperity of Britain is one of
the key themes of the Five
Year Forward View”
‘Healthy Children’ sets
out the case for
restructuring our
information services and
systems for children,
young people, parents
and families so they can
contribute fully to improving
their health and wellbeing
and collaborate easily with
professionals across the
spectrum of care.”
"Information is not enough by
itself. There have to be
personalised transactions,
leading self-management
“There is a clear pathway to
improvement “
Tailor the health system to
meet the needs
of children and young
people, their parents and
carers
Health and Social Care
2015 Children and
Family Act 2012
Key Policy Drivers

8. Collaboration for the development of ‘Healthy
Children: Transforming Child Health Information’
Professional Bodies
Royal Colleges
- Paediatricians and Child Health
- Nursing
- Midwives
- Psychiatrists
BMA
Association of British Paediatrician
Nurses
Directors of Children’s Social Services
National Childbirth Trust
National Children’s Bureau
Children’s Commissioner
Association of Directors of Public
Health
Socitm
System Suppliers
& Commissioners
Parents & Young
People Group
Association for
Young People’s
Health
Young Minds
National Council for
Voluntary Youth
Services
National
Organisations
NHS England
PHE
NHS Digital
DH
NIB
LGA
Tech UK
Providers
Across London
Blackpool Teaching
Hospitals NHS Foundation Trust
Great Ormond Street

9. Healthy Child Programme
0-5
5-19
Health Visiting
School Nursing
Hearing, NIPE, Bloodspot
Immunisations 0-19 Health Record CHRD Staff
CHIS System Personal Child Health
Record
CHIS Services

10. Current Challenges
Personal Child Health Record
still paper based services still
very paper driven and manually
intensive
Up to 20% of children
unregistered with GPs: very
limited information and service
access
Services still very paper
driven and manually intensive
Closure of LSP programmes left
funding and expertise gap for CHIS IT
Population inaccuracies and tracking
of children has worsened since the NIT
report
Healthcare professionals don't have
access to core child health information.
Changing commissioning and provider landscape in light of the policy drivers

11. Healthy Children – where do we start?
With the basic building blocks:
 A first layer of essential child health information for exchange
 A first phase of systems exchanging that information - Maternity, Child Health GP
systems and Personal Child Health Records
 A roadmap for growing the scope of the information exchange
 Adding in new services as they become available, for example, national Failsafe for
Healthy Child Programme

12. 0d 5d 8d 11d 7w 9w 12m 13m 24m 40m 4y 5y
NIPE
Bloodspot
Hearing
NewBaby
Review
6-8WeekExam
8/12/16wkImms
12mthReview
12/13mthImms
2/2.5yrInteg
Review
3yr4mthImms
4-5yreyesight
check
SchoolEntryChk
Year6Check
Year8HPV
Booster
Imms
Public Health
England
PersonalHealthProfessionalHealth
Public
Health
Commissioners
Directors of Public
Health & Children’s
Services
Delivery of Healthy Child
Programme
(All Children)
Delivery of all other care services
(Some Children)
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
School NursingPrimary CareHealth VisitingMidwifery
Education ServicesVoluntary Services
Mental Health
Services
Emergency &
Acute Services
Justice ServicesSocial Services
Community
Services
Neonatal Services
Maternity
Information Systems
Screening
Information Systems
Primary Care
Systems
GPESCYP Dataset
CAMHs
Dataset
PCHR
90
CHRDs
Research & Policy
Maternity
Dataset
SCR
National Audit

13. Enabling essential information exchange
How do we decide what is essential as the core record of a child’s health
and development available to professionals and to parents to assist in
diagnosis and treatment ?
 We use what is already agreed as being essential to the foundation of a child’s health:
• By the Royal College of Paediatrics and Child Health – the Personal Child
Health Record (PCHR) owned by parents
• By Department of Health – the Healthy Child Programme
• By commissioners – the Maternity and Children and Young People’s
Datasets
 This is only the first layer of interoperability, additional data will be designed and
endorsed through a national design authority

14. 33 events in first interop layer
14
Maternity Screening Health Visiting Primary Care School Nursing Personal Other
E1 Birth
Details
E2 NIPE
E3 Blood
Spot
E4
Hearing
E5 New
Baby
Review
E6 Imms
E7 6-8 Wk
Review
E8 6-8 Wk
Review
E9 Height
& Weight
E9 Height
& Weight
E9 Height
& Weight
E9 Height
& Weight
E9 Height
& Weight
E10
Vitamin K
E11 1
Year
Review
E12
Conditions
E13
Special
Needs
E14
Allergies
and Drug
Reactions
E12
Conditions
E14
Allergies
and Drug
Reactions
E14
Allergies
and Drug
Reactions
E15
Accidents
& Injuries
E15
Accidents
& Injuries
E17
Family
Conditions
E18 2/2.5
Yr Integ
Review
E16
Family
Relationsh
ips
E18 2/2.5
Yr Integ
Review
E19
School
Entry
Check
E20
Profession
al Advice
E20
Profession
al Advice
E20
Profession
al Advice
E20
Profession
al
Comment
E22/33
Hep B/
BCG
Indicated
E23
Responsible
Professionals
E23
Responsible
Professionals
E23
Responsible
Professionals
E23
Responsible
Professionals
E24
Address
Add or
Change
E24
Address
Add or
Change
E24
Address
Add or
Change
E25
Interpreter
Required
E25
Interpreter
Required
E6 Imms
E26 Rest
of NIPE
E27
Breast
Feeding
Status
E28
Developm
ental
Firsts
E29 Teeth
E30
Parental
Comment
E31
Personal
Comment
E33
‘About Me’
Event
recorded
once
Multiple
Events
across
Systems

15. www.england.nhs.uk
How – by introducing digital basics
Access to key child health data at the point of care
Interoperability to allow data sharing between health and care
professionals
Patient empowerment through the use of personal health
records

17. www.england.nhs.uk
Digital Child Health–Service Transformation
The Vision
“As a parent and carer I
am informed and can
make choices that best
meet my child’s health
and care needs.”
I have access to information that
enables me to make the best
health and care choices for my
child
• Online record of their child’s
health and development.
• Can share my own health and
wellbeing information with
professionals.
• Can set their own preferences
for information sharing and can
see who subscribes to their
information.
• Can access online peer support
networks or health promotion
support more easily
“As a HCP I can provide
the best care options to
children and young
people as information is
real time and available at
the point of care ”
I have access to real time information
at the point of care that helps me to
provide a better care experience for
children and their families
• Core view of child health
information at the point of care.
• Record information about a
child/young person and publish
automatically to those in the
extended network of care.
• Up to date health events will be
available in their own health record
systems, they will not need to
access other systems.
• Failsafe management service will
alert preventative programmes of
care when an intervention is due
or has been missed.
“As a commissioner I can
access he right
information to understand
the health and care needs
of children and young
people”
I know that children under my
care have received the
appropriate health
interventions to keep them
healthy
• Failsafe management
services will give
assurance for
safeguarding children.
• Commissioners can
analyse data and
intelligence to make
service improvements
and modifications
“As a provider I have
access to IT systems of
Choice that meet
national data and
technical standards”
I can provide an
information service that
underpins the needs of
health and care services
• Can offer digital
services to
parents, children
and young people
which allow them
to take ownership
of their own care
• Have a choice of IT
systems that will
enable information
exchange across
extended network
of care.

18. Dr David Low
NHS Digital
Digital Child Health
A Clinical Perspective

21. The early years of a child’s life have a lasting impact. What
happens in the home and how parents interact with their
children is crucial to their development.

22. • More robust clinical
decision making
• Avoids duplication
• Better Safeguarding
• Reduces risk for
‘Borderline cases’

23. Digital aspect - when
Commissioning

24. Direct interoperability into native Clinical Systems
Clinical Digital Environment
Portals – multiple logins – lack of confidence
I have access to real time information at the
point of care that helps me to provide a better
care experience for children and their families

25. Working and thinking in silos creates
access issues
a

26. Examples - Immunisations/ Medications
ProfessionalHealth
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
CHIS /
CHRD
School NursingPrimary CareHealth VisitingMidwifery
Education ServicesVoluntary Services
Mental Health
Services
Emergency &
Acute Services
Justice ServicesSocial Services
Community
Services
Neonatal Services
Maternity
Information Systems
Screening
Information Systems
Primary Care
Systems
SCR
Delivery of Healthy Child
Programme
(All Children)
Delivery of all other care
services
(Some Children)

27. Standards for Clinical Safety in
IT Systems
SCCI 0160
In use of the
system by the
Health or Care
Organisation
SCCI 0129
In the system
development and
modification by the
manufacturer
https://digital.nhs.uk/clinical-safety

29. Reflections on Strategy and Clinical
Perspective (10 minutes)
‘Knowing where every child is and how
healthy they are’
‘Appropriate access to information for all
involved in the care of children’
What are the
opportunities and
challenges in
delivering the vision?

30. Breakout Session – Redesigning our Services
You are asked to describe the key considerations if Child
Health Information Services (CHIS Services) were to be
reconfigured:
What are the key considerations when redesigning children's
information services /other health and care services. (Each table
has different scenario)
• Local Authority
• Clinical Commissioning Group
• Child Health Record Department
• STP / Regional Planning
• NHS England (S7a)
• General Practice

31. Break out session
Reflections on Strategy and Clinical (10
minutes)
Scenario exercise (10 minutes)
Group feedback to the room from each table
( 10 minutes )
Discussion on all perspectives (10 minutes )

32. www.england.nhs.uk
Digital Child Health
Transformation Programme
Jo Gander
Senior Programme Lead

33. www.england.nhs.uk 33
Integrated
Digital Care
Records
across health
and care
Technical
adoption
Business
intelligence
Purchasing
FrameworksIT Systems
of choice
Service
spec
Market
Development
Commercial
arrangements
Business
Intelligence
Datasets
Interface
Commissioning
and Operating
Model
Core service
& contracts
Data Sharing
e-Consent
model
Configure national infrastructure
to meet technical and data
standards enabling local
commissioning insight
Develop a vibrant,
competitive
marketplace with
choice of suppliers
Develop
commissioning
model that
promotes proactive
health and care
commissioning
Collaborate with local
service models to make
Information accessible at
the point of care
e-Personal
Child Health
Record
Standards
Develop digital tools to provide choice for
parents on access to record and support
services
Develop a
trusted
consent
model for
patients and
professionals
Accreditation
Levers &
Incentives
Develop a commercial
model to support
procurement of local IT
systems of choice
Architectural
Blueprint
Standards
National
Service
Design
Interop.
National Failsafe
Management Service
Evalu.
Benefits
Redesign Fail-safe
management
services
Test /
Discovery
Preventative
programmes
to monitor
the uptake of
the Child
Health
Development
Programme
Service
Blueprint
Achieving transformation

34. Central data sharing hub

35. www.england.nhs.uk
Test Assumptions
Trial New Methods
Deploy New Services
March 2017
1st layer of child
health information
Q: Can events be standardized for
exchange rapidly?
Trial 1st layer
information
in eRedbook
(London)
Yes
Content
Agreed
Yes
Collaboration on
standardization
Q: Can this standard be
widely supported?
Events Catalogue
for child health
information
created
Q: Can systems be
modified for interop
Yes
Deploy new
PCHRs with
standard
content in
other regions
June 2017
Systems development
Yes
Q: Trial a success?
National events
management
service ready to
go-live
Interoperability
between CHIS,
Maternity, GP
systems and
PCHRS
Dec 2017

36. • We would like feedback from this event please do complete the feedback
forms
• Contact us to register your interest email England.healthychildren@nhs.net
stating which communities of interests you want to be involved in or have
an enquiry
How do we keep in touch
@tracey_grainger
https://www.england.nhs.uk/digitaltechnology/info-revolution/digital-
primary-care/child-health/

37. Next steps

38. www.england.nhs.uk
National Engagement Partners – high
level
 Professional Bodies
 Commissioners (LGA/ NHSE /CCGs)
 Transformation Initiatives (STP.
LDR, NMC)
 Partner Organisations – NHS Digital,
PHE, CCGs, LA,
 Existing CHIS System Suppliers
(LPF/SBS)
 Potential new suppliers
 Service Providers
 Children & Young People
Governance Boards
 Department of Health
 Workforce
 Ministers
 Maternity Providers
 Parent and Carer Groups

39. Levels of involvement
• Doers - services who are willing to get their hands dirty trying out different ways of sharing
data.
• Thinkers – services who are willing to publically offer views, advice or critiques.
• Watchers – services who just want to follow progress.
Everyone to consider at a local level Child Health Information, from an
operational and commissioning perspective

40.  Progressing options for regional and locality based responses to enable a
transformational use of child health information
 A review of the configuration S7a CHIS Services in response to the transformation
changes, led by NHS England
 Building of the technical building block of the new national infrastructure, including
proofs of concept, led by NHS Digital
 Progress of regional pilots and trials different child health commissioning approach
and technology
A wide ambition, so what will you see first?

41.  Service redesign workshops to agree potential new service models for Child Health
Information (end Feb for 6 months)
 1st part is for CHRDs to complete situational questionnaire to help understand the
current local landscape (January – please support)
 Additional focussed events for different stakeholder communities e.g.
• technical forums (led by NHS Digital)
• Commissioning
• Clinical
Next steps