Opinion

Securing the digital future

11 January 2021

Helene Feger of the Professional Record Standards Body on the rapid rise of online consultations and the greater scrutiny needed to keep healthcare safe and accessible. 

Covid-19 has drastically changed every aspect of our lives, including the way we provide health and social care. In a sector that has traditionally been focused on home visits and personalised care and communication, community practitioners (CPs) and health visitors are among the many NHS workers who have embraced digital ways of working through the pandemic. Before 2020, progress in the digitisation of health and social care was patchy. Though many organisations were taking steps to support better digital services and information sharing, there were blocks and challenges to overcome – some of which seemed insurmountable.

Pressure drop

In some ways, the rapid rise of digital consultations has been a useful tool for CPs and HVs, supporting more people to engage in services in their homes, which is far more convenient for busy new mothers and their babies. It also means that the whole family can participate in the consultation, which can relieve the pressure on mothers or stressed carers. However, it’s not always safe or practical for clients’ needs to run consultations online. For example, new mothers with postpartum depression or those with English as a second language may find it particularly hard to adapt to online consultations, as much of their communication may be nonverbal.

There are also cases where a professional feels that a face-to-face interaction is safer or more valuable, such as when it comes to supporting vulnerable families or speaking directly to someone who has a learning disability. From the evidence we’ve seen so far, it’s clear that digitisation presents a lot of opportunities, as well as challenges. In addition to online appointments, the use of self-care apps and other digital monitoring has increased, which helps to support people in managing their own health and care at home, reducing the need for hospital interventions. This will help people and professionals to personalise the support they are getting, hopefully leading to higher levels of engagement and better quality care. For these to become a mainstay of care, there must be greater scrutiny of the changes that are happening and their implications for both professionals and patients.

The Professional Record Standards Body (PRSB), a national body set up by the Department of Health and Social Care to set standards for health and care records, asked 100 members and partners about the ‘digital lessons’ that people have learned throughout the pandemic. Contributors included representatives from the royal colleges, social care system leaders, health and care providers, patient groups and those who have been impacted by the rapid changes within health and social care. The PRSB published the Digital health and Covid-19 report, which identifies safety, quality and accessibility issues in online patient-clinician interaction and digital use during the pandemic and the challenges around the coordination and collection of data across the UK. The report makes recommendations for what can be done next, building on the enthusiasm for digital, as well as reviewing and evaluating safety and accessibility.

Early signs of autism and other conditions can be recorded more quickly and easily, and children’s health can be closely monitored for changes

Marking milestones

The PRSB has already begun to address many of these through the production of information standards for transferring digital information between different services. These are always developed in consultation with a wide range of health and care professionals, as well as patients and carers. Their use in practice will support the development of a more connected NHS and social care system, which is integral for patients who are accessing many different services.

One of the standards that will be especially helpful for HVs is the Healthy Child Record standard, introduced in 2017 to support the Healthy Child Programme and its prevention agenda. The information standard spells out what information on screening tests, immunisations and developmental milestones should be accessible to ensure that children receive appropriate care. The innovation means that everyone involved in a child’s care, including parents, will have secure access to a standardised set of paperless, digital child health records. It will mean, for example, that early signs of autism and other conditions can be recorded more quickly and easily by those involved in care, and children’s health can be closely monitored for changes. It will also help to support vaccination programmes. For example, the South, Central and West Commissioning Support Unit (England) has been working with clinical commissioning groups and GPs across a number of UK localities to reconcile child vaccination records in order to encourage increased take-up of vaccines. Standardised records are helping to track this.

Another of the challenges that currently face community care teams is the growing number of older people who need integrated support to manage their long-term conditions at home. Our digital care and support plan standard will help enable people to manage their own care, with the support of a wide range of services including GPs, hospitals, occupational therapy, social care and CPs, and doctors. It covers general care planning as well as end-of-life care support, and has an ‘about me’ section, which contains crucial information about a person’s individual’s needs.

All about me

Where the PRSB’s standards are being used, evidence shows that care is becoming more joined-up, leading to better and safer outcomes and experiences for patients. For example, pharmacists in Wales have found that by accessing the medications information from hospital digital discharge summaries, they have been able to successfully help people stay on top of their medications and take them properly when they return home.

Meanwhile the introduction of digital ‘about me’ sections in care records has made a big difference to people using health and social care services. From recording information about food preferences to the best ways of communicating with a person who has severe autism in a crisis situation, standardising this personalised information has been hugely helpful for both carers and patients accessing services. The ‘about me’ standard is also contained in our latest social care standards, which aim to join up information between social care and health, and which will be hugely beneficial to all professionals, especially those working in the community.

As we build on the momentum to drive digitalisation forward, it’s vital that we ensure the foundations are in place, with good-quality care information at the forefront. As well as supporting better and safer direct care, standardised information will help us to deliver the wider improvements that are needed in services, and ensure that new digital developments are safe, secure and prioritising patients.  

Helene Feger is director of strategy,communications and engagement at the Professional Record Standards Body (PRSB). 


Resources 


Time to reflect

How have the PRSB’s standards helped you deliver better care? What are your hopes and fears for faster and deeper digitisation generally? And how will this help you deliver in practice? Join the conversation on Twitter @CommPrac with hashtag #digitalfuture

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