Transfer of care discovery report (July 2023)

Summary

The eDischarge Information Record Standard was first published in 2015. Despite significant investment in programme initiatives, the widespread implementation of the standards has been slow. 

In this report from the Professional Record Standard Body, authors identify the challenges that have inhibited the adoption of the standard, make recommendations for improvements and set out the anticipated benefits that this will bring.

The aims of this discovery and user-design phase were:

• To review the current state of adoption of transfer of care messages between secondary care senders and primary care receivers of transfers of care and identify reasons for the low uptake to date.
• To understand GP’s needs and priorities for computer readable data that can be shared with primary care systems without loss of meaning.
• To make recommendations for what needs to happen to enable widespread adoption that supports the needs of GPs to deliver safer patient care.

Content

The report includes seven broad recommendations regarding e-discharge as well as recommendations regarding other transfers of care and general recommendations regarding lessons learned and their applicability to standards and interoperability generally:

Recommendations regarding e-discharge

1. Adapt General Practice systems, processes and workflow to better meet GP needs.
2. Drive wider adoption of the standard in Secondary Care and specialist providers of care (e.g. gender identity clinics).
3. Encourage joint system working (primary care, secondary care, patients) facilitated by ICS’s.
4. Improve e-discharge standards and documentation to make it easier for suppliers and implementers to follow.
5. Review and streamline assurance and conformance processes.
6. Establish programme, leadership, governance and incentives to lead the change programme required.
7. Recommendations for other related programmes.

Recommendations for other transfers of care and for standards and interoperability generally are included in the detailed recommendations below.

To be successful, the proposed approach must include the following key features:

• Collaborative leadership and governance including all key stakeholders (ICS, NHS E and programme teams, software suppliers, PRSB, techUK, INTEROPen) and taking a ‘whole-system’ approach.
• Strong involvement from Integrated Care Systems ensuring local ownership and fir for purpose solutions.
• Focus on clinical continuity and better outcomes for patients.
• Clinical and technical support to enable problem solving and rapid removal of barriers. 
• Pilot deliverables will be assured and shared for national benefit.