How can a shared care record deliver better personalised care planning?

For many years the NHS has talked about the need to shift to a more personalised approach to health and care. Personalised care means that people have choice and control over the way their care is planned and delivered, based on “what matters” to them and their individual strengths, needs and preferences

Personalised care and support planning is increasingly being seen as a national priority. Local health and care organisations are working more closely than ever before, and together with improvements in digitisation and the introduction of new standards, many systems are making plans to shift to a more personalised approach.

Ben Wilson, product solution director at Orion Health, outlines recent developments and makes the case for care planning being delivered at an integrated care system level, building on existing shared care record platforms which are agnostic to a particular care setting and are already contributing to individuals receiving more joined-up care.

What has been done to make care planning a national priority?

Ben: The current focus stems from the NHS long-term plan, which emphasises that personalised care needs to be “business as usual” across the health and care system. Since then, a lot of work has been done to lay the groundwork to make that a reality. The introduction of shared care records to every ICS has been an important first step, however there remains a desire to increase the breadth and depth of these platforms. To date, there have been pockets of good practice across the country and successful digitised care planning initiatives, but it’s important we now move to a more coordinated approach in order to realise the full potential and benefits.

Earlier this year, NHS England’s digital arm and the Professional Record Standards Body issued an Information Standards Notice to standardise the collection of the data required.

NHSE has also published a set of ambitious interoperability priorities over the next two years, which includes the introduction of a single, personalised care plan for every individual that needs one. These should be shareable nationally, so whenever and wherever a person might be receiving care, their plan, wishes and care preferences can be respected.

Why use the shared care record for care planning?

Ben: As things stand, care plans are often created on either paper or within digital systems centred in single organisations. The shared care record acts as a person-centric cross-organisational platform, enabling care plan management activities to be centralised and available to any health and care professionals who need to jointly collaborate.

Other benefits include the rich collection of information already available within the platform that can be made available to the care plan to reduce duplicate data entry. Our shared care record – the Amadeus Digital Care Record, can also be accessed within the record systems professionals use every day, which reduces the frustration with using new systems and this has been shown to increase adoption.

The platform also includes care coordination tools that make it faster and easier for providers to design and create care plans and facilitate version control, meaning changes to care plan templates can be made and rolled out easily as standards evolve over time.

It also comes with role-based access, so different professionals can see the most important information to their role for example, an ambulance crew member may want to see a different view of the care plan information than a care home worker. Our Virtuoso Digital Front Door enables individuals to contribute to their plans, including the PRSB’s About Me standard, that captures what really matters to them.

Who is doing this already?

Ben: Orion Health provides shared care records to 10 out of the 42 ICSs in England. Devon and Cornwall is about to digitise its Treatment and Escalation Plan. While Joined Up Care Derbyshire is passionate about modernising end-of-life care plans, because of the difference that will make to patients and families.

What is the future of care planning?

Ben: Personalised Care Planning requires the individual to be an active participant in their plan and empowered to take responsibility for their own care. Orion Health Virtuoso will allow individuals to not only view but contribute to their personal health records and care plans.

Information entered into these plans, either via a professional or the individual and/or their carer, with appropriate information governance agreements in place, can also be made available for analysis and utilised in population health initiatives, which will give a much richer picture of what is happening across the system and what matters to the individuals and families who rely on it.

What should system leaders be thinking about, to make the most of the opportunity ahead?

Ben: Digital care planning initiatives have had mixed success to date. These initiatives call for professionals to work together in new ways, so the change management aspect is important. It’s also important to be thinking ahead and making future-proof technology choices now, to avoid curtailed ambitions and frustrations down the line. Timing is important, generally, a well-adopted and more mature shared care record is likely to have a better chance of centralised care planning being a success.

So, the challenge for system managers will be to make the case for care planning, to get people on board with it, and to make sure they’re comfortable with the technology that is available to make it work. It’s tough – but if we wind back eight or 10 years, it was hard to get shared care records adopted: and nobody would be without them now.