Information requirements for pharmacy, optometry, dentistry, ambulance and community services

Information requirements for pharmacy, optometry, dentistry, ambulance and community services

The aim of this project was to identify the information in care records that should be available to professionals working in pharmacy, optometry, dentistry, ambulance and community services, and consult on whether the PRSB core information standard for shared care records would meet their needs, or whether additional standards should be developed to support care in these settings.

Research was undertaken to understand what information is currently available in these care settings, followed by a survey of people to understand their experience of how information is/should be shared with community care professionals. Several online workshops were held with multidisciplinary professionals, people who use services and suppliers and stakeholders to test whether the core information standard would provide the information required for care, or whether additional information or in fact new standards were needed. 

On this page

Background

To provide clinically safe, high quality and effective care, all care professionals need access to accurate, up-to-date information about the people in their care and their history. Current systems don’t always allow easy access to information between health and care professionals working in pharmacy, optometry, dentistry, ambulance and community services. In particular, professionals working in these care settings often struggle to query or access the information they need to provide joined-up, holistic care.

The reasons for this are multifaceted and include problems with digital tools that are outdated and don’t interact with one another, resulting in staff having to invent time-consuming workarounds or work without information about care in other settings. There has been no standardised way to share clinical information in people’s care records between settings and services, which in turn leads to the risk that care may be poorer in quality and outcomes less good.


Using standards

Developing a standard or standards for sharing information with these five community services will ensure that professionals working in these care settings have access to the right information at the right time to provide clinically safe and effective care, subject to appropriate information governance controls.

Using the core information standard in these settings should improve care and outcomes for people and it should improve the working lives of professionals who won’t need to create workarounds to ensure they have a complete picture of a person’s current and relevant care history, before starting treatment.

Find out more: Digital Community Pharmacy, Optometry, Dentistry, Ambulance, Community Care (PODAC) Programme – NHS Digital

PRSB's role

The PRSB produced the core information standard for shared care records in 2019 to make sure all relevant information about a person’s health and social care could be accessed, subject to appropriate information governance controls, to support safe and effective care. 

PRSB was asked by the NHS in 2022 to help accelerate the sharing of health and care information in the five community care settings listed above, by validating the use of PRSB’s core information standard for shared care records for this purpose, producing new standards where needed and assessing whether or not GP records could be used to speed up access to the right information. 

Key objectives

The objectives of this project were to:

  • Review the applicability of the existing PRSB core information standard for each care setting of PODAC
  • Develop new standards if the PRSB core information standard was not the appropriate standard
  • Map the standards to the contents of the GP record to identify opportunities to speed up implementation of the standards using the GP record

Findings and report

  • The key finding of the project is that the PRSB core information standard is the appropriate standard for all five care settings, with appropriate information governance access controls.
  • Extensive consultation, evidence gathering and comparative research identified a wide range of recommendations and concluded that no additional data items were identified or requested for any of the five care settings.
  • No changes to the existing PRSB core information standard: Version 2.0 would be required to enable implementations to begin in these five care settings.
  • There is overwhelming support from those who participated in the delivery groups and workshops for the introduction of the PRSB core information standard, with widespread agreement that doing so is important for the benefit of both care professionals and those accessing care. 
  • Implementation projects must include review of processes, training and governance to maintain and ensure safe, effective and authorised use of shared data.


Full report: Use of the PRSB core information standard in community settings

Further resources

Core information standard
This standard brings together the main components and covers the broadest range of uses of health and care information. 

Podcast: Implementing standards
Dr Afzal Chaudhry speaks to PRSB about the positive changes he has seen as a result of using standards.

Find out more about our standards
A guide to help you understand PRSB standards and how to use them.

CHAT theory also explicitly addresses five areas which if addressed systematically will help overcome stakeholder differences in pursuit of the common goal:

1. Understanding the artefacts that characterise the group and its activity.
• The artefacts might be clinical settings or the forms and templates used to capture and share information. During the pilot we heard about hard copy Dialog response forms; locally generated templates for collating information from different systems; letters and emails to GPs; images, poems or other non-text artefacts that service users might want to include in their ‘about me’ or care plan.

2. Understanding the multi-views of the group. Such groups are always a community of multiple points of view, traditions and interests. 
• Different participants in the group will have different roles and will bring to the group and their roles their own histories, language, and ‘rules’. During our Stocktake preparations and workshops we worked with psychiatrists, mental health nurses, occupational therapists, social workers, transformation leads and voluntary sector representatives, all professions and interests with their own language, approaches professional ‘rules’ but united in their interest in care plans, care planning.

3. Activity systems (like the ICSs) take shape and get transformed over periods of time. ‘Historicity’ is a term coined to express how the group’s problems and potentials can only be understood against their own history. 

 

• ‘We’ve always done it this way’, ‘that didn’t work before’, ‘it’s always like this’, ‘it wasn’t always like this’, ‘they are changing things again’, are all typical statements that often frustrate those charged with overseeing change initiatives. Without addressing the experiences that lie behind such comments you risk repeating mistakes of the past, alienating your stakeholders or just not understanding the real starting point for your transformation project. This is particularly the case for the implementation of the PCSP standard, the success of which will be largely reliant on point-of-care practices and information protocols as well as having systems which are user friendly and appropriately configured.

4. The central role of contradictions as sources of change and development. Contradictions are not the same as problems or conflicts. Contradictions are historically accumulating structural tensions within and between activity systems. Collectively addressing contradictions in how policy, practice, culture and technology interact will empower teams to find genuinely novel solutions for apparently intractable challenges, like interoperability and shared care plan/planning. 

This links to the fifth principle that:

5. the possibility of expansive transformations in activity systems. As the contradictions of an activity system are aggravated, some individual participants begin to question and deviate from its established norms. In some cases, this escalates into collaborative envisioning and a deliberate collective change effort. “An expansive transformation is accomplished when the object and motive of the activity are re-conceptualised to embrace a radically wider horizon of possibilities than in the previous mode of the activity.”