Thousands of digital technologies and apps are used to support people’s health and wellbeing and the use of technology has only accelerated during the pandemic, with more remote monitoring and online services multiplying almost daily to meet people’s needs. But how can people feel confident that digital technologies support high quality care and how can professionals advise on their safe use? NHSX has recently published its Digital Technologies Assessment Criteria (DTAC).

Those developing a digital technology will now be able to undergo assessment against the criteria set by NHSX following wide consultation and collaboration. 

The NHSX team responsible for the assessment process asked PRSB’s members to give feedback on the DTAC process and its usefulness. They presented to a specially convened group of Advisory Board representatives from 36 organisations.   

Although PRSB is pleased with the progress that has been made to make digital technologies meet high quality and safety thresholds, there is still much more to do. This is a critically important area and we are looking forward to supporting the NHS with future digital technology assessment initiatives. 

What people are saying

“We need to make the process of adoption of these standards attractive, enjoyable, and as easy as possible” 
Charlie McCay (PRSB)

“From our engagement with citizens in Scotland, individuals do want to know that services and tools they are using are safe, assured, and suitable for them, but it is a complex theme, and we need to take health literacy and digital literacy in consideration, as well as the intersections between them. Using a digital tool often requires a large degree of interaction so we do need to focus on citizen empowerment as well as ensuring tools are safe, and people should be helped to make their own judgements too. 
Carmen Paputa-Dutu (Health and Social Care Alliance Scotland) 

In 2018, the PRSB produced a report on urgent care information flows which set out the high-level requirements for a referral from a 111 clinical assessment service to another service.  

Currently a 111 report (or Post Event Message) can flow to the receiving organisation using an older technical messaging system – the Interoperability Tool Kit (ITK). Also, the current report does not organise the information in a way that clinicians find easy to use. A newer interoperability standard known as FHIR (Fast Healthcare Interoperability Resource) is now being adopted by many clinical IT systems which offers potential for an improved message sharing capability including urgent and emergency care systems. 

The PRSB has been asked to develop a standard for all 111 referrals that will replace the current 111 report with clear, succinct, and effective information to inform the receiver. This information can be shared with the service that the individual needs after a 111 consultation. It will also inform the GP that a person has had contact with the 111 service.  

Making decisions about end-of-life care are often challenging and difficult for people and their families. Increasingly people want to communicate their wishes and needs before they become too ill or unable to express themselves. Once people have made it known how they wish to be cared for, it is important that the professionals involved in delivering their care have access to this information to ensure the person’s wishes are met and needs addressed as much as possible. Safe and personalised care at the end of life not only makes the person feel more comfortable and in control, but it can also bring some comfort to the bereaved family to know their loved one’s final wishes and needs were met. 

PRSB was commissioned by NHS England and NHS Improvement to refresh the standard for Electronic Palliative Care Co-ordination Systems (EPaCCs) so that emergency or palliative and end-of-life care information is accessible and supports people across all care provider settings.  PRSB worked in collaboration with the charity Compassion in Dying and surveyed 1,700 people about their experiences of sharing information for palliative or end-of-life care. Respondents powerfully shared their views about how people’s needs should be better understood and met. We also collaborated with Together for Short Lives, a charity for children and young people living with life-limiting conditions, and their families to learn from their experiences and use this information to inform the revised standard.  We are consulting further on the draft standard and are due to complete our findings and recommendations shortly. 

Getting end of life care right – PRSB Podcast

Campaigner and former carer Roberta Lovick joins the PRSB podcast with Compassion in Dying nurse Sarah Malik, to talk about their own experiences with end of life care. As well as discussing the difficulties of opening these conversations to begin with, they talk about the challenges of what happens when conversations don’t happen, or information isn’t communicated correctly.

PRSB is admired for its strong clinical and professional networks and growing network of people with lived experience of health and care services.  

This year we set up new groups on social media for clinicians interested in digital standards for clinical records. The group is being used to engage with clinicians, connect with implementers and raise awareness of published standards and others in the pipeline. We are also using these groups to promote clinical leadership role for our upcoming projects.  

 A dedicated WhatsApp group for clinicians and professionals kicked off in April and LinkedIn pages and PRSB web pages are being planned to showcase leadership opportunities, update clinicians on how standards are benefitting people receiving care and the teams providing care and raising awareness of workshops and other ways to participate in PRSB activities. 

As the largest workforce in health and care, nurses provide crucial care across a wide range of settings, with patients and other professionals often reliant on their expertise. The PRSB will be working with NHSX to develop a new nursing standard for use across all the different health and social care settings. The standard will aim to improve quality and safety of care in key nurse-led areas, including care planning. It will reflect best practice and standardise documentation across different nursing settings, to free nurses’ time and give them more time to care. For example, the standard will allow a district nurse in a care home setting to access and share people’s information between care providers in the same way as a practice nurse or hospital nurse, creating joined-up records and supporting personalised care.  

Whilst the emphasis is on nurse-led care, we will also speak to other professionals and people who use services to build consensus and support for the standards.

A holistic approach to health and care can help people to live well, especially when they have long-term conditions or personal difficulties which impact their health. Social prescribing aims to connect people to local services, navigating routes to financial assistance or help losing weight. Link workers are key to delivering this service through the voluntary sector or primary care networks.  

It is a relatively new part of the health and care system’s vision for personalised care, and PRSB have been commissioned by NHS England and NHS improvement to develop an information standard for social prescribing. The standard will help ensure information can be shared to identify people who would benefit from social prescribing and support their overall wellbeing. It will also help health and care services to evaluate and improve social prescribing as it develops.

Sharing accurate and complete information quickly when a person is discharged from hospital to GP or community services ensures continuity of care and reduces the risk of re-admission. The eDischarge summary standard enables hospitals to safely transfer standardised clinical information that, when combined with structured, coded data (SNOMED CT and dm+d), can be imported directly into GP IT systems when a person is discharged from hospital care.  

The standard allows all relevant information on diagnoses, medications, procedures and allergies about a person to be shared with GPs in order to improve the quality and consistency of care. Best practice is also to share the discharge summary with the person. 

The PRSB, as part of its maintenance process for standards, has completed updates to four transfer of care standards including the eDischarge standard, originally produced in 2016. The latest version of the eDischarge summary standard (v3.0), published in summer 2021, has been aligned with more recent PRSB professional standards such as the Core information standard along  with latest developments in national, technical standards such as FHIR profiles, the NHS Data Dictionary and SNOMED CT terminology. The other transfer of care standards that have been updated include the emergency care discharge standard, the mental health inpatient discharge standard, and the outpatient letter standard. 

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