Looking to advances in data science, the opportunities for PRSB could be game-changing.
“Artificial intelligence and natural language processing will profoundly affect how we develop and deploy standards.”
Lorraine Foley, CEO
Ten years ago, our pioneering founders and members had the vision to establish the PRSB, and throughout our first decade we made and continue to make a unique and significant contribution to the successful digitisation of health and care.
Through our membership organisations, partners, and extensive networks of stakeholders we have built and continue to develop awareness, understanding and buy-in to standards, their fundamental importance as the cornerstone of good information sharing upon which safety, quality, insight, and research depend. For these reasons, PRSB has become an integral and crucial part of the standards infrastructure for health and care.
Our value in the health and care system is increasingly recognised and highly regarded with NHS England project teams describing PRSB as “supportive, knowledgeable and resourceful”. (Source: Mace Menter report)
Our focus is on people
As we grow and strengthen the voices of our members and Partners in our work, one thing will always remain constant: people will always be at the heart of our work.
Our focus on people was most powerfully exemplified in the #CareAboutMe campaign. We launched the campaign in May 2022 to promote the About Me standard and the importance of capturing and recording a person’s health and care needs and preferences, enabling truly person-centred care. A total of 27 member organisations endorsed the standard and campaign, and 6,500 people visited the About Me Standard on our website. Early adopters include the NHS Wales App, Nottinghamshire Integrated Care Board. We are working with the digital team in Scotland and the NHS App team in England to incorporate its use in systems. Suppliers too have embraced the importance of adopting the About Me Standard, with more opting to become conformant with About Me than any other standard, which is helping accelerate its use.
Despite the challenging national context, PRSB has done profoundly important work during that time. We developed five new standards to support policy priorities and address critical health and care needs. The Diabetes Record Information Standard is a model for developing standards for long term conditions that define the information needed by both professionals and people themselves to manage the condition. Support for implementation will include piloting use of the standard in 2023. The 111-referral standard will support the new front door to direct people to the right care. The standard for 111 referral services is being tested in the Northwest. Also, our ambition to drive the delivery of person-centred care saw the development of three standards – social prescribing, shared decision making, and palliative and end of life care. Each of these standards will help people receive personalised services by ensuring that their needs and wishes are shared with professionals, so that their care matches their aspirations at a critical time in their lives.
Putting standards into practice
We consulted on extending the use of the Core Information Standard, the standard that supports the development of Shared Care Records, to include pharmacy, optometry, dentistry, ambulance services, and community care settings. We collaborated with the Royal College of Paediatrics and Child Health on an initial phase of work to develop an epilepsy care standard and we are working with our members and other key stakeholders to identify priorities to collaborate on. We also worked with the National Wound Care Strategy Programme to develop a standard for wound care.
PRSB has taken an active lead in driving implementation of standards. Our Standards Partnership Scheme is the centrepiece of this work. Now in its second year, the scheme boasts 56 partners representing a broad and diverse cross-section of health and social care suppliers, both large and small. During the past year we expanded our support offer to NHS trusts and social care providers to help them adopt standards, and we are seeing strong interest in this offer.
Increasingly system suppliers and NHS and social care organisations are evidencing their conformance to standards and commitment to integrated care by undertaking PRSB’s conformance assessment process. If successful, they are awarded the PRSB Quality Mark, providing respected, independent evidence of their conformance with standards. This year completed conformance assessments grew by 220 per cent with solutions against a range of our standards, with many in progress for the coming year.
Our standards and the Standards Partnership Scheme are also gaining recognition nationally with policy makers and regulators. We are working very closely with our Digital Social Care Records colleagues at NHSE to conformance assess all solutions on their procurement framework Assured Solution List – Digital Social Care . All solutions on this framework must reach a minimum of About Me and Personalised Care and Support Planning standards conformance, taking the positive impact of both standards across social care to the next level and empowering patients to be actively involved in their care. The Care Quality Commission last year recognised our standards, signposting adult social care providers to them in recognition of the role that information record standards play in supporting good outcomes of care for people. We are also working with Integrated Care Systems (ICSs) through the national ICS programme directors to support adoption of the Core Information Standard for Shared Care Records, which is fostering greater understanding of the importance of standards and the role they play in driving truly integrated care.
Our new range of training materials help explain standards and encourage organisations adopt them. The Standards Explained guide aims to make standards accessible to professionals and the wider public and our toolkits help local systems implement standards. We produced a Palliative and End of Life Care Information Standard toolkit in 2022-23 and will produce toolkits for the diabetes and wound care standards in the coming year with more to follow.
We added important new products to our portfolio including extending our standards development offer to include development of SNOMED code sets to ensure that the information in care records is consistently high-quality and contents are searchable. We also provide piloting and templating services to support the use of standards. For example, we recently delivered a hackathon with INTEROPen to support implementation of our Diabetes Information Record Standard. We will be undertaking further work with pilot sites on the diabetes standards in 2023-24. More information about the range of complementary services we provide is published on our website at products and services – PRSB (theprsb.org). In providing these services we hope to stimulate further adoption of standards and improve our product offers so that standards are always current, relevant and fit for purpose.
Evaluating the impact of standards is critical to their uptake and future development. For instance, we know that sharing information between services and care settings is integral to good discharge practice, enabling better continuity of care and potentially reducing escalations of care. The PRSB e-Discharge standard was developed in 2015 and widely endorsed by royal colleges because it represents best practice and defines what information should be shared digitally to enable better transfers and continuity of care between services. However, the adoption of the standard has been slow, partly because the potential benefits to primary and secondary care are not well understood. There is also little awareness of the standard’s impact on managing admissions into secondary care. We undertook a review of implementation of the standard to understand how it can be improved and found that information received in general practice does not consistently meet GPs’ needs. Discharges are often unstructured, the quality is mixed, and people don’t always receive discharge information that enables them to play a meaningful role in their own care.
As a result, we have made recommendations to the NHS about how to improve transfers of care by working with suppliers and providers to implement SNOMED CT effectively, in conjunction with PRSB standards, ensure that suppliers are conformant with the e-Discharge standard and systems can support interoperability, and above all stressing the importance of good discharges to improve care. We intend to pursue this work in the coming year.
Looking into the future
Looking ahead, our main aim is to get standards more widely used, finding new and creative ways to progress our members’ priorities, and engage professionals, suppliers, and the public to see the benefits of using standards. We will continue to explore ways of linking information record standards better with data standards for research and audit so that the richness of people’s health and care data can help improve care and support the development of new and innovative treatments, where people agree to share their data for these purposes.
We will work with system leaders to ensure that we have the right plans and processes in place to drive conformance with standards. Legislation to mandate conformance with standards is on the horizon in England and Scotland. We will ensure our conformance assessment methodology is recognised by procurement frameworks, service contracts and advocacy of the Standards Partnership Scheme so that suppliers and health and care provider organisations can meet these new requirements. We will also seek UKAS accreditation for PRSB’s standards conformance and methodology.
Looking to advances in data science, the opportunities for PRSB could be game-changing. Artificial Intelligence (AI) and natural language processing will profoundly affect how we develop and deploy standards as well as the standards themselves. Equally these exciting new developments depend on successful adoption of standards so that comparable data can be gathered into data sets for testing and learning. Already we can see the potential impact of improvements in data science in population health management and accelerating research to deliver new therapies and treatments.
We will build on the work we undertook with NHS England to support better use of data by connecting information from local NHS trusts, ICSs and national data. And we will continue working with NICE on how to align PRSB standards to NICE guidance to make them computable and easy to implement in systems.
Our achievements over the past year and our plans for the months and years ahead provide ample evidence, if it were needed, that PRSB is an unparalleled asset to the health and care system. We fully intend to continue to deliver high quality information record standards and support for their adoption as the mainstays of our work, while finding new and innovative ways to exploit the potential of the PRSB to deliver our member’ priorities and help improve care through data.
Finally, I want to thank the staff of PRSB, who continue to amaze me with their insights, ideas, hard work and dedication to delivering high-quality information record standards and their implementation for the benefit of health and care professionals and people who use health and care services. Their unflagging commitment is what enables PRSB to deliver consistently excellent products and services.