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Central Care Record

Click here to download the CCR Information Poster (.pdf)

Click here to download the below Central Care Record GP Practice FAQ (.pdf)

Central Care Record GP Practice FAQ

General Information

What is Central Care Record?

Central Care Record is a local electronic system which will bring relevant health and social care information together in one place, making it a much simpler, joined up system. It is being introduced across Sandwell, Birmingham and Solihull.

Why are we introducing it?

It will help provide continuity of treatment across Birmingham, Sandwell and Solihull. Health and social care staff will have faster access to relevant patient information. Regardless of whom a patient sees health and social care staff will be able to see relevant information in a single record.

When is it happening?

Central Care Record is being introduced from mid February 2014 to every GP registered patient in the Sandwell, Birmingham and Solihull area. Initially there will be a five week programme of mailing out to households. After that there will be a 12 week opt-out period. Central Care Record will begin to go live in summer 2014.

Why do we need it?

We want to makes things easier for you and improve the way your information is accessed.

At the moment, there are many different computer systems which hold your health and care records and not all of them are connected to each other.

By having a Central Care record everything is in one place and patients won’t have to repeat their information to whoever is treating them.

Patient Information

What information will be included on Central Care Record?

  • Demographics e.g. name, address, NHS number
  • Allergies
  • Medication
  • Tests, results and measurements
  • Alerts
  • Diagnosis
  • Treatment / care (past or present)
  • End of life care plan

What do you mean by alerts?

Alerts are key information that the Clinician should be alerted to, such as safeguarding information.

What do you mean by end of life care plan?

End of life care plan take into account decisions regarding preferred place of care, preferred place of death, whether or not to actively resuscitate and similar preferences to suit that individual.

How will Central Care Record help patients?

By having Central Care Record, It will give health and social care staff faster, easier access to relevant information about patients, to help provide them with safe treatment whenever they are seen by any participating health or social care organisation in Birmingham, Sandwell and Solihull.

Who is involved in Central Care Record?

Which organisations are involved?

Clinical Commissioning Groups from Sandwell and West Birmingham, Birmingham CrossCity, Birmingham South Central and Solihull.
Signed up GP practices in Birmingham, Solihull and Sandwell

Hospitals:

  • Birmingham Children’s Hospital
  • Birmingham Women’s Hospital
  • Queen Elizabeth Hospital Birmingham
  • Royal Orthopaedic Hospital
  • City and Sandwell Hospitals
  • Heartlands, Solihull and Good Hope Hospitals (including Birmingham Chest Clinic)

Ambulance:

  • West Midlands Ambulance Service

Social Care staff:

  • Birmingham City Council
  • Sandwell Metropolitan Borough Council
  • Solihull Metropolitan Borough Council

Community Health:

  • Birmingham Community Healthcare NHS Trust
  • Solihull Community Services

Mental Health:

  • Birmingham and Solihull Mental
  • Health NHS Foundation Trust
  • Black Country Partnership NHS
  • Foundation Trust 3

Access

Will patients be able to access their own Central Care Record?

Patients will be able to access their own record, but not from the start of the project.

Who will be able to access/look at records?

With consent patient information will be made available to health and social care staff.

Health and social care staff will ask for consent each and every time before they look at a patients Central Care Record and their details will be recorded every time. This will happen except in certain situations, for instance in an emergency or if someone is unconscious.

Will staff that have access to Central Care Record be able to see all aspects of a patient’s record or just sections that relate to their area?

Just the relevant information in context to the treatment they are receiving.

What about safeguarding?

By law, everyone working for us or on our behalf must respect patient confidentiality and keep all information secure.

The NHS Care Record Guarantee for England explains how the NHS will collect, store and allow access to electronic records and choices for how information is stored and looked at.

Copies of the Care Record Guarantee are online at www.nigb.nhs.uk/guarantee/crs_guarantee.pdf

Where do patients go if they feel their record has been inappropriately accessed?

Patients can report it to the practice or organisation that they feel has inappropriately accessed their record. The organisation would treat any such query in the same way as they would treat any breach of confidentiality. The organisation would liaise with the system administrator in conducting an investigation.

What will happen if a member of staff has been inappropriately accessing confidential information?

The same as any breach that currently happens; it would be dealt with in accordance with that organisations disciplinary policy. This would be a breach of the Data Protection Act and treated accordingly.

What level of social care staff will have access to Central Care Record?

The level of access will depend on the team/service within social care. Each user of Central Care Record must have a legitimate relationship with the patient and the patient’s permission to view their record and will only be able to access information relevant to their role/service.

Will third party health providers have access to Central Care Record?

Initially no. Any additional providers would need to submit a request to the Central Care Record project board as well as having the necessary governance policies/procedures in place.

How have you determined what information is sensitive?

There is an existing exclusions list based on other local information sharing records across the country. This list will be reviewed; any changes made and signed off by the CCGs. 4

How will sensitive information be excluded from Central Care Record?

Each clinical system provider filters what data is extracted from each GP Practice based on the read codes specified by the CCG (as above).

Confidentiality/Data Protection

How secure is Central Care Record?

The system is very secure, information will be held in a secure environment with robust technical and organisational controls in place.

What do you mean by secure environment?

It will be subject to information security risk assessment and approval. The system will have appropriate organisational and technical measures in place to comply with the 7th Data Protection Principle, safeguarding against unauthorised or unlawful processing of personal confidential data and against accidental loss or destruction of, or damage to, personal confidential data.

What security do you have in place to prevent someone hacking the Central Care Record system?

Information will be held in a secure environment with robust technical and organisational controls in place and it will be subject to information security risk assessment and approval.

Each organisation that uploads information to Central Care Record has a legal responsibility as a Data Controller under the Data Protection Act 1998.

The uploaded data will not be combined into a single record but will, once the appropriate consent has been applied, be presented as a single integrated view.

Access to the system will be granted only to health and social care professionals who have legitimate need to access information for provision of care.

Staff will have to validate their identity and their role and be subject to verification tests consistent with Registration Authority checks, i.e. provide proof of identity and their role and have their access requirements validated by the employing organisation.

Staff are not permitted to view data without patient consent. There are provisions for emergency consent however any emergency consent or override will result in a privacy alert and subsequent investigation.
Any user that accesses information without authorisation or justification will be in breach of Data Protection and common law Duty of Confidentiality, and the Computer Misuse Act.

How will GP practices be informed that a patient wants to opt-out of Central Care Record?

Patients will either return their opt-out form to their practice who will add the opt-out read code to the patient’s record and no data will be extracted.

Alternatively the patient can use the freepost address and the opt-out forms will be collated by the mail house. The mail house will provide an electronic list of those patients who have opted out to the GP practice. In addition the forms themselves will be returned to the GP Practice who will then add the opt-out read code to the patient’s record and no data will be extracted. 5

Understanding of literature

Do patients have a choice?

Yes they do, they can choose either to have a Central Care Record or to opt-out.

What do patients do if they want a Central Care Record?

They don’t have to do anything. It will happen automatically and a Central Care Record will be created for them.

How long will it take before a Central Care Record is created?

A Central Care Record will be created over the next six months, subject to their GP practice participating. However, patients should make a choice within 12 weeks from the date of the letter being received.

What if a patient doesn’t want a Central Care Record?

They will need to fill in and return an opt-out form, which would have been sent to them with the letter and information leaflet. They will need to complete and return that form FREEPOST within 12 weeks.

An opt-out form will also need to be completed for each individual family member or dependant for whom a patient is responsible for.

If a patient decides to opt-out they should be reminded that important health information may not be available to health care staff when they are making decisions about their treatment in life threatening situations.

How can a child or dependant opt-out?

If someone has parental responsibility for a child (under 16 years old) or other dependent family member an opt-out form will need to be completed per child / dependant.

In this case their GP practice will consider this request. In some circumstances health and social care staff may feel that it is in your child / dependant best interests to have Central Care Record. For example, if they have a serious allergy that health and social care staff treating them should know about, or where it is required to share information by law.

How long has a patient got to decide?

Patients have 12 weeks from the date that they receive their letter to opt-out.

What happens if my GP practice chooses to opt-out of Central Care Record?

No data would be shared with Central Care Record about any of the GP patients.

Can a patient change their mind?

If a patient chooses not to have CCR but then changes their mind later, they need to let their GP practice know. It may take up to six months for CCR to be available, depending on which GP practice they are registered with.

If a patient has CCR and decides they no longer want one, they will need to tell their GP practice. CCR will then remove the information and it will no longer be available locally to be accessed.

What happens if a patient does not have Central Care Record?

Health and social care records will remain in all the places where a patient currently receives care across Birmingham, Solihull and Sandwell. It will not be available to view through Central Care Record.

What happens if a patient moves out of Birmingham, Sandwell or Solihull?

A Patient’s Central Care Record would be archived and retained in accordance with national guidelines.

What happens if a patient returns and registers with a GP in Birmingham, Sandwell or Solihull?

If they already have a CCR record, it can be reinstated.

What happens if a patient has moved, gone away or no longer lives at that address?

Any mail returned to the mail house will be scanned, an electronic list produced for each practice and the physical mail destroyed after 60 days.

What’s the difference between this and other NHS systems?

What’s the difference between Central Care Record (CCR), Summary Care Record (SCR) and care.data?

SCR

The national SCR and local CCR share some similarities, such as the ability to share clinical information and robust controls over access to data. However, CCR is not part of the SCR project and would not provide information to the national system. CCR will be a much more detailed record and will be held locally throughout Birmingham, Solihull and Sandwell.

Care.data

NHS England are rolling out a new national service called Care.data. It will collect patient information from GP practices to help in planning and research. CCR is not part of Care.data.

Useful links for more information:

How long is the Call Centre operational?

The call centre will be operational from mid-February for approximately 20 weeks. Call centre staff will be at hand to support with any complex queries from patients and GP practices. They will also be able to provide additional patient information materials such as posters, leaflets and opt out forms.

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