Making your Local Health and Care Record initiatives Real in 2019

2019 is going to be a very important year for the NHS, and I wanted to resume our ongoing conversation here with a timely reminder to all NHS leaders that the clock really us ticking on a very crucial piece of work – what you need around your STP work.

As I won’t need to remind you, STPs – Sustainability and Transformation Partnerships – were set up by NHS England back in 2016, split into organisations covering every part of the country.

The idea is to find new local and integrated ways to improve health and care, with NHS organisations and local councils in England being asked to join forces to co-ordinate services around the whole needs of each person.

STPs are very much part of the idea of delivering against some of the key goals of Simon Stevens’ Five Year Forward View vision of a much more sustainable and digital NHS. But they are also very, very local – the stated aim is come up with plans to plans drawn up in your area that will set out practical ways to improve NHS services and population health where you live.

STPs then in turn have led to another great programme, Local and Health Care Records – an attempt to enable the safe and secure sharing of an individual’s health and care information as they move between different parts of the NHS and social care. To make that idea a reality, a number of a number of so-called Local Health and Care Record Exemplars have been set up that have been given special finding partnerships of up to £7.5 million over two years to put in place an electronic shared local health and care record that makes the relevant information about people instantly available to everyone involved in their care and support.

Exemplars were supposed to be 2018 spend drawing up requirements for what a ‘local health and care record’ is supposed to look like. They were meant to be building a Proof of Concept (PoC) against that definition that can then be proven and tested, leading to building of a full solution by the end of the 2019, and rolling out to all members of their STP during the 2020 Financial Year.

But here’s the problem: A lot of organisations really trying to do the right thing here are a bit stuck, as there are no clearly defined requirements

A ready-to-use Local Health and Care Record Demonstrator

We’ve talked to lots of organisations on the ground on both the NHS and the local council side of this who are struggling to find a suitable technology to use to build their PoCs.

This really does prove how far we are from the days of NPfIT, when the plan was that a central system should have been provided to work with. Now, the onus is on the local teams to find their own best fit for this work – and it’s not easy. A big issue seems to be scale… a lot of the systems people have been testing out seem very precarious at connecting multiple back-end systems together in the secure way that NHS England will want.

So we have addressed this head on.  Working with a number of frontline NHS organisations, we at SynApps have built a Local Health and Care Record proof of concept (POC) to demonstrate how this works.

What that means in practical terms is that we have a testbed ready based off our NHS Integrated Digital Care Record system.  It is proven technology and utilises all of the power of our Vendor Neutral Archive (VNA) and Enterprise Document Sharing (XDS) solution and which you can literally plug in to you and your partners’ systems tomorrow to help you build a convincing PoC.

That also means you will have a system which can support every sort of content a Local Health and Care Record will need – from path lab results to X-ray imagery, NHS Records to GP notes and even your social care records.

So if you are starting 2019 concerned about what you can do to capitalise on the opportunity the Local Health and Care Record programme represents for your area, fear not – we can likely help you.

Get in touch to see what we can do to help you move your Local Health and Care Record ideas off the PPT and into real instantiation in working software.

Chris is Director of all SynApps Solutions’ Sales & Marketing activities

IDCR: A great new way to help clinicians via a single view of a patient’s complete medical history

Chris Brice catches us all up SynApps’ work to help NHS and local authorities’ better share key medical information

As many of you are aware, SynApps is one of the leading providers to the NHS of a very special and actually highly desirable solution called the Integrated Digital Care Record, the SynApps IDCR.

IDCR is a solution that encompasses everything that every NHS Trust, and an increasing number of local authorities, across the UK are trying to achieve – being able to provide a cradle to archive view of a patient, finally joining up all the different back office systems that a physician needs to access to give us a total view of that patient.

More importantly, this can be extended to include not just the information within an NHS Trust, but also a GP system in a local government/external stakeholder Shared Care Record scenario – enabling a clinician, or any approved person who has access to medical records, to see everything that relates to a person, from when they were born to an archive scenario.

An open, highly functional, approach

The IDCR is an enabler to allow access to all these different systems. Ultimately it will become your integrated digital care record for easy secure access across the NHS and beyond.

Why? Because it’s designed to allow all relevant stakeholders, including social care, local authorities, clinicians and GPs, to access your clinical record or social care record. And as it’s architected to be a simple open source, open product that allows you to log in through a portal and then have access to all of the information, it’s revolutionary – and at the moment, we believe we are the only provider who can delivery this on demand. Chief Clinical Information Officers (CCIOs) in the NHS that we’ve talked to tell us they want a single view of all information irrespective of what system if comes from or where that system is, and what make this really interesting is this includes external systems too.

Our solution, then, will allow you to have a single view from any device, anytime from anywhere, from of all of the multiple, different systems, including any case notes or paper that’s been scanned. It can also provide a tracking system to overcome some real issues organisations are having with the referral to treatment (RTT) pathway that means you the patient has to be seen within a certain period of time – something all Trusts, of course, have to monitor, report on and is mandated against with significant fines if they miss their targets.

The SynApps IDCR provides a total view of any GP notes, any x-rays, any illness or ailment you’ve ever had where you’ve had engagement with the social care system, you’ve had engagement with the GP, with an NHS Trust, all displayed in a single view, in a timeline view – which means it’s a really  secure means of providing that real time link to  a patient or citizen or somebody who’s in social care in one single view and could also track where they are in the process.

Save resource

At the moment most Trusts are running over 90% of their referral targets – which sounds like a very high percentage, but the reality is, the ones that fall out are where you see horrible negative local or national press… yeah, the terrible times somebody who should have been seen because they had a serious cancer wasn’t seen, or they got missed for some reason and actually died.

Failing to address this means there’s a huge risk that you’ll miss your NHS compliance targets… and if you miss those targets, you could potentially receive significant fines or even worse go into special measures and all that that implies.

It could also save you a lot of resource, time too; by providing integrated digital care record and a RTT pathway tracking system rather than a validation system, – going from 30 to 40 people down to maybe three or four people to track, not validate, how this works.

Got to make sense, right? If you agree – drop me a line and let’s see how we can get an IDCR to help you with some of your heavy lifting!

Chris Brice is SynApps Solutions’ Director Sales & Marketing

SynApps Collaborates with Alfresco and Enovation to Produce Blueprint for Integrated Digital Care Record

September 6th, 2016 – SynApps is working with NHS Trusts to open up a practical pathway for health and social care stakeholders to share information – the IDCR (Integrated Digital Care Record).

Working with teams at Alfresco and Enovation, SynApps has developed a blueprint that offers a way for many different data owners to securely and efficiently share data, checking it in and out of a rich central repository.

Find out more about SynApps’ IDCR solutions.

Join us at the NHS Clinical Commissioners Annual Members’ Event

August 23rd, 2016 – SynApps will be attending the NHS Clinical Commissioners Annual Members’ Event on 3 November 2016 at the Amba Hotel, Marble Arch.

This year the event will look at how CCGs are delivering for local populations with NHS England Chief Executive Simon Stevens as a keynote speaker. The agenda will focus on the key current issues for CCGs, including the future of commissioning, the ways in which local partnerships and effective resource allocation can support the delivery of the Five Year Forward View and how to make the difficult commissioning decisions locally that will allow this to happen. See here for more details.

If You Too Are Struggling With IDCR – Let’s See If We Can Help



In the past decade or so, in various forms and to varying degrees of success as we all know, the government has been trying to introduce a more joined-up, computerised NHS. That’s been with the aim of improving efficiency, saving vital budgets, and offering the same kind of easy access and ownership of our medical journeys as we all get in our Amazon, Facebook and TripAdvisor-based daily lives.

There have been various programmes and names for this initiative, be they Care Records, a paperless NHS, EPRs (electronic patient records) and so on. We’ve made a lot of progress, and had some knockbacks (such as However I think anyone working in or with the NHS agrees that a really promising new push is the IDCR, Integrated Digital Care Records. The idea is to find a way to allow multiple stakeholders in both primary but also acute care and other bodies, especially social care ones, to be able to safely and securely share information about patients both in and out of the surgery and front-line care context.

The 2020 digital NHS agenda

Of course, the IDCR idea is not new. NHS England started talking about this three years ago (see its key ‘Safer Hospitals, Safer Wards’ document , where it discussed the need for a “a fully integrated digital patient record across all care settings by 2018” that could only be achieved “ when NHS providers are connected to the flow of information”. Another key document in the IDCR debate is the NIB (National Information Board’s) Personalised Health and Care 2020 white paper, which, while not mentioning IDCRs specifically, provides the direction of travel here – joined up care, with different stakeholders, in and out of the GP surgery and hospital, able to talk to one another. Plus it explains how that supports the Five Year Forward View agenda, too.

The other thing to flag is that despite IDCR not being especially recent, there hasn’t been a huge amount of progress made delivering against the IDCR agenda. One metric of this is the relative paucity of coverage of it on the main NHS England website; there’s a fantastic success story there, from Bradford and Airedale, which is really inspiring, but we should really be expecting to hear of a few more examples by now.

Wise third parties who monitor NHS progress in digital agree. In a presentation for The Kings Fund, now departed NHS IT supremo Tim Kelsey saw the co-creation of tools and resources to support IDCRs coming on stream last year, while 2020 would see “all local areas” at full local implementation stage.

I think the reality is that the IDCR idea maybe needs a bit of a push to get it going. I think we all know that is unlikely to come from the top of NHS England, which is all about setting strategic direction, and which encourages local, bottom-up thinking by CCGs and Trusts to find affordable, tactical ways of doing things (very much in contrast to the National Programme for IT way of doing things).

If you look out over the current NHS IT landscape, there are some technologies available that can help with IDCR projects. More are coming, and some of which we’re working with, like our partners over at Kainos.

But what a lot of these solutions (apart from Kainos) suffer from is a lack of openness – they are often closed and rigid. That may be changing, but the spirit of IDCR and the 2020 targets is openness and interoperability. It’s hard to see how a siloed package can really push around the wealth of data and data types you need for a good IDCR, like path test results, DICOM format scans, referral notes, social care records and so on.

It’s a lot to ask some software technically, but it’s also a lot to ask software that isn’t totally lined up with all the standards that will need to be at the centre of any convincing IDCR plan, like FHIR, Fast Healthcare Interoperability Resources and CDA, Clinical Document Standard (CDA).

Time to start your IDCR journey

The honest truth about IDCR in 2016 is that no-one has the silver bullet. But with SynApps’ proven track record in working with multiple data formats, our wide range of Open Source and innovative tech partners, and with our rock-solid commitment to open-ness and interoperability standards, it’s just a fact that our approach stands a better chance of delivering IDCR success than more restricted alternatives.

This is why I’m issuing an open invitation to the NHS community.

We are starting to have really promising early-stage discussions with CCG’s/Trusts who want to open the door marked ‘IDCR,’ but who don’t see how quite yet.

We suspect there are many more CCIOs and Chief Executives in the same position as those we are talking to, with the same problems as you.

Let’s open a dialogue about how an open, standards based, partnership-driven approach, backed by some of the best clinical content management technology on the market, can help you make a truly digital and integrated 2020 not another missed NHS ambition, but a real milestone of progress for you, your patients, and your social and health partners.

I encourage any NHS team to get in touch to discuss their own LDRM (Local Digital Roadmap) or individual strategies on how they’re going to deliver IDCR.

Gary Britnell

See us at two UK health events in November, EHI Live & NHS Clinical Commissioners Annual Members’ Event

We’ll be attending two major health events in November 2016.

EHI Live is the UK’s number one show for all those involved in digital health, hospital information and healthcare innovation. In November, more than 4,000 professionals dedicated to IT healthcare will attend EHI Live to discuss frontline use of healthcare technology and just what products will shape the future of the healthcare industry and we’ll be there. More on EHI here

NHS Clinical Commissioners Annual Members’ Event is the only independent membership organisation of clinical commissioning groups. The event will focus on the key current issues for CCGs, including the future of commissioning, the ways in which local partnerships and effective resource allocation can support the delivery of the Five Year Forward View and how to make the difficult commissioning decisions locally that will allow this to happen. Find out more here.

More information coming up.  Mark the dates in your diary.  Drop by and meet the SynApps Healthcare team at these two major health events.