1. The Summary Care Record London Ambulance Service: Clinical Hub Pilot

2. London Ambulance Service Clinical Hub The Clinical Hub is situated within the Emergency Operations Centres of the London Ambulance Service It is staffed by experienced clinicians and provides a number of important functions including; Enhanced telephone assessment of lower categorized calls Enhanced telephone assessment of calls which are being held for dispatch to ensure patient safety Answer clinical queries from the call taking and dispatch areas of the control room Provide clinical support to crews and clinical staff in operations, over the telephone and using various tools to assist in decision making Contact the on-call clinical advisor (who may be remote) with any queries outside of their work remit. Liaise with hospitals regarding inter-hospital transfers and admissions.

3. Summary Care Record Pilot In August 2014 LAS provided clinicians working on the Clinical Hub with access to the Summary Care Record application as part of a 6 month pilot The SCR is being used to support the “enhanced telephone assessment of lower categorised calls” also known as “ring backs” Clinicians carry out a clinical assessment over the telephone and determine the best outcome for the patient e.g. to upgrade the priority of the call, to refer the patient to a GP or other appropriate care provider or to advise on home management.

4. Anticipated Benefits 1.Increased efficiency in delivering appropriate care to patients 2.Increased ability/effectiveness of clinicians to make informed decisions 3.Improved Communication

5. Capturing Benefits The following methods were used to capture benefits data; 1.Paper based survey completed for each patient encounter where SCR was accessed 2.Management information from CommandPoint 3.HSCIC clinical use survey

6. Interim Results Initial pilot period: August 26th - November 26th 2014 Number% Total number of calls received by clinical hub 65395* Number of calls receiving a ring back875213% Number of ring backs where an SCR was available to view (estimated based on uploads) 700180% Number of SCR’s viewed2603.7% Number of surveys returned12849% * total includes calls from ; police, patient welfare calls, 111 referrals, surge calls and clinical support to crews

7. Interim Results 1.Increased efficiency in delivering appropriate care to patients 29% of patients were guided to a more appropriate pathway when SCR was viewed 52% of patients had an unknown medication identified when SCR was viewed 20% of patients had an undisclosed allergy or adverse reaction identified when SCR was viewed SCR saved time for 53% of encounters

8. Interim Results 2. Increased ability/effectiveness of clinicians to make informed decisions 48% of clinical decisions were felt to be safer or better for the patient given the additional information provided in the SCR In 50% of encounters clinicians felt more confident about their decisions when SCR was viewed 76% of records contained relevant information that assisted clinical assessment1

9. Interim Results 3. Improved Communication Results expected from clinical use survey – closing date for responses 31/1/15

10. Interim Results Survey Comments “The SCR is useful as it prompts further questions and discussions when the patient is unsure of their history” “The SCR was useful to confirm medications used for pain relief”

11. Summary Care Record Pilot – interim review conclusions/actions Survey results show significant safety benefits where SCR is viewed Identify methods to quantify safety benefits Survey results show efficiencies in patient referrals where SCR is used Identify method to quantify this benefit

12. Connect with us www.hscic.gov.uk/scr scr.comms@hscic.gov.uk Sign up to the SCR BulletinBulletin @NHSSCR