NHS England Patient Online - Patient Access to their Medical Record in General Practice
Background It is well recognised that the NHS has to change: Simon Stevens, NHS England CEO predicts a £30billion overspend. General practice, which manages 90% of NHS care is going through a workload/workforce crisis, and patients are living longer with multiple morbidities and higher expectations...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2015-10-01
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| Series: | Frontiers in Public Health |
| Subjects: | |
| Online Access: | http://journal.frontiersin.org/Journal/10.3389/conf.FPUBH.2016.01.00083/full |
| _version_ | 1818141967564931072 |
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| author | Jana Dale |
| author_facet | Jana Dale |
| author_sort | Jana Dale |
| collection | DOAJ |
| description | Background
It is well recognised that the NHS has to change: Simon Stevens, NHS England CEO predicts a £30billion overspend. General practice, which manages 90% of NHS care is going through a workload/workforce crisis, and patients are living longer with multiple morbidities and higher expectations of the NHS. The NHS National Information Board’s strategy “Personalised Health and Care 2020” provides details of the envisaged huge change in philosophy of how health care is delivered. NHS England Patient Online is charged with delivering the programme, initially and primarily focusing on general practice and the patients.
In the first year there was a huge change from 4% to 96% of practices that enabled digital access to repeat prescriptions, appointments, and summary information such as allergies, adverse reactions and medications. So far, in this second year from April 2015, there has been a marginal change in the number of patients who have been able to access additional details of their medical record.
Description
In this paper we describe the “change equation” model of behavioural change and how this can be used to understand the problems , but also provide the solutions to the implementation of patient access to their medical notes:
Despite problems of excessive workload and low morale which should act as a catalyst for change, the required behavioural change has not occurred for several reasons:
• General Practice overload has resulted in lack of capacity to manage the necessary change in healthcare provision.
• Assured, easy to use, stable software has not yet been developed by the four GP software companies despite the requirement that practices will have implemented their contract in relation of online services by 31 March 2016.
• In an environment where there is the potential closure of a substantial numbers of practices, there is a reluctance to encourage patients to put pressure on their practice to change by adopting Patient Online access to records.
• Innovative practice has demonstrated anecdotally the benefits of patient record access, but there is little consistent published British evidence that NHS England can use to support practices to change their behaviour.
The succinct vision of the behavioural change is documented in “Personalised Health and Care 2020”
Supporting those first steps is a major function of The NHS England Patient Online Team – a substantial work programme has provided practices with the policies and processes to implement these services.
Conclusions
The limiting factor for Patient Online patient access to record is whether patient safety can be maintained and/or increased – practices must therefore largely decide how quickly they can inform their patients of this huge change in how health care is delivered. The real benefits materialise with patients having access to their full medical record, but practices must ensure they have introduced the processes within their practices to do this safely – and here the implementation of the 2015/2016 GP contract supports this change.
This paper defines the problems and solutions to resistance to change.
Patient Online can be promoted quickly and successfully when the clear evidence demonstrates it reduces workload. Its implementation will then result in the improved patient care and changes in behaviour necessary for the NHS National Information Board “Personalised Health and Care 2020” Implementation. |
| first_indexed | 2024-12-11T11:08:18Z |
| format | Article |
| id | doaj.art-cbf649ea92f74a75b4e63e2768eedaf7 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-12-11T11:08:18Z |
| publishDate | 2015-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-cbf649ea92f74a75b4e63e2768eedaf72022-12-22T01:09:38ZengFrontiers Media S.A.Frontiers in Public Health2296-25652015-10-01410.3389/conf.FPUBH.2016.01.00083174728NHS England Patient Online - Patient Access to their Medical Record in General PracticeJana Dale0NHS EnglandBackground It is well recognised that the NHS has to change: Simon Stevens, NHS England CEO predicts a £30billion overspend. General practice, which manages 90% of NHS care is going through a workload/workforce crisis, and patients are living longer with multiple morbidities and higher expectations of the NHS. The NHS National Information Board’s strategy “Personalised Health and Care 2020” provides details of the envisaged huge change in philosophy of how health care is delivered. NHS England Patient Online is charged with delivering the programme, initially and primarily focusing on general practice and the patients. In the first year there was a huge change from 4% to 96% of practices that enabled digital access to repeat prescriptions, appointments, and summary information such as allergies, adverse reactions and medications. So far, in this second year from April 2015, there has been a marginal change in the number of patients who have been able to access additional details of their medical record. Description In this paper we describe the “change equation” model of behavioural change and how this can be used to understand the problems , but also provide the solutions to the implementation of patient access to their medical notes: Despite problems of excessive workload and low morale which should act as a catalyst for change, the required behavioural change has not occurred for several reasons: • General Practice overload has resulted in lack of capacity to manage the necessary change in healthcare provision. • Assured, easy to use, stable software has not yet been developed by the four GP software companies despite the requirement that practices will have implemented their contract in relation of online services by 31 March 2016. • In an environment where there is the potential closure of a substantial numbers of practices, there is a reluctance to encourage patients to put pressure on their practice to change by adopting Patient Online access to records. • Innovative practice has demonstrated anecdotally the benefits of patient record access, but there is little consistent published British evidence that NHS England can use to support practices to change their behaviour. The succinct vision of the behavioural change is documented in “Personalised Health and Care 2020” Supporting those first steps is a major function of The NHS England Patient Online Team – a substantial work programme has provided practices with the policies and processes to implement these services. Conclusions The limiting factor for Patient Online patient access to record is whether patient safety can be maintained and/or increased – practices must therefore largely decide how quickly they can inform their patients of this huge change in how health care is delivered. The real benefits materialise with patients having access to their full medical record, but practices must ensure they have introduced the processes within their practices to do this safely – and here the implementation of the 2015/2016 GP contract supports this change. This paper defines the problems and solutions to resistance to change. Patient Online can be promoted quickly and successfully when the clear evidence demonstrates it reduces workload. Its implementation will then result in the improved patient care and changes in behaviour necessary for the NHS National Information Board “Personalised Health and Care 2020” Implementation.http://journal.frontiersin.org/Journal/10.3389/conf.FPUBH.2016.01.00083/fullPatient Access to RecordsGP workloadpatient onlinedigital general practicepatient in controlonline service in general practice |
| spellingShingle | Jana Dale NHS England Patient Online - Patient Access to their Medical Record in General Practice Frontiers in Public Health Patient Access to Records GP workload patient online digital general practice patient in control online service in general practice |
| title | NHS England Patient Online - Patient Access to their Medical Record in General Practice |
| title_full | NHS England Patient Online - Patient Access to their Medical Record in General Practice |
| title_fullStr | NHS England Patient Online - Patient Access to their Medical Record in General Practice |
| title_full_unstemmed | NHS England Patient Online - Patient Access to their Medical Record in General Practice |
| title_short | NHS England Patient Online - Patient Access to their Medical Record in General Practice |
| title_sort | nhs england patient online patient access to their medical record in general practice |
| topic | Patient Access to Records GP workload patient online digital general practice patient in control online service in general practice |
| url | http://journal.frontiersin.org/Journal/10.3389/conf.FPUBH.2016.01.00083/full |
| work_keys_str_mv | AT janadale nhsenglandpatientonlinepatientaccesstotheirmedicalrecordingeneralpractice |