Chamber and committees

TrakCare is a client/server system and therefore, in general, the servers will be located in a secure server room at some distance from the required access to the record. In boards the servers will normally be at a hospital site, but a third-party data centre could also be selected. These are choices for the boards to make. There should be no need for TrakCare servers in GP practices.

There are no plans for the Scottish Government to develop an electronic single shared assessment specifically for patients and clients with drug and alcohol problems.

The Scottish Government has developed single shared assessment for all users of community care services based on an the National Minimum Information Standards (NMIS).

Agencies can introduce other aspects into single shared assessments to meet local priorities and to inform performance management reporting. These can include specialist assessments for drug and alcohol services.

Agencies had until March 2009 to implement NMIS in support of single shared assessment in paper form and are expected to share information electronically within six months of the systems being put in place to do so.

Currently, patients can restrict their personal health information being accessible by anyone other than the clinicians directly involved in their care, irrespective of the means by which this is done. Health professionals must respect these wishes, unless the disclosure would be justified in the public interest or by the law.

A health professional means a doctor of medicine, nurse, dental practitioner, midwife, pharmacist or another professional as described in Section 69 of the Data Protection Act 1998.

Within NHSScotland dedicated Health Records and Medical Secretarial staff support the delivery of direct clinical care by the initiation, retrieval and maintenance of patients medical records both manual and electronic.

These administrative staff support the progression of the patient throughout their pathway from initial referral by ensuring that all relevant clinical information is assembled and kept up to date within the medical record, through generation of clinical correspondence, indexing and filing of clinical documents and reports. This ensures that a comprehensive medical history is available at the time of clinical intervention.

The 10 year cost to each board is outlined in the following table. The annual cost has not been presented as there are annual fluctuations depending on local implementation and choice of specific modules. The annual cost if all Scottish NHS boards sign up cannot be accurately predicted as it is dependent on the options under the contract that boards might choose, which will vary according to their local needs at the time. This is reflected in the Lothian figures which are proportionally higher as they have chosen a fully managed service and their service cover community as well as acute sectors.

NHS Board	Licence	Deployment	10 Year Support	Total By Board
Ayrshire and Arran	1.47	1.01	2.88	5.36
Borders	0.65	0.64	1.37	2.66
Grampian	2.31	1.01	4.36	7.68
Greater Glasgow and Clyde	6.31	4.11	11.47	21.89
Lanarkshire	2.07	1.01	4.28	7.36
Sub Total 5 Boards	12.81	7.78	24.36	44.95
Lothian	3.8		15
Total	16.61	7.78	39.36	63.75

 

The Clinical Change Leadership Group conducted a wide survey of clinicians in 2009, receiving well over 3,000 responses from all parts of the service. There was a high degree of consensus around the information clinical staff considered to be of most importance. The Clinical Portal Programme Board accepted the recommendation of CCLG and the eHealth Leads Group that the following information content should be prioritised for Phase 1 Clinical Portal:

Category	Information
Patient Health Summary	Past medical history Current problem list Current medications Allergies Alerts
Clinical Letters	Referral Hospital discharge Outpatient clinic
Diagnostic Tests Results	Laboratory results Radiology results and images Other diagnostic text results
Knowledge Support	Local clinical guidelines National clinical guidelines eBNF

 

The Data Protection Act 1998, permits uses or disclosures of personal data for the purpose of the prevention or detection of crime or the prosecution or apprehension of offenders. NHS boards have mechanisms in place to respond to appropriate information requests from the police.

The Scottish Government published, CEL (2008)13 Information Sharing between the NHSS and the Police. This letter enclosed guidance, developed with the Association of Chief Police Officers Scotland, setting out how NHS boards and police forces should work together to develop a consistent approach to the sharing of information to promote the prevention and detection of crime, while respecting and safeguarding the interests of patients and the public in the confidentiality of personal health information.

There are no plans to introduce a separately designed Scottish solution. The consortium procurement to deliver a PMS solution that is available to all boards was set out in the eHealth Strategy in 2008. Boards beyond those in the consortium will consider whether to move to the PMS solution based on individual business cases and taking into account their existing products and contractual commitments.

Access to all patient identifiable information including health records is on a strict need to know basis in accordance with the Caldicott principles, Data Protection Act 1998, NHS Scotland Information Governance Standards and various codes of professional conduct.

In July 2006, the Scottish Government issued, NHS HDL: (2006) 41 NHSScotland information security policy. It set out Information Security Policy Principles covering authority, accountability, assurance and awareness and makes clear to NHSS staff aware of the limits of their authority and the levels of their accountability for their actions.

In accordance with these principles, NHS boards define policies and procedures to audit the access to patient identifiable information.