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CfH issues new SCR data quality guide

Tags: CfH   Data quality   PCTs   PHCSG   RCGP  

25 Feb 2010

NHS Connecting for Health has issued new guidance on the data quality standards GP practices are expected to meet before data is uploaded to create Summary Care Records.

The interim guidance follows the ending of the IM&T Directed Enhanced Service (DES) in March 2009, which had set the data quality standards practices had to meet before records could be uploaded to the Spine.

The “interim requirements statement” sets out “essential requirements” which all practices will be expected to meet before data is uploaded and “desirable standards”.

ChB said the interim requirements would apply until revised Good Practice Guidelines for electronic records were published later this year.

Essential requirements cover compliance with the RCGP’s guidance on standards for the SCR, recording of all prescriptions electronically, electronic coding of allergies and adverse reactions, electronic recording of clinical summaries and compliance with local paperlight accreditation schemes.

Desirable standards including previous completion of component two of the IM&T DES or a local equivalent, use of electronic disease registers for the clinical areas covered by the Quality and Outcomes Framework and electronic coding of data to meet the QoF requirements on repeat medicines, summarising of new patient records and medication reviews.

On the desirable standards the guidance says: “Meeting this standard will ensure that a high level of data quality has been achieved and maintained within a GP practice and is therefore preferable for practices participating in SCR.

"However, it is recognised that an investment of time and resource would be needed on behalf of the PCT and GP practice to meet these standards.”

Following the ending of the IM&T DES, CfH had advised primary care trusts that practices need only have been approved to be paperlight before records could be uploaded.

However, CfH said that stakeholders had called for “a more defined data quality requirements statement” which had led to the production of the interim requirements.

The British Computer Society’s Primary Healthcare Specialist Group was among those that expressed concern that paperlight accreditation left considerable discretion to PCTs and had few real teeth.

The PHCSG added: “It is disingenuous to suggest that paperlite accreditation as currently applied offers any reassurance as to the fitness of records for sharing or indeed use within a practice.”

This week Roz Foad, chair of the PHCSG, said the problem with the latest guidance was that there was no “carrot or stick” to incentivise practices to improve data quality.

She added: “Leaving it up to PCTs to implement data quality will result in wide differentiation of approach. Some will appoint facilitators to thoroughly train practices but in these days of austerity it is likely that many will be tempted just to put in a tick box exercise.”

Foad said the PHCSG believed there was a difference between upload of the core data summary and the enriched added with medications, allergies and adverse reactions likely to be the most accurate anyway.

She added: “We have concerns over proposals to upload everything bar sexual and mental health details and if you are going down this route, you need to ensure that what goes up has been validated thoroughly.”

Dr Mary Hawking, a GP in Bedfordshire and a campaigner on data quality issues, said she failed to address continuing concerns about SCR data quality

She added: “I don’t feel this takes us any further forward. They are saying how nice it would be if everyone adhered to these standards but what isn’t addressed is what levers you have and what mechanisms you have for knowing that the data is up to the standards you need.”

Fiona Barr

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Reader's Comments
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1

GP Summary - caveat lector!

25 Feb 10 10:02

The RCGP document sets out the "purpose of GP summary.. for use by other clinicians in unscheduled care settings... an extract of events in the patient’s medical record that may have a bearing on the current consultation."

Unsurprisingly therefore the content and standard demanded of a GP Summary are those of any high quality clinical referal letter. The additional complication being one does not know in advance to whom or why the patient is being referred!

It is explicitly stated one must know the patient and discuss the content with them.

Constructing such summaries cannot be a fully automated extraction process. Even the simplest requires individual and 'mindful' sign-off by a clinician familiar with the patient's history.

Each summary of more complex patients will require many minutes of editing and thought.

Once constructed the summaries require review and updating - typically after each subsequent encounter.

Are these standards compatible with available resource or motivation - let alone political pressure to 'deliver' millions of summaries in time for the election campaign?

http://www.ehiprimarycare.com/news/5624/london_scr_roll_out_complete_in_a_year

The trouble is if the stringent RCGP standards are not met, it arguably would have been safer (and indisputably cheaper) not to bother at all. Oh dear :-(

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