Integrating care is central to plans to improve health and social care services across the country. The key to creating these integrated services is being able to easily, yet securely access patient records. NHS Digital’s strategic goals for London include an objective to provide real-time access to patient records. 

The aim is to ensure that healthcare professionals across the NHS can access the full records of a patient to better inform decision making. Bill Jenks, Digital Programme Lead: North East London NHS Tower Hamlets CCG, spoke to us about the expansion of the East London patient record links to become One London Connection.  

Understanding the Successes of the East London Patient Record (eLPR 

Health and social care providers across east London have utilised a shared care record since 2013. The service links all health and social care services across east London, pulling through any, and all information to those who need to access it. Therefore, if a patient is at any of the shared locations the health or social care professional can access all of their records. This includes GPs, mental health services, hospices, and pharmacies. 

The East London Patient Record: Benefits Study Evaluation, 2017, found that the eLPR made significant savings ‘by avoiding duplication, and efficient administration, as well as retrieval of information, thereby saving consultation time’. The study found that the costs of running the eLPR each year equated to 57p per patient per year compared to the saving of at least 121p per patient per year [2].  

Another important finding was that clinicians felt: 

‘not only the relationship with patients was better but also better patient engagement. It was felt that patients were more confident in the level of care received’ [2] 

Following the successes of the eLPR, One London was established across London utilising a software application called Health Information Exchange (HIE). 

One London Connection: Enabling Access to Patient Records 

One London connects local information hubs such as GP surgeries and hospitals to a central hub, with each service able to update and access and share information such as lab results, A&E discharge summaries and appointment data. Bill explained to us how the hub can be easily accessed across SystemOne, Adestra, RiO and Mosaic.  

The success of the system is due to ensuring the information governance (IG) is clinically led. 

Having an information-sharing agreement (ISA) has also been useful in guaranteeing that there aren’t any conflicting agreements and that any future sharing agreements should be added to that single ISA.  

One London also has a central privacy policy website that all organisations link to. If any changes are made then, only one website needs to be updated and all organisations are then up to date. 

Lessons Learnt 

Bill ran us through the key lessons learnt: 

  1. This data is being shared anyway but through conversations, phone calls, and letters. This system just allows that to be done digitally​, quicker and more securely. 
  1. It is a journey of trust, and that journey has to start somewhere​. The evident benefits are persuading those who were sceptical before. 
  1. We must try and ensure sharing is reciprocal where possible​ – often GP records are shared but records back from other organisations are not returned. This data needs to be reciprocated as it significantly cuts admin time. 
  1. You don’t need to switch everything on at once. Get something switched on and shared and as people understand the system and its benefits you can increase the amount of data shared.  
  1. Control of patient information (COPI) has sped up data sharing and ISAs and governance need to catch up​. 
  1. Directly handle any objection to information sharing from patients. You should empower your organisations to have conversations with patients about their objections​.  

As of December 2020, the eLPR system was accessed 200,000 times. It is expected that the HIE will similarly grow on a continued upward trend [1].  

[1] Jenks, B. 2020. NHS Technology: Harnessing Digital, Data and Technology in Healthcare Conference

[2] East London Health and Care Partnership. 2017. East London Patient Record: Benefits Study Evaluation

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When implemented effectively, technology can be used in the NHS to improve communication between health and social care providers. This case study looks at the expansion of the East London patient records.

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