Moving to a single Electronic Patient Record across Lancashire and South Cumbria

The Lancashire and South Cumbria Integrated Care System (ICS) has a five-year strategic vision to improve the lives and healthcare outcomes for our 1.8m citizens. Our aim is to create a collaborative, responsive health and social care system, implementing new models of care that benefit our citizens and colleagues. We wish to provide equitable access to services according to need and reduce unwarranted variation.

To underpin this vision and support safe, integrated care, NHS organisations in Lancashire and South Cumbria are committed to supporting the implementation of an area-wide Electronic Patient Record. Over the last few months, clinical and technical experts have been working together to develop a Clinical Systems Roadmap which outlines the systems and services to be consolidated, including the work required to improve the IT infrastructure in-line with government standards. This will enable provider organisations and acute hospital trusts to move towards a common set of clinical systems which will benefit our patients and local people. These shared, inter-connected systems will form a single Electronic Patient Record.

The Clinical Systems Roadmap is a 10-15-year programme of change. The design has three components:

• Core Clinical System - This is the main component of an Electronic Patient Record within a hospital setting. It holds the bulk of the clinical record and supports hospital administration.
• Common Departmentals – These systems are fully integrated into the core clinical system, providing bespoke functionality for a department or pathway e.g. Pathology, Ophthalmology and Maternity. They are the same solution, deployed consistently across all Trusts.
• Data Orchestration Layer - This integrates all the data related to a patient or individual. It also provides ICS partners with a common set of digital functions, supporting technology enabled care, data analytics and patient-held records.

The exact form and function of each sub-component within the Clinical Systems Roadmap is still being considered along with the timeline and prioritisation of system consolidation and replacement. One of the early projects is the sourcing of a core clinical system for all our acute hospital providers. This solution will form the cornerstone of our Electronic Patient Record.

The procurement exercise is being led by the Lancashire Procurement Cluster (hosted by East Lancashire Hospitals NHS Trust) for and on behalf of the following:

• Blackpool Teaching Hospitals NHS Foundation Trust
• East Lancashire Hospitals NHS Trust
• Lancashire and South Cumbria NHS Foundation Trust
• Lancashire Teaching Hospitals NHS Foundation Trust
• University Hospitals of Morecambe Bay NHS Foundation Trust

The Lancashire Procurement Cluster will also ensure that all related IT purchasing decisions and contract renewals are aligned to the goal of a single electronic patient record. The ICS is using the Health Systems Support Framework for procurement, which is a purpose-built mechanism for integrated care systems to address their digital needs. In conjunction with NHS England and NHS Improvement, NHS Digital and NHSX, they held a webinar via the Framework on Friday 18 September. This pre-market engagement event was positively received and attended by around 200 suppliers. Further engagement with suppliers will take place in coming weeks to support us refining the best possible ‘Invitation to Tender’. This will lead to procurement of a new Acute Provider EPR System for our ICS by the end of March 2021.

Colleagues from East Lancashire Hospitals NHS Trust have taken a lead on drawing together a requirements specification for the common core clinical system that has been shared with the other Trusts for review. We have partnered with Ethical Healthcare to support the programme’s stakeholder engagement in order to fully understand all the individuals and groups impacted by this proposed change and to achieve a deeper understanding of their interests and views. 

Members of the Clinical Systems Roadmap Mobilisation Team are reaching out to clinical and operational representatives to take part in further engagement work that will be done virtually and structured into short slots. Trust staff were given options to enable them to choose the most suitable date and time, and the sessions will be split into clinical, operational and technical. This approach will enable frontline staff from each of the Trusts to easily access the slots and allow for wide participation.

In addition to the organisational engagement work, the intention is also to align the Clinical Systems Roadmap to the emerging clinical strategy. In part, to address the IT systems issues raised in the first Clinical Senate, but also to ensure that the IT systems underpin new clinical models and integrated care.

The procurement process for a core clinical system for all our acute hospitals will start in late November 2020, after requirements specifications have been finalised. Bids from the market are expected by 24 December 2020, with an aim to have the contract in place by the end of March 2021. The reward of a single system is likely to have a huge positive impact on integrated care and those staff delivering it.