South Western Ambulance Service NHS Foundation Trust (SWASFT) Connector Programme – sharing patient information with South Western Ambulance Service

One of the major challenges for ambulance clinical staff is access to appropriate information when delivering acute patient care. 

The ambition of the SWASFT Connector Programme is to deliver a single Urgent and Emergency Care view of the information required by ambulance clinical staff in order to deliver safe, efficient, timely, equitable, person-centred pre-hospital care across the South West region. 

SWASFT covers a total population of more than 5.5 million, plus an additional 25 million visitors that come to South West England each year. Patient health records, held by multiple organisations, are hosted on six different shared care record systems for the seven integrated care systems (ICS) across the patch.  

As ambulance crews routinely travel over ICS boundaries they therefore need to access and navigate several different systems, on multiple different platforms, to find the patient information they require. Care plans, such as the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT), treatment escalation plans and patients’ preferences of care, tend to only be available to ambulance staff on paper in the person’s home.  

This places an unacceptable and unsafe expectation on time pressured ambulance colleagues to make optimal care decisions and prevent inappropriate conveyance to hospital

The first stage of the SWASFT Connector Programme was a Discovery Phase, using the User Centred Design process, collating the experiences of SWASFT clinical staff in accessing patient information and its impact on decision-making. A questionnaire was sent to 3,500 SWASFT ambulance clinical staff, with a 12% completion rate (409 responses) and structured interviews with clinical leads across the region. 

The discovery phase report identified a series a quick wins – such as ensuring clinical staff are supported in having smartcard and biometric access to national Summary Care Record – and the longer term scoping of what needs to be done so that digital care plans can be shared efficiently.   

The findings are being used to inform NHS Digital’s own discovery work on creating an Urgent and Emergency care view of the national summary care record and by the NHS England Transformation Directorate (formerly NHSX) to optimise the directory of services, providing more detailed ‘backdoor’ information so that ambulance staff can easily contact other health care professionals to discuss where best a patient receives treatment. 

Claire now works full time as Clinical Lead – Digital Transformation at NHS England, taking the discovery phase forward to defining and designing and delivering the solution to get treatment, escalation plans into the hands of clinical staff. 

The Topol Fellowship allowed her the freedom of two days protected time giving the headspace to do a deep dive into the experiences of SWASFT clinical staff, the systems across the region that feed into creating patient’s health records and the national systems that underpin onward care.  

Claire adds: “The Fellowship has helped me in so many ways. It helped truly embed the principles of user centred design and the ability to bounce ideas off the network of Fellows was really invaluable. 

“It really challenged something within myself. It has helped grow my self-confidence and self-belief. I’ve learnt to step out of my comfort zone, leaving my die-hard imposter syndrome behind. It is these softer skills that have helped me talk to people across the NHS and take people with me on this journey. I’m now on the summary care record Expert Advisory Committee helping to shape national strategy.”  

“It is an amazing opportunity. If you’ve identified a problem and the thought of finding the solution to that challenge makes the hairs on the back of your neck stand up, then apply for a Topol Digital Fellowship. 

“I am one of five nurses who have done the Fellowship and I would really encourage other nurses, and other allied health professionals, to become digital leaders. Our perspective of the issues and potential solutions from the frontline can really contribute to improving patient’s experiences and outcomes.” 

Dr Paul Atkinson, Chief Clinical Information Officer, NHS Gloucestershire: 

“In her Topol Fellowship year, Claire Lambie delivered a discovery report which addressed the issues around access to patient information by a service (SWASFT) that spans multiple Integrated Care Systems. This is now primary use case for the One South West Shared Care Record Programme – a remarkable achievement.”

Follow on social media

Claire Lambie

Twitter @ClaireLambie1

NHS England South West

NHS South West @NHSSW