Understanding information access and sharing for direct care

My Topol fellowship problem / project:

During my Fellowship I will be exploring how information for direct care is shared and accessed at local, regional and national levels particularly across organisational boundaries. The information I am interested in is both the ‘backward view’, as in a person’s history and the ‘forward view’, as in their care plans. I am most interested in this from the care professional’s perspective – is it useful, useable and used?

We face the problem that information may sit in multiple electronic records with variable interoperability and/or on paper – both in health records and care plans held by the individual. A care plan capability to fully support a multi-disciplinary personalised care approach seems some way off. Simple qualifying questions that need asking include: Can all the care professionals who need to create or add to the digital care plan do so? Can all the care professionals who need to view the digital care plan do so? Can individuals or their carers contribute to their own care plans?

My work will include mapping access to care information across the South West and West of England regions, paying particular attention to anticipatory care plans and accessibility by ambulance and out of hours’ services in unplanned care situations.

I intend to provide a toolkit, supported by a communications campaign, for care professionals to more easily find relevant information relating to individual care across the multiple systems (paper and digital) which they currently have access to, but might not be aware of.

This activity will identify the existing state of sharing and accessing care information and the issues that need addressing. I will share this work at local, regional and national level to inform digital roadmaps, both interim (what can we do now?) and longer term, in order they meet the real needs of the people requiring the information that supports direct care.
I would be interested to hear from others who share my interest and welcome any input.


I am the Chief Nurse Information Officer at Gloucestershire Clinical Commissioning Group (CCG) bringing a clinical voice into digital transformation projects across Gloucestershire. This has included the development of our shared care record. A common theme in my role is acting as interpreter between care and informatics staff – ensuring that digital implementations address the issues and add the benefits the care staff require in order to deliver safe, efficient, effective, person-centred care.

I trained at Queen’s Medical Centre in Nottingham and since then have worked within the NHS specialising in respiratory medicine. I also spent some time working in the pharmaceutical and telemedicine industries, working on clinical pathways supported by digital services. This experience enabled me to bring back into the NHS capabilities and insights such as structured project and change management skills.

I am a member of the Faculty of Clinical Informatics.