What’s New in SCR?

Vision 3 Release DLM 483

Vision 3 release DLM 483 contains the following new features and improvements for the Summary Care Record:

Important - Please remember that you should login to Vision 3 using your Smartcard so that the Spine and Vision 3 are synchronised. This is not just important for Summary Care Record but also for other Spine services (such as GP2GP and EPS) to function correctly.

New RBAC Functionality and Roles

  • RBAC must be fully enabled - Role Based Access Control (RBAC) has been in place for some time without directly affecting your access to specific functions in Vision 3. However, RBAC becomes a compulsory part of Vision 3 once SCR 2.1 is installed. You must ensure that you have all the relevant RBAC activities and roles added to your Smartcard via your Registration Authority this must be completed prior to receiving DLM 483. See Preparing for SCR
  • New RBAC Roles for SCR v2.1- New RBAC roles have been implemented to accommodate some new functionality in SCR v2.1. In order to use some of the new functionality you must ensure that you have any relevant new SCR RBAC activities added to your Smartcard via your Registration Authority and are advised to do this prior to receiving DLM 483. See RBAC Roles used in SCR

New SCR Functions

  • Enabling/Disabling SCR - System Administrators can now enable/disable SCR via Options - Setup on the Vision 3 front screen. From here, you can also set a date offset to auto-overwrite external summaries when running the initial upload. See Enabling/Disabling GP Summary. For existing SCR users this option is enabled by default.
    Note - Before enabling SCR, you must have permission from your ICB to go ahead. You will be informed by your ICB when your practice has met all the requirements needed to participate in SCR and when your allocated date of commencement will be.

Consent Changes

  • Patient SCR Consent Status Stored on the Spine - As well as being recorded on the patient record, SCR consent status is now also stored on the Spine alongside the SCRs. This means that SCR consent is now part of the patient synchronisation criteria (ACS mismatch) when selecting a patient in Consultation Manager.

    Existing SCR practices are strongly advised to run the Consent Migration utility as soon as possible after receiving DLM 483 so that existing dissent preferences can be uploaded. New SCR practices should run this on their Go-live day prior to running the Initial Upload. If you do not do this, you may see the ACS mismatch screen when the patient is selected. If mismatches are not resolved then a task is created to encourage resolution and to allow SCR updates to continue for the patient. It is vital to run this so that dissenting patients have their dissent recorded on the Spine so that it is flagged when other agencies attempt to access their SCR. See Consent Migration.

  • New Implied Consent Read code - Patients without express consent recorded who have an existing SCR will now have the implied Read code 9Ndl. Implied consent for core Summary Care Record dataset upload added to the Spine when Consent Migration utilities are run. See Recording Consent
  • Legacy Read codes changed during Consent Migration - Patients with legacy Read codes for SCR consent will be converted to the new Read codes when you run Consent Migration. See Consent Preference Read Codes

Changes to SCR Bulk Upload Functionality

  • GP Summary Bulk Uploads - GP Summary Bulk Uploads is a new utility that incorporates the existing Initial Upload and the new upload processes. It is available from the new SCR ribbon group on the Vision 3 front screen.

    The following uploads are available from this utility:

  • Initial UploadEnhancements- We have made some functional enhancements to the Initial Upload screen.
  • New Bulk Update Messages - Is a new tool which sends up to date SCRs in bulk to the Spine. This is useful, for example, if a large number of patients need a refresh of their existing SCR.
  • New Consent Migration Facility - The new Consent Migration utility uploads patient consent status to the ACS (Access Control Service) on the Spine in bulk. As previously mentioned, you are strongly advised to run this on receipt of DLM 483 or on your Go-live.
  • New Bulk De-registration - This new functionality sends a de-registration update for all qualifying patients and should be run if the Practice splits. To do this you must create a group of the patients being transferred out, which can then be used for this update. The updated SCR is sent to spine with additional text indicating that the patients are no longer registered.
  • New Practice No Longer Contributing to SCR - For practices who are closing and will no longer be contributing to SCR, this new function enables you to bulk send a GP Summary update for all qualifying patients at the practice with an additional message indicating that the practice is no longer contributing to SCR. This can only be run once the SCR function is disabled/Switched off. Practices should only disable SCR functionality in extreme circumstances and ensure they have fully understood the implications before disabling it. Disabling SCR has a potential impact on the care their patients will receive and it is possible that all patients should be written to, to confirm the practice is no longer updating their SCR. See Enabling/Disabling GP Summary

    See GP Summary Bulk Uploads

New SCR Modules

  • Authorise Queued Summaries module (SCR Created when not Logged in with Smartcards) - From DLM 483, if you have not logged into Vision 3 with your Smartcard and SCR data has been changed, or there are other reasons the SCR cannot be sent immediately, Vision 3 now queues the message allowing other users with the appropriate RBAC role to authorise and send the message via the Authorise Queued Summaries module. See Sending National Summaries that are Queued.
  • SCR Viewer Module - Viewing SCR for Non-Registered Patients - You can now access SCR records for patients that are not permanently registered at your practice via the SCR Viewer module. The patient must first be added to the Registration module in Vision 3. This SCR Viewer includes options for emergency and legal access, you are required to appoint a practice Privacy Officer to monitor access to temporary patient's SCRs. Note: This functionality requires changes to user Smartcard roles and activities by your local RA manager. Please contact your local SCR Implementation Manager for more information; http://systems.hscic.gov.uk/scr/implement/viewing. See Viewing the National Summary for a Non-Permanent Patient and Appointing a Practice Privacy Officer.
  • SCR Reporter Module - The SCR Reporter module enables you to report on success and failures when sending updates to the Spine, these may be sent from Consultation Manager as new data is added to the patient’s record or when running the GP Summary Bulk Transmissions. For example, this enables you to identify patients who were ineligible for an Initial Summary. Once identified, you can use the information to check the patient’s details and resolve the problem that may be preventing them from having a SCR. See SCR Reporter.

National Summary Tab in Consultation Manager

The following changes have been made:

  • Sending Summaries - The Send button has now been moved to the right mouse menu. This is because summaries are now automatically sent when the patient is deselected if eligible summary data has been changed in Consultation Manager or any other Vision 3 module. Summaries are also automatically sent when registration and FP69 status changes. You can still manually send a summary if you wish. See Manually Sending the National Summary.
  • Additional Information Automatically Included on the SCR - For patients with consent for Additional Information recorded, using the Read code; 9Ndn. Express consent for core and additional SCR dataset upload, specific patient data is automatically included in the SCR. This data, including Priority 1 medical histories, Problems, Immunisations, End of Life and other patient preferences, displays in the main window of the National Summary screen under the Additional Information (automatic) heading. This replaces the Supplementary Data heading. See Additional Information.
  • Patient Data Automatically Excluded from the SCR - For patients with consent for Additional Information recorded, using the Read code; 9Ndn. Express consent for core and additional SCR dataset upload, specific patient data is automatically excluded from the SCR. This data, including such items relating to sexually transmitted diseases and pregnancy terminations, displays in the main window of the National Summary screen under the Withheld Items heading. Patient data can no longer be manually withheld. See Withheld Data.
  • Withdrawing Summaries - There is a new RBAC business function that enables the user to withdraw summaries. You can now only choose to withdraw an SCR from the View Last Sent button on the National Summary (SCR) screen. Also patients who have changed their NHS number no longer have their SCR automatically withdrawn. See Withdrawing Summaries and RBAC Roles used in SCR .
  • Comparing Summaries - The PSIS tab has now been removed. However, you can continue to compare existing and potential SCR from the Preferences - Preview screen. It is no longer possible to view locally held historical updates. See Preview and Compare the SCR.
  • Repeat Medication - The National Summary now displays the patients Current Repeat Medication, this is all repeat medication excluding those that have been discontinued in the last 6 months. The date displayed will be the Date of Issue, if it hasn't been issued the Date of Authorisation is used. The patients SCR will list separately, the patients current repeats and all items discontinued in the last 6 months.

SCR Messages

  • SCR Message Monitoring -Vision 3 no longer uses Mail Manager for sending and receiving SCR Messages. Instead, the Vision 3 Message Bus is used (this is new infrastructure which supports the sending and receiving of messages between Vision 3 and specific systems). If there are any SCR message errors, a task or notification is created and assigned to the SCR group. These need to be monitored and processed in either Daybook or Tasks where necessary. You can also run the SCR Reporter tool to track errors. See SCR Reporter, Daybook and SCR or How do I manage SCR error message tasks?.
  • Changes to behind the scenes functionality- As well as all the above enhancements to SCR, we have also improved the messaging functionality that is not visible to customers. This means that the messages are processed more efficiently and the user experience for SCR is greatly improved.

Daybook

  • Daybook Changes - The following new tasks and notifications are generated in Daybook as a result of SCR activity in Vision 3. The following tasks/notifications are viewed in Daybook:
  • ACS (Consent) Mismatch messages - If the patient has dissented, but there are differences between the spine and the local record, an ACS mismatch message displays. A Daybook task is created each time the patient is selected in Consultation Manager until the consent mismatch is resolved.
  • PDS Mismatch messages - A task is created each time the patient is selected until the PDS mismatch is resolved. SCR messages cannot be sent until the mismatch is resolved.
  • Queued items have been sent - When a user works offline, SCR updates will be queued until the user next logs in with their Smartcard or an administrator with the appropriate RBAC rights authorises a queued list, using the Queued GP Summaries utility. When the queued message is successfully sent a notification is delivered to the originator of the SCR message to inform them their patient's SCR update has been sent. The notification may contain multiple patient details, dependant on the items queued.
  • Notification of Transmission errors - If a message is not sent correctly a task or notification is created so that action can be taken by the system administrator or other nominated person. If there are many failures, they are grouped together in a single notification or task.

    See Daybook and SCR .

  • Control Panel Changes - To manage notifications, create a new group in File Maintenance - Staff Groups for SCR messages. You can then assign specific admin staff to this group to resolve transmission errors and notifications for SCR message failures. See Create a SCR Group in Control Panel.

Previous Releases

20/12/2011

  • Prescription Repeat Until date – Changes have been made to how GP2GP imports prescription records with a repeat until date. SCR has been updated to reflect these changes. See Critical Data.
  • Patients Registered at Another Practice – Initial uploads and summary updates are only sent for patients registered at your practice. See Patients Registered Elsewhere.

13/10/2011

  • SCR PDS Synchronisation – During the Initial Upload and after deferring a PDS mismatch in Consultation Manager, an SCR PDS synchronisation is now run. NHS number, gender, DOB and, surname in addition to either forename or postcode must be synchronised as a minimum for an initial summary to be uploaded or to access the SCR via Consultation Manager. See SCR PDS Synchronisation.
  • Changes to Patient Consent Preference–
    • Change to Consent Preference Read Codes - The Patient Preferences screen has been updated to reflect the new patient consent codes. There are now two forms of express consent: one for express consent for medication, allergies and adverse reactions only and one for express consent for medication, allergies, adverse reactions and additional information.
    • For existing SCR users, the old consent preference Read codes will not be automatically replaced with the new ones and will function as previously intended. However, you are advised to start using the new codes for all future data input. See Recording SCR Consent Preference.
    • New Warning when Changing Consent Preference Read Codes – When adding, editing or deleting a patient consent preference or corresponding Read code via medical history, a warning message is now displayed advising you to make sure that the patient understands the implication of their new choice.
    • New History Screen – From DLM 380, there is a new History button on the Patient Consent Preference screen. This lists all previously recorded consent preferences and allows you to access a full audit trail. See Recording SCR Consent Preference.
  • National Summary Tab Changes
    • Reason for Medication – From DLM 380, you are still able to add Problem headers manually to the National Summary (which give reason for medication issue) but the patient must have a patient preference of 9Ndn.00 Express Consent for Core and Additional Summary Care Record Data Set Upload recorded.
    • New Warnings when sending a National Summary – The send button on the National Summary tab is now constantly available to allow you to easily resend summaries. Because of this there are new warnings when trying to send a summary with data which does not match the patient preference. See Confirm Consent Change.
  • PDS Checks –After deferring a PDS mismatch in Consultation Manager, an SCR PDS synchronisation is now run.. NHS number, gender, DOB and, surname in addition to either forename or postcode must be synchronised as a minimum for an initial summary to be uploaded. This means that you can access the SCR for a patient matching a curtailed PDS criteria. When this happens, Identity Confirmed displays in the patient title bar and you are only able to access national services for this patient with regards to SCR. See SCR PDS Synchronisation.
  • SCR Functionality Removal
    • Warn If No Patient Preference - It is a new Connecting for Health requirement that practices should not be warned if the patient does not have a preference recorded. We have therefore removed this option from Consultation – Options Setup in Consultation Manager.
    • National Summary Auto Selection Options – It is also a new Connecting for Health requirement that supplementary data is only manually added to the SCR, hence the auto-selection option for SCR has been removed from Consultation – Options – Setup in Consultation Manager (NB Auto selections is still available for referral message purposes). This is option also no longer accessible from any of the National Summary right click menus.

29/03/2011

Summary Care Record - Initial Upload Changes

  • We have introduced a facility which allows you to specify start/resume and stop/pause times for the initial upload. This allows for timed processes, such as the backup, to run and not interfere with the upload process. See "Start/Resume Stop /Pause Times".
  • There is now also a Total Patients Uploaded count and an Upload Time Per Patient display which appears on the Initial Upload progress bar. You can also see how many messages have been sent to the message queue. See "Start/Resume Stop /Pause Times".
  • If a new patient is made permanent before the Initial Upload is completed, but after SCR functionality has been enabled, they will NOT be included in the Initial Upload. Such patients will have the chance to create an SCR at the next relevant face-to-face consultation. Applied patients are still exempt from this process.
  • You are now able to tailor the content of the SCR before the Initial Upload is run. See "Tailoring the SCR before the initial upload is started".

Summary Care Record - Consent Changes

  • CfH have now issued a revised consent model which should be used in accordance with the existing preferences screen.
  • To accommodate user requests, we have moved the Preferences prompt so that it appears at the start of the consultation rather than at the end.
  • You can also disable the automatic preferences prompt on a per user basis if required. This is done from Consultation – Options – Set up in Consultation Manager.
  • When a patient changes their consent status to Dissent, a blank summary is generated and sent to the Spine automatically. There is now no longer a need to press Send.
  • Recording dissent for the SCR scheme will now not interfere with any of the other national services programmes i.e. you should still be able to create a Choose and Booked Referral, send GP2GP messages.

Summary Care Record - Management Changes

We have made the following changes to assist in the day to day management of the Summary Care Record:

  • You can see a preview of the SCR without being logged into Vision 3 with a Smartcard.
  • You can now maintain a local summary for patients who do not wish to be part of the SCR programme. This information is stored in the patient record only. See "Creating Local Summaries".
  • Multiple Normal Summaries – previously if there were multiple summaries, the last summary was automatically replaced with the most recent summary. From DLM 290 you are able to select which summary should be replaced. See "Dealing with Multiple Summaries".
  • SCR Withdrawal. You are now able to view and withdraw SCR messages by viewing patient SCRs from the PSIS tab. See "Withdrawing Summaries".
  • When a user tries to access SCR data for a patient who has dissented, a warning message appears stating that the Caldicott Guardian will be informed of this inquiry. See "Caldicott Warning – Consent Override".
  • The Event log now audits all changes to preference and SCR updates.
  • If a third party healthcare professional has edited the SCR, you are prompted.
  • Inactive Repeat Master information received from GP2GP messages will not be included in the SCR.