Data sharing: the Better Start Bradford SystmOne Pilot

Better Start Bradford, in partnership with the Better Start Bradford Innovation Hub (BSBIH), are in the process of piloting the use of SystmOne as a data collection and reporting tool for a number of Better Start Bradford projects.

These reports will improve contract monitoring and service evaluation across each project. On top of its capabilities as a data collection system, SystmOne has several ways of facilitating data sharing between organisations.

What opportunities and challenges does using SystmOne’s sharing functionality present?

SystmOne is available in a variety of ‘modules’ that cater to different health and social care settings, such as GPs, district nursing, hospitals, and out of hours services.

Across all these services and modules, there is a single, central record for each individual patient. The whole record is not always visible to all services and is based on what information that service has recorded themselves and which organisations the patient has given sharing permission to.

Having a single shared record has numerous advantages and some drawbacks.

On the one hand, it becomes easy to share important information across multiple settings, such as safeguarding observations, hospital admissions, A&E attendances and so on.

On the other hand, staff must be careful not to record certain pieces of information that could affect the operation of other services, such as diagnosis codes, pregnancy codes, or child protection plan status.

Even relatively mundane changes like updating an address or phone number can affect external staff who perform home visits, where mistakes or temporary contact details can create difficulties for staff trying to contact families. While the system has some safeguards in place to ensure users do not inadvertently make problematic changes, proper training and adherence to procedures and policies is vitally important to ensure that all services that share a record can do so without adversely affecting one another.

How can system design and implementation maximise benefits and minimize issues around data sharing?

Working towards a shared child record is a central aim of the SystmOne pilot, aimed at giving local health and social care providers the information they need to make the best decisions for their patient.

Better Start Bradford SystmOne units do not share data with external service providers just yet, but this is a planned in phase 2 of the pilot project, so all decisions have been made with this next stage in mind.

One obvious consideration was the use of Read Codes – these are medical and administrative codes that record specific, reportable, information about a patient, such as diagnoses, family history, and demographic details.

These codes can be the backbone of much of SystmOne’s functionality and can be used to trigger alerts, status markers, presence in reports and a lot more. To this end, templates and questionnaires were designed to keep Read Code usage low. Even for projects that deal with antenatal and postnatal education, we have avoided using codes that indicate pregnancy, birth, loss of pregnancy and so forth. Using these codes would run the risk of adversely affecting other services by potentially adding or removing pregnancy markers or even creating conflicting due dates in some instances. For services who rely on these markers to offer certain support or add or remove referrals, this can be disruptive to the patient journey and result in patients not receiving care at the right time.

Much of the difficulty in implementing data sharing comes in building trust and confidence in the system and processes involved. To facilitate this process, we focused on developing clear, concise and accessible privacy notices from a very early stage. The privacy notices were developed in conjunction with service delivery partners as well as members of the community. Following this, project staff were supplied with privacy notices and given training and guidance on how to approach the topic with confidence. This approach has proven very successful in the initial implementation of SystmOne, where personal data is used for research and evaluation purposes. The intention is to use the same approach when informing users about their options for sharing their data to and from other SystmOne-based services.

Better Start Bradford and BSBIH are in the process of producing a comprehensive ‘Lessons Learned’ paper centered around the SystmOne Pilot. Once available, this document will give insight into how various roadblocks and challenges have been overcome in rolling out SystmOne to the voluntary and community sector. It is our hope that this can help other organisations in the future to undertake similar projects with confidence.

Richard Scholes is SystmOne Product Specialist, Better Start Bradford.

About A Better Start

A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK. Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication.

The work of the programme is grounded in scientific evidence and research. A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier

The National Children’s Bureau is coordinating an ambitious programme of shared learning

for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.

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