What's New in SCR

DLM 483 (28/07/2015)

• DLM 483 introduces the following enhancements to Summary Care Record:

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. However, RBAC becomes a compulsory part of Vision 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 New Practices 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 480. 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 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 are 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 NHS Spine - As well as being recorded on the patient record, SCR consent status is now also stored on the NHS 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 NHS 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 now have the implied Read code 9Ndl. Implied consent for core Summary Care Record dataset upload added to the NHS 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 are converted to the new Read codes when you run Consent Migration. See Consent Preference Read Codes

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 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 is 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

• 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.