Patient Records, Sharing and Reporting Systems Quick Reference

Patient records, sharing and reporting systems – Quick Reference

System / Local/
National / Practice Participation / Type of System / Patients Informed? / Patient Opt-Out Available? / Recording Patient Opt-Out? / Timescales
Connecting Care / Local to BNSSG / Voluntary via Data Sharing Agreement / Clinical support for direct patient care / Yes - Joint letter with SCR / Yes via letter, PALS, website form, email / Done within and by Connecting Care / Roll-out - imminent
Summary Care Record / National / Voluntary via Data Sharing Agreement / Clinical support for direct patient care / Yes - Joint letter with Connecting Care / Yes - via return of letter or in person at Practice / GP - addition of Read Code ‘9Ndo’ to Patient Record / Patient Opt-Out – LIVE
System Roll-Out - TBC
EMIS Search & Report / Local to BNSSG / Voluntary / Secondary Uses Commissioning/
Planning / No – other legal controls apply – see overleaf for more details / Yes / GP Addition of Read code ‘93C1’ to Patient Record / Pilot - LIVE
Roll-out - imminent
PCDR / Local / Voluntary / Risk Stratification Tool (but contract expires 2014) / As above / Yes / GP Addition of Read code ‘93C1’ to Patient Record / To be replaced by EMIS Search & Report
Avon Business Intelligence (ABI) / Local to BNSSG / Voluntary
All BNSSG Practices have access / Secondary care, prescribing, patient transport, end of life
. / As above / Yes / GP Addition of Read code ‘93C1’ to Patient Record / LIVE – (but does not include primary care data). Development continues
care.data GPES / National / Mandatory / Secondary Uses / Via Practices / Yes / GP Addition of Read Code ‘9Nu0’ to Patient Record / Patient Opt-Out – LIVE
System Roll-Out - TBC
CQRS / National / Mandatory for QOF / Reporting & Payments / Not applicable / Not applicable / Not applicable / LIVE
(Replacement for QMAS)
MiQuest / National/ Local / Voluntary / Secondary Uses / Not applicable / Not applicable / Not applicable / To be replaced by EMIS Search & Report

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Patient records, sharing and reporting systems – a guide

The table below is a summary of some of the different national and local systems and projects. This is not an exhaustive list of all national and local projects – but it lists the ones that are more prominent at the moment and / or where work is currently being done.

System / Connecting Care
Local / National? / LOCAL
Purpose / To provide a shared patient-centric record to support direct patient care and local care co-ordination. This is not a reporting system – this is a system to support clinicians at the point of care.
Practice participation? / Practice participation is voluntary. Practices are encouraged to support this project by signing the Data Sharing Agreement.
Informing patients / Patients have been informed about Connecting Care via a letter which was sent to all adults in the local area.
This will be supplemented by locally produced materials for practices and other providers. Practices are advised to use these materials for current patients and also to share them with new patients when they register.
Can patients opt out? / Yes. Patients can opt out – the recent letter provided information on how to do this.
There are a number of flexible ways to support patient opt out. Patients can (a) phone PALS and request opt-out verbally (b) download the form on the CCG website and post it to PALS (c) ask PALS to post them an opt out form (which they can then return) or (d) email the opt-out form to PALS
Patients can opt in and opt out at any time (and can change their mind).
How is patient opt out recorded? / This is done within Connecting Care
Patient queries and support / Patient can contact PALS on 0800 073 0907 or 0117 947 4477.
When is this happening? / The Connecting Care project is underway now.
System / Summary Care Record
Local / National? / NATIONAL
Purpose / To provide an emergency care summary that can be accessed from anywhere in England. This is not a reporting system – this is a system to support emergency care
Practice participation? / Voluntary
The CCG have not yet commissioned this project but when it starts then practices would be asked to sign a Data Sharing Agreement. CCGs are currently intending that this work will start later next year
Informing patients / Patients have been informed about Summary Care Record via a letter which was sent to all adults in the local area.
This can be supplemented by national materials which are available on the website
Practices are recommended to use these materials for current patients and also to share them with new patients when they register.
Can patients opt out? / Yes. Patients can opt out – the recent letter provided information on how to do this.
The central mailing house will answer queries and then collate and log all ‘opt outs’ that are sent to them. They will then send practices details of all the patients who need their records marked with an ‘opt out code’. (see below)
How is patient opt out recorded? / This is done by using the read code 9Ndo. Alternatively it can be done within your GP system[1]
There are some older read codes which still work – however the national guidance is to use the new code 9Ndo.
Patient queries and support / Any queries should be directed to the national team on 0300 123 3020. There is also a patient website
When is this happening? / Whilst the mailing of the letters has happened the CCG is not starting this project yet. Initial plans are to carry out the implementation of Summary Care in 2014 however the dates have not been agreed. Practices will be informed when dates have been agreed.
System / EMIS Search & Report
Local / National? / LOCAL
Purpose / Reporting / secondary uses.
This is a reporting system which is part of EMIS. The system enables searches to be set up and run across multiple practices, and allows practices to share searches (thus reducing workload)
This replaces some of the existing ‘PCDR’ reports (see below). EMIS Search & Report is expected to be used to support enhanced services reporting and should provide a time-saving to practices.
Practice participation? / Voluntary
Practices are encouraged to participate as it will save them time and it supports public health reporting
Informing patients / There are already IG posters and leaflets on ‘how we use your information’ which are available to GP practices. These existing materials include reference to the fact that patient information can be used to support care planning / service planning / public health.
This is an appropriate way to inform patients given thatpatient identifiable data (PID) is not generally accessed in EMIS Search & Report, except in very limited and tightly controlled circumstances where the legal basis has been checked.
Can patients opt out? / Yes
How is patient opt out recorded? / Patients can opt out of data being released from GP practices systems for reporting using the read code 93C1 (or using the EMIS Web data sharing screen).
Patient queries and support / It is not anticipated that there should be any queries on this project – but if any patients are concerned about information being used in reporting then it is expected that they would address their concerns to their GP practice.
When is this happening? / The project is underway now – some practices are piloting EMIS Search & Report and wider roll-out is commencing in September.
System / PCDR
Local / National? / LOCAL
Purpose / This is a risk stratification and reporting tool which takes data from GP systems and ABI.
This system has been in place across Bristol, North Somerset and South Gloucestershire for several years – but the contract ends in 2014 and so needs to be replaced.
It is planned to be replaced by EMIS Search and Report (see above) and ABI (see below).
Practice participation? / Voluntary
All practices in South Glos currently participate.
25 North Somerset practices and 40 Bristol practices currently participate.
Informing patients / There are already IG posters and leaflets on ‘how we use your information’ which are available to GP practices. These existing materials include reference to the fact that patient information can be used to support care planning / service planning / public health.
This is an appropriate way to inform patients given thatpatient identifiable data (PID) is not generally accessed in PCDR, except in very limited and tightly controlled circumstances where the legal basis has been checked.
Can patients opt out? / Yes
How is patient opt out recorded? / Patients can opt out of data being released from GP practices systems for reporting using the read code 93C1 (or using the EMIS Web data sharing screen).
Patient queries and support / It is not anticipated that there should be any new queries on this project as it has been running for several years now – but if any patients are concerned about information being used in reporting then it is expected that they would address their concerns to their GP practice.
When is this happening? / This project has been in existence for several years now. PCDR will be finishing soon - the contract ends in 2014 and so needs to be replaced.
System / ABI (Avon Business Intelligence)
Local / National? / LOCAL
Purpose / Reporting / secondary uses.
ABI (Avon Business Intelligence) provides reports to support commissioning for practices and CCGs. ABI currently includes data from secondary care, prescribing, patient transport, end of life – but it does not yet include any primary care data.
A risk algorithm is being implemented in ABI which will replace PCDR – and which is seeking to provide risk assessment based on secondary and primary care data combined. This work is currently being piloted with one GP practice in South Glos to establish the feasibility of this
Practice participation? / Voluntary. All Bristol, North Somerset and South Gloucestershire practices are able to use and access ABI.
If the risk algorithm feasibility work in South Glos provides positive feedback then plans will be developed to include GP data into ABI to support improved reporting – any participation in this will be voluntary.
Informing patients / There are already IG posters and leaflets on ‘how we use your information’ which are available to GP practices. These existing materials include reference to the fact that patient information can be used to support care planning / service planning / public health.
This is an appropriate way to inform patients as ABI work is subject to the legal powers of HSCIC and where appropriate ‘S 251’ exemptions.
Can patients opt out? / Patients cannot opt out from flows of secondary care data, but will be able to opt out from flows of GP data if these are implemented in the future
How is patient opt out recorded? / Patients can opt out of data being released from GP practices systems for reporting using the read code 93C1 (or using the EMIS Web data sharing screen).
Patient queries and support / It is not anticipated that there should be any new queries on this project as it has been running for several years now – but if any patients are concerned about information being used in reporting then it is expected that they would address their concerns to their GP practice.
When is this happening? / ABI for GPs has been in existence for several years now and continues to be developed.
System / care.data and GPES
Local / National? / NATIONAL
Purpose / Reporting / secondary uses
Historically there has been national collecting of secondary care health data. This is known as ‘HES’[2] and has been used for national reporting and research.
The aim of care.data is to build on this by including primary care information too. The stated aim is “to make increased use of information from medical records with the intention of improving health care”.
GPES is the national primary care data extraction service managed by the HSCIC[3]. GPES is capable of obtaining information from all GP practices in England for “specific and approved purposes.”[4] GPES will be the mechanism to provide a flow of GP data for care.data.
See also for more information
Practice participation? / Mandatory
All practices are required to be part of care.data and GPES.
Informing patients / There are new national materials available to support informing patients.
Practices can use these leaflets & publish posters in the surgery and on their website. Practices can also use other methods of informing such as using right hand side of prescriptions.
This is an appropriate way to inform patients given that care.data / GPES is using legal powers of HSCIC under 2012/2008 act
Can patients opt out? / Yes
How is patient opt out recorded? / Dissent from secondary use of GP patient identifiable data - where a patient objects to their information leaving the GP practice use the read code 9Nu0
Dissent from disclosure of personal confidential data by Health and Social Care Information Centre – where a patient wishes to prevent information which has left the practice (gathered from any health and social care setting) from leaving the HSCIC – use the read code 9Nu4
Patient queries and support / If any patients are concerned about information being used in reporting by care.data / GPES then it is expected that they would address their concerns to their GP practice.
When is this happening? / Practices are being informed about care.data and GPES now.
Data will only be extracted from the official go-live date (as yet unconfirmed, but expected to be mid-November) and not retrospectively.
System / CQRS(QMAS)
Local / National? / NATIONAL
Purpose / Reporting and payment
This is the Quality reporting system for QOF (Quality and Outcomes Framework) – it replaces QMAS
Practice participation? / Mandatory - if practice wishes to receive QOF payments.
The Calculating Quality Reporting Service (CQRS)[5] intends to take data directly from GPES (see above), although practices are currently required to upload some data directly into CQRS
Informing patients / Not applicable
CQRS uses aggregated data to perform the required calculations and will not receive or hold any patient identifiable data. Because of this, there is no legal requirement for practices to inform patients on this.
Can patients opt out? / Not applicable
How is patient opt out recorded? / Not applicable
Patient queries and support / Not applicable
When is this happening? / This is happening now.
System / Miquest
Local / National? / NATIONAL & LOCAL
Purpose / Reporting / secondary uses
This is a tool to support searches across multiple systems – it has historically been used for searches for medicines management and other similar ad hoc queries.
This tool is no longer supported and will be replaced by EMIS Search and Report.
Practice participation? / Voluntary
Informing patients / There are already IG posters and leaflets on ‘how we use your information’ which are available to GP practices. These existing materials include reference to the fact that patient information can be used to support care planning / service planning / public health.
This was an appropriate way to inform patients on Miquest as aggregate data is extracted.
Can patients opt out? / Not required as this tool is replaced.
How is patient opt out recorded? / Not required as this tool is replaced.
Patient queries and support / Not required as this tool is replaced.
When is this happening? / This is an existing system but this will not be used in future.

Version 1- Dated13th September.

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[1]For INPS see

For EMIS WEB see the ‘Care Record’ section in EMIS Web Help for more details

In EMIS LV and PCS select ‘Medical records’ and then ‘A’ (Add)

[2]

[3]Health and Social Care Information Centre

[4]

[5]See