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Enabling integrated care through the Dorset Care Record

Supporting the Dorset Care Record Partnership to create shared care records that NHS and social care organisations across the county are using to enable better care for residents and improve the patient experience.

Our client’s ambition

In May 2015, eight health and care providers across Dorset formed a partnership to develop the Dorset Care Record (DCR); an integrated data-sharing platform and portal.

The partnership’s ambition for the DCR was to offer a centralised, complete source of patient data to regional NHS and social care organisations across the county, enabling better care for residents and improving the patient experience.

The initial partner organisations were The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust (RBCH), NHS Dorset Clinical Commissioning Group, Dorset County Hospital NHS Foundation Trust, Dorset County Council, Poole Borough Council, Bournemouth Borough Council, Dorset Health Care University NHS Foundation Trust and Poole Hospital NHS Foundation Trust (PHFT).

The challenge

After two years of implementation work, the DCR programme was struggling to make progress at the required pace and had run into technical and operational barriers it couldn’t break through. In short, the programme was stuck. The Dorset team selected Channel 3 as their partner to get the programme back on track because of our experience in successfully designing and implementing complex integrated care record initiatives across the UK.

“This highly complex programme was struggling to make progress as a result of a multitude of issues. It was becoming difficult to see the wood from the trees.”

Peter Gill, Director of Informatics at RBCH and PHFT

They asked us to help them assess the cause of delivery challenges and recommend changes to address them, including:

What we did

The first step in getting the programme back on track was to undertake a programme review. The review identified that the governance structure was not supporting the needs of the programme’s delivery and that a lack of escalation processes was causing significant delays.

The review also highlighted a lack of effective decision making, which was creating challenges in relationships across the partnership and with the programme’s technology supplier. Additionally, the programme urgently needed to address challenges with recruitment, planning and the provision of the central operational support it needed to succeed.

Following the review, Channel 3 worked with DCR to address these challenges, starting with the design of a new governance structure that would enable the implementation pace to accelerate.

The new governance structure introduced clear processes for the cross-partnership working group and the partnership’s work with its technology supplier. It also provided Dorset’s programme leadership team with a clear understanding of the steps it needed to take to minimise further delays and meet their ambitious delivery timescales.

To help Dorset embed the new governance processes and accelerate technical and clinical change delivery, Channel 3 then provided resources to work alongside the client in key PMO roles, creating a blended team of skilled senior managers, programme leads and subject matter experts. The joint approach with Channel 3 improved leadership, planning and communication among the programme working group and with the technical supplier, helping everyone look ahead and achieve the successful roll-out of multiple tranches of DCR functionality at pace.

Our impact

With stakeholders across the programme working collaboratively, the programme had firmly shifted from recovery to reset mode. The partnership had a governance blueprint to take forward and was ready to restart the implementation confidently.

As the structured implementation of the DCR continued across Dorset, the number of health and care professional accessing the shared record grew rapidly. In just 7 months, the number of logins rose by 211%, the number of records accessed grew by 429%, and the information types available on the platform increased 57% (with a clear pathway to increase this to 143%).

With an average of 10,000 records now being accessed and updated monthly, the DCR is making substantial improvements to the quality of patient information available to health and care professionals in Dorset. More importantly, this shared record functionality and the quality of data it provides is literally saving lives.

Saving lives through integrated care

A man in Dorset with complex learning difficulties, a history of alcohol dependency and a form of psychosis often presented himself to hospitals saying he had something in his heart or that something was trying to get out of his stomach.

When clinicians noticed that he exhibited very high cholesterol levels, they added this information to his Summary Care Record – which feeds into the Dorset Care Record – and gave instructions he should be physically examined before being discharged if he presented himself again at hospital.

The man presented at Dorset County Hospital and the first consultant, who did not have access to the DCR, referred him to a psychiatrist on mental health grounds. A second consultant looked on his DCR, saw the note about cholesterol and requested tests that showed the patient had suffered a heart attack. Appropriate cardiac treatment was provided, and the man’s life was saved directly as a result of the DCR.

The expertise Channel 3 has brought to our programme has been second to none. It has transcended our previous arrangements and enabled us to significantly accelerate our delivery. Their highly skilled team brought exactly the right blend of ‘grip’, challenge and support to our programme.

Peter Gill, Director of Informatics
The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust and Poole NHS Foundation Trust

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