Several Manchester health and social care providers are live with an integrated care record for ‘at risk’ patients using Graphnet’s CareCentric.

Central Manchester, North Manchester and South Manchester clinical commissioning groups have worked with Manchester City Council to bring together key information from health and social care provider systems into a single care record accessible by relevant care professionals.

After a successful pilot, GP practices in the area are able to use these records to develop care plans for patients who are identified as being at risk of unscheduled or unplanned care.

Care plans can be shared and accessed by other professionals, including community nurses, social workers and community mental health workers.

At this stage, data is available from 90 GP practices in the region, Manchester City Council’s social services department, Central Manchester University Hospitals NHS Foundation Trust, Pennine Acute Hospitals NHS Trust and University Hospitals of South Manchester Foundation Trust 

According to Graphnet, just under 6,000 care plans have been created by GPs in the city so far and there are around 900 registered users of the system.

Ed Dyson, project sponsor and assistant chief officer, Central Manchester CCG, told Digital Health News that GPs in Manchester will soon be able to access CareCentric from within their Emis primary care system in order to view and update a patient’s integrated record. This will be in place in the next few weeks.

Other professionals are able to access the integrated record directly via Graphnet, although there are plans in place to link the service to other IT systems in use.

The integrated record includes live information from the three trusts, which will provide summarised information on acute inpatient, outpatient and A&E attendances, discharges and future appointments and pathology results.

The social care feed from Manchester City Council provides details of current and recent social care interactions, as well as planned services.

It is hoped that by sharing information in this way the Manchester healthcare community will be able to improve the discharge process and make sure patients are supported successfully in the community.

Although in its early stages the project is already demonstrating results with an analysis of the pilot showing an 8% reduction in overall hospital activity (9% in costs) for patients on the programme.

A&E attendances and emergency admissions are down 19% and 15%, with financial savings of 17% in A&E attendance costs, although the partners were keen to stress that these are very early results.

Dyson told Digital Health News that sharing a care plan in this way can “improve care massively” and he hopes to see 8,000 to 9,000 people on the programme.

He said that there local agreements in place between providers to share data appropriately and that patients are only added to the programme provided they give consent.

Of the 6,000 people asked to go on the programme, only one had refused to give consent and this was because of their poor relationship with their GP rather than any problems with the principle of information sharing.

“I think that is a strong message to the health service,” said Dyson.

The project is set to expand further to include information from both Manchester Mental Health and Social Care Trust and North West Ambulance Service later in the year.