Making the right information available to health and care professionals at the right time can save lives and improve care. For example, giving professionals access to a single, shared care record allows them to understand your needs and make the best decisions with you and for you. As well as providing individual care, shared information can help to provide the best possible health and well-being outcomes for our communities, and reduce health inequalities.
The work of OneLondon supports this vision of joined-up care. We continue to work closely with Londoners to implement this vision in a way that meets public expectations. This includes how we join-up personal information to support individual care, and using non-identifiable information to help plan and improve services, and support research and innovation.
The work of OneLondon is part of a wider ambition for London to be the healthiest global city, and the best global city in which to receive health and care services.
This OneLondon collaborative is supported by NHS England (London region), the Greater London Authority, and London's three Academic Health Science Networks (AHSNs).
The five Integrated Care Systems (ICSs) are:
London was awarded Local Health and Care Record Exemplar (LHCRE) status in May 2018, after its five health and care partnerships came together to invest in the transformation of London’s health and care services by joining up information to support fast, safe effective care. With funding committed by NHS England over three years, matched with local contributions, the OneLondon LHCRE programme was born.
In line with national LHCRE delivery milestones, the OneLondon LHCRE focussed on three deliverables:
- Level 1: London Care Record - joining-up information for direct care Giving health and care professionals across London a view-only mechanism to see a joined-up picture of a persons’ health and care information, available at the point of care
- Level 2: London Data Services Layer - joining-up information for secondary purposes Using non-identifiable information to support planning, improvement, and research
- Level 3: Personal health records Enabling patients to access and contribute to their health and care information
This has been driven by the expectations of Londoners, including recommendations made by the public as part of a large-scale deliberation on the uses of health and care data.
Since being awarded Exemplar status, OneLondon has successfully demonstrated the safe and secure join-up of health and care information from over time and across organisations and geographies in London.
On 1 April 2021, OneLondon transitioned from an Exemplar to a sustainable component of London’s health and care landscape, with local funding committed. OneLondon is continuing to support the five health and care partnerships to deliver integrated care, and to accelerate the delivery of population health outcomes - supporting the best possible health and wellbeing outcomes for our communities, and reducing health inequalities.
Integrated care is about giving people the support they need, joined up across local councils, the NHS, and other partners. It removes traditional divisions between, for example, hospitals and family doctors, physical and mental health, and the services of NHS providers and local authorities. In the past, these divisions have meant that too many people experienced disjoined care.
The continuing work of OneLondon is delivering benefits for London’s health and care system and - most importantly - for Londoners.
- Strategic benefits: reducing cost of consumables and overheads. E.g. reduced duplicative imaging and pathology investigations, allowing organisations to save on costs
- Clinical care benefits: reducing Length of Stay of complex patients or ensuring that patients receive personalised treatment
- Population health benefits: identifying gaps in care and targeting interventions at high-risk patients when appropriate
- Service improvement benefits: reducing the proportion of ambulance 999 calls that result in avoidable redirection to an A&E department, or reducing non-elective admissions
- Research benefits: creation of dashboards that enable live research using anonymised or de-personalised (non-identifiable) data
OneLondon has worked closely with Londoners as part of a large-scale public engagement programme to understand their expectations for how data should be joined-up and used for multiple purposes.
This Conversation with Londoners included the world’s largest public deliberation on uses of health and care data, where 100 people (reflective of London’s diverse population) came together to form detailed recommendations and conditions.
The outputs of this citizens’ summit are now being used to shape policy for London, to ensure that the system is operating in line with public expectations.
The recommendations set out by Londoners involved in the citizens’ summit means that, for the first time, there is clear instruction from the public to policymakers and health and care leaders as to how data should be used in a way that builds trust and confidence. This also offers clarity and direction to health and care professionals and frontline staff.
These local initiatives are better known as:
- Connecting your Care (South West London ICS)
- Health and Care Information Exchange (North West London ICS)
- Health Information Exchange (North Central London ICS)
- East London Patient Record (eLPR) (North East London ICS)
- Connect Care (South East London ICS)
Where these initiatives are sharing information at a local level, OneLondon is supporting pan-London join-up of this data to support fast, safe, effective care. This means that local care teams can see relevant information about a person that is held by organisations in any of the other ICS geographies.
So if someone from Hackney (North East London) turned up at the A&E in Croydon (South West London), care teams can access the information they need to treat that person quickly and safely. This could include any allergies, current medications, and existing long-term conditions.
This pan-London shared care record - or London Care Record - can be accessed by health and care professionals across London in their native electronic health record system.
The London Care Record currently covers a population of 7.5 million Londoners. Acute and primary care services across four of London’s five ICS geographies are connected to the London care Record, in addition to some mental health, community care, NHS 111 and social care services. This includes North East London, South East London, South West London, and North Central London. Work continues to connect North West London.
Access to the London Care Record is monitored and logged to make sure access to it is lawful, secure, and fair. Your care teams can monitor access logs, identify any inappropriate access, provide copies of information, and reassure you with support from data-protection departments.
Your personal health and care information cannot be accessed for any purpose beyond your care and treatment unless you agree otherwise.
- This means that health and care professionals can access your information to support your direct care
- Systems are auditable, so it’s possible to see who has accessed your information and when
- We are using trusted health data environments when joining-up data for service planning and research to ensure that it is safe, secure, and can’t be accessed for unauthorised use
- Applications for using data in this way are approved via local governance arrangements and processes that involve the public and data controllers
- This is enabled by the London Data Sharing Framework which provides a ‘gold standard’ for what local health and care organisations should be doing
- The five ICSs and London Ambulance Service are working together as a OneLondon collaborative to ensure this consistency
- Control of health and care data remains with individual local health and care providers
Equally importantly, here’s what we’re not doing with your health and care data:1. We are not sharing your personal (identifiable) health and care data for anything other than to support your direct care
- There are examples where we use personal data to support your direct care by conducting analysis to support your care. This is sometimes referred to as ‘proactive care’ and can support effective intervention (for example, notifying somebody about their flu jab, or cervical screening)
- Instead, we are charging for services to support the research based on a robust application process involving local data controllers and citizens. This could include providing access to the data in a trusted health data environment for a defined period of time and for a specific, agreed purpose
Find out more or contact your local health and care partnership:
- Sets out the purpose and principles (the ‘why’) for the join-up and use of health and care information in London
- Sets out the information governance (IG) processes in place to support safe-secure join-up of information across London
- Includes examples of the types of data that will be shared
- Provides detail of the lawful basis for data sharing
- Details who has access to the data and the safeguards in place to protect it
- Run the health service
- Manage epidemics
- Plan for the future
- Research health conditions, diseases, and treatments