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NHS Digital develops online patient record ‘flag’


Mark Say Managing Editor

NHS Digital has developed a ‘flag’ for patient records to alert medical staff of when a patient has a disability or impairment.

Red flag

Named the Reasonable Adjustment Flag, it can make them aware special communication requirements, such as how to be contacted for appointments or changes to the environment such as using music to reduce anxiety.

NHS Digital highlighted its potential for improving the treatment of patients with learning disabilities, but added that it could be used more widely.

It has published the results of pilots that took place in GP surgeries, hospitals and community services in Gloucestershire and Devon between June 2019 and March of this year.

More than 70 flags were created by clinicians with patients and carers, identifying the need for a range of adjustments. The relevant information was created securely and provided to the summary care record application on the NHS Spine.

The flag uses a bespoke code to highlight an adjustment, details of which are recorded in free text.

Feedback has been positive and further development and testing is taking place, with the aim of making the capability more widely available from the end of the year. Developments include work on an API based on the Fast Healthcare Interoperability Resources (FHIR) standard, aimed at making it possible to integrate the flag into clinical systems.

Well structured and simple

Dr Rob Jeeves, GP clinical lead for the project, said: “The feedback from this pilot shows that the process to create and share reasonable adjustment information through the flag is well structured, simple and quick to follow.

“Patients, families and their carers were involved in discussions about the patient’s needs and adjustments to care. The initiative was warmly received, with enthusiasm for the benefits arising from the wider sharing of this key information.

“The initiative also promoted collaboration between colleagues and across organisations as to how best to record well formed reasonable adjustments on the flag and in local records.

“With further evaluation and wider use, we will be able to explore the benefits when a patient with learning disabilities accesses healthcare and sees a particular clinician for the first time. We hope having a Reasonable Adjustment Flag will mean the patient has a better experience of care, with their needs being addressed earlier and more consistently.”

NHS Digital said the flag could provide other benefits such as financial savings through reducing the number of missed appointments.

Image by Andy Wright, CC BY 2.0

Detail on code and API added on 19 June on availability of further information.

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