Manual DOS searching including
Z codes and Mobile DOS
Andy Rees – Head of Service and Programme Delivery
Louise Doogan – Implementation Manager
Greg Thomas – Implementation Manager
Ian Smith – Head of Development
Copyright © 2014 Health and Social Care Information Centre
Agenda
• Manual DOS Searching by Call Handlers
• Z codes
• Mobile DOS
Integrated vs Manual DOS
• Integrated DOS
At the end of a Pathways Triage the Host System
automatically links to DOS and returns a list of services
• Manual DOS
The call handler/clinician opens a web browser to access
the DOS. Call Handlers then perform a service search
based on;
• service name
• location (postcode, town, city or region) along with the
service type and opening hours
Clinicians can perform a clinical search based on z codes.
Call Handler and DOS Returns
Sub Group
• Formed following the DOS workshop at the January 2014
National Partnership Forum when queries were raised
about Manual DOS searching
• Includes representatives from Providers and DOS leads
• The aim is to agree the reasons for the acceptable use of
manual DOS, based on real life examples
• A draft paper has been reviewed by the sub group to form
the basis of an action plan to address inappropriate uses
of manual DoS and to provide policy guidelines for
Commissioners, Providers & DoS Leads
Why is the Manual DOS used?
• The data quality of services in some team types is poor
and the DoS Leads have limited power/ resource to sort
this out
• The complexity of the commissioning landscape and the
ability of DoS to accurately reflect this
• Inappropriate services returned for cross border/out of
area calls
• The need to find a service that is open at the time of the
call rather than at a later point within the Disposition
timeframe
Reasons given for current use
of Manual DOS
• To find a service that is open at the time of the call.
• Unsuccessful look ups – If a clinician overrides a
disposition an invalid SG/SD combination will be created
• The DOS returns are not based on where the patient is
currently located
• The services that return are not one of the nearest for the
patient
• Dental calls as it’s not clear if the service will accept new
patients
• Invalid postcodes (invalid parameters)
Pilot to quantify Manual DoS
usage
SWASFT are running a pilot that:a) Limits manual DoS searching to clinical staff only in a
specific hub
b) Staff wanting to manually search DoS raise a card
and the DoS lead will support them to understand the
issue and log the reason.
c) If limiting manual DoS searching to clinical staff only
does not materially affect call lengths, the pilot will be
extended to all staff.
d) This analysis of why DoS is being manually searched
will be shared.
Enhancements to reduce the
use of Manual DOS (1)
We have already made a couple of changes that should
reduce the need to use the standalone DOS;
• The NHS Pathways call handler and clinician training
includes an updated DOS training session
• Release 8 includes an improvement to the way clinician
overrides are handled
Enhancements to reduce the
use of Manual DOS (2)
The following strategic enhancements are in the
development pipeline, dependent upon resource availability;
• The ability for in certain circumstances more services in a
team type to return for a call handler, possibly through a
‘more’ button
• A change to the ranking strategy to work on the patient’s
postcode so that appropriate services return
• A change to the current DOS search functionality to use
the actual travelling distance for the patient rather than as
the crow flies.
Providers Acceptable Use of Manual DOS
Document – Next Steps
• Final review by the Call Handlers and DOS Returns Sub
Group
• Wider circulation to Regional DoS Leads, Providers and
NHS 111 team to feedback on document
• Final document, with policy guidelines, issued to
Providers and Commissioners
Z Codes
Background
• The ‘other’ clinical content in DoS,
available in DoS for many years.
• Used to capture skills, capabilities
and service types.
• Searched by GPs, paramedics,
discharge planning teams, social
care teams…
• Grouped in a similar way to SG/SDs.
Profiling
• Designed to enable a wide ranging clinical profile to be
captured for all health and social care services.
• Aligned to SNOMED preferred terms – including
synonyms.
• Services should tick anything that they do at any level.
• Templates can be created and shared
Searching
• Does not change referral policy or protocol.
• To be used by Clinician (or user directly supervised by a
clinician).
• Could be direct search or phoning a SPoA or Support
Desk function.
• Use own clinical and local knowledge to choose from the
options presented.
Searching in practice
1. Front-end of the DoS System.
2. The MobileDoS website (currently in prototyping phase).
3. Third-party application (E.g. MiDoS).
Management of Content
•
Z Codes sub group – DoS Leads / User Orgs.
•
Quarterly Updates.
•
Simple feedback process – via DoS Leads.
•
Anticipate adding new content based on evidence as
usage increases nationally.
•
Expect to retire codes which aren’t profiled/searched for.
Z Codes : Key Points for discussion
•
Value of content (within a DoS setting)
•
Profiling and maintenance – does this sit well within the
existing DoS Leads role?
•
Do people understand the ‘relaxed’ governance around
profiling Z Codes?
•
Do people already have plans in place for deployment
and use?
Mobile DoS
Tablet Demonstration
Contact us
For further information about NHS Pathways visit
www.hscic.gov.uk/pathways
Twitter @nhspathways
Email: [email protected]