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]
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