Background

Covid-19 mass testing results volumes, which flow to Keystone and on to GP systems, will significantly increase as there will be a scale up in testing.

The current platform was originally built on an existing pathology results flow that is not designed for

mass testing volumes

. The Covid-19 results flow is expected to increase to around 10 million

records a day, possibly higher at exceptional periods, from February 2021.

Lord Bethell has requested the inclusion of all Patient test result data in the Patient record.

Currently, filtered data, e.g. LFT negative results, is being sent to GP systems

to mitigate high volumes of test data in Keystone and the GP systems.

Outline Plan

Two options have been identified that will provide GPs and Healthcare Professionals with test result data, however, only one of these meets Lord Bethell’s preference of populating the Patient record with all test result history.

• Option 1: Provide an API that GPs and Healthcare Professionals can use to retrieve data from the Results Service datastore as and when required

The data pull will allow for the retrieval of all related (i.e. non-filtered) Covid-19 test result data.

Outline Plan

TBC

• .
• Option 2: All Covid-19 Test Result Data to be sent automatically to Keystone and GP Systems.

Both options are to be impact assessed before being presented for a decision to be made on which option(s) are to be implemented.

Summary of Change

Option 1:

Two new API’s to be introduced for use by each of the GP Systems to filtered and non-filtered test result data from the Results Service datastore.

Only the current filtered data would continue to be sent to Keystone.

The exact nature of the details to be retrieved are

TBC for each of the 2 API use cases

.

• API 1 - Latest test result for Patient identified by NHS number
• API 2 - All

• test results for Patient identified by NHS number

It is at the GP System provider’s discretion how the user interface will work best in their system e.g. real-time access to the results in a consultation or download the results via the API in advance and/or store the data locally.

Assumptions:

• It is assumed that the authentication will be by Smartcard and the relationship is established in the local system before accessing the results data.
• It is assumed that if the data is downloaded by a GP system and inserted into the record, then the GP systems providers would do this in a way that triggers a GP upload in SCR.
• It is assumed that GP Practices being migrated from Evolution to the other GP System providers will be captured within the new provider’s scope.

Option 2:

All test results (circa 10 million per day) would be pushed into Keystone and then on to GP Systems. Filtering of data to Keystone would be disabled.

The inclusion of auto-filing should be considered to reduce GP/Clinician administration.

The user interfaces may need to be modified to present large volumes of results in a more concise manner.

Assumptions:

• It is assumed that the GP systems providers should assume that other services such as MESH, SCR etc will scale appropriately.
• It is assumed that the test results will flow to SCR subject to the current rule, but that LFDs will flow to GP systems.
• It is assumed that GP Practices being migrated from Evolution to the other GP System providers will be captured within the new provider’s scope.

As a GP / Healthcare Professional

I want to see the most recent Covid-19 Test result for a Patient identified by their NHS Number

So that I can deliver appropriate clinical care using a dataset that provides the latest Covid-19 testing history for that Patient.

This will also support visibility of a longitudinal record of Covid-19 testing activity for Healthcare Professionals to view and provide ongoing clinical care, particularly in the context of long Covid-19.

As a GP / Healthcare Professional

I want to see all historic Covid-19 test results for a Patient identified by their NHS number

So that I can deliver appropriate clinical care using a dataset that provides full Covid-19 testing history for that Patient.

This will also support visibility of a longitudinal record of Covid-19 testing activity for Healthcare Professionals to view and provide ongoing clinical care, particularly in the context of long Covid-19.

Full Specification

A draft requirements specification has been shared with GP IT Futures, Supplier Managers and GP System providers.

A technical specification is being developed and will be shared with the same audience in due course.

Assurance Approach

TBCNHS Digital and suppliers will undertake functional and non-functional assurance of the agreed solution(s) to ensure Healthcare Professionals can retrieve Covid-19 Test result data from the GP systems.