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Clinical Digital Resource Collaborative

Clinical Digital Resource Collaborative

Designed and developed in the North East and North Cumbria by local GPs

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You are here: Home / Resources / SystmOne Resource Centre / SystmOne Administration

SystmOne Administration

This page includes guides and information on Data Sharing, Referral Management, Online Services and Safety Netting.

Data Sharing

The CDRC has a module to help professionals and patients understand and control how their personal data is shared. 

Set-up

The Data Sharing information can be opened from the CDRC Index. 

Alternatively, place a link to the Data Sharing template in your clinical tree or toolbar.

Vaccination 
Vaccim 
Rotavir Influem„ Pneuny 
s 
Shingle n 
Medicines Management 
LESDES 
INR LES Minor S 
care Pin 
Drugs 
Administration 
Data S ,
Data Sharing Template

Home Page

The Data Sharing home page provides a quick overview of the patient’s current sharing preferences  

The drop-down boxes can be used to amend or update the preferences quickly and easily 

Homel Share SCR 
Data Sharing 
Local Data (MIG) 
Specified 3rd partf 2nd Data use NHS Digital 
Direct Care Sharing 
NOA 
Resource 
systmone Share (EDSM) 
Current SystmOne shares are shown here 
Click the Record Sharing button to amend the preferences 
The EDSM settings also control sharing via the MIG 
More Info EDSM 
Record Sharing 
Summary Care Record 
More Info MIG 
SystmOne Sharing 
Outgoing Record Sharing Implicitly Consented 
Incoming Record Sharing Implicitly Consented 
Two-way data sharing with Adult- Derwentside West (care started 15 Apr 201 6) 
SCR Core data is shared (implied consent) 
SCR Additonal data not shared - no record of SCR preference 
Default is to share core SCR and not share additional SCR dataset 
More Info 
Change SCR Consent 
use this section to record consent withdrawal of consent to share with 
specified 3rd parties relatives and carers 
More Info 
7 Jan 2017 
Consent given to share patient data with specified 3rd party CXaNwR) 
Indirect Use ot Data 
In certain circumstances patient data can be used for indirect purposes 
Examples might include research: education and training 
Secondary Data Use 
Data collected by NHS Dlgital to improve NHS care and help with planning 
Default is to share 
NHS Digital Data Sharing 
Data collected by NHS Dlgital to improve NHS diabetes care 
Default is for the organisation not to share 
If the organisation shares: individuals can opt-out 
National Diabetes Audi 
Secondary Use of Data 
NHS Digital Data Sharing 
DCS National Diabetes Consent has no data for patient

Specific Share Pages

Each type of share has a specific page where more detailed information can be found as well as relevant hyperlinks and the ability to print or email specific information for patients. 

SystmOne Share

The SystmOne share page shows the current preferences for SystmOne to SystmOne shares – known as the EDSM model. 

Sl Sharel SCR Local Data (MIG) 
SystmOne EDSM Share 
Current SystmOne shares are shown her4 
Specified 3rd partf 
2nd Data use 
NHS Digital 
I esl 
NOA Resourc 
Click the Record Sharing button to amend the preferences 
The Sl EDSM share also controls data sharing via the MIG 
A patient opting out of MIG will also opt out of local community shares 
Record Sharing 
0 
Launch SI EDSM Patient Info 
Guide for professionals 
SystmOne Sharing 
Outgoing Record Sharing Implicitly Consented 
Incoming Record Sharing Implicitly Consented 
wo-way data sharing with Community Rehabilitation Derwentside (care started 10 0 
Two-way data sharing with Nutrition and Dietetics (care started 22 May 201 4) 
wo-way data sharing with COD Diabetes Service (care started 25 Feb 201 6) 
Two-way data sharing with County Durham And Darlington EPR Core (care started CL 
Two-way data sharing with Podiatry Adults (care started 02 Mar 201 6)

Summary Care Record

The Summary Care record share page shows the current preferences for SCR sharing with information about the core SCR and the ‘SCR with additional information’ 

Specified 3rd partf 
2nd Data use 
NHS Digital 
NOA 
Summary Care Record 
Core Summary Care Record Information 
Information shared in the core SCR is limited to demographics: medication and adverse reactions 
The core SCR will be shared unless the patient has opted out 
Info for GPs can be found here, 
Newly registered patients should be given the letter found at the link below 
Change SCR Consent 
0 
PrintyEmaiI SCR Patient Info 
Summary Care Record With Additional Information 
The information shared in the additional SCR i. 
Significant medical history 
Reason for medication 
Anticipatory care information 
Communication preferences 
End of life care information 
Immunisations 
SCR Information Letterfor new patier 
Resource 
SCR Core Data is Shared (implied consent) 
SCR Additonal data not shared - no record of preference being 
Most of this information is shared via a long list of Read codes and associated text 
Some codes are excluded. 
Other Read codes can be manually added to the SCR 
Further Info for GPs can be found here. 
The additional SCR will NOT be shared unless the patient has opted im 
Change SCR Consent 
0 
PrintyEmaiI SCR (Addtional info) Patient Info

Local Data Sharing

Local Data Sharing (MIG) page shows any relevant Read codes for consent or dissent for local data sharing.   

me 1 Share SC Local Data (MIG) I Specified 3rd partf 2nd Data use NHS Digital 
Local Data (MIG) 
No data will be shared with the MIG until the practice has joined the MIG by agreeing to a data 
sharing agreement on the Information Sharing Gateway (ISG) 
Once the practice has joined the MIG: patient data will be shared to the MIG depending on the 
patient's SystmOne EDSM settings (see second tab on this template) 
The MIG data includes 
Patient summary 
Problem. 
Diagnoses (Read codes and free text) 
Medication (current past and issuesX 
Risk and warnings 
Procedure. 
Investigations 
Blood pressure measurements 
Encounters: admissions and referrals 
Patient demographics 
Info for GPs can be found here, 
NB To opt-out of the MIG the patient will also need to opt-out of all SystmOne sharing 
NOA 
Resourc 
SystmOne Sharing 
Outgoing Record Sharing Implicitly Consented 
Incoming Record Sharing Implicitly Consented 
wo-way data sharing with Community Rehabilitation Derwentsid. 
Two-way data sharing with Nutrition and Dietetics (care started 22 
wo-way data sharing with COD Diabetes Service (care started 25 
Two-way data sharing with County Durham And Darlington EPR Cm 
wo-way data sharing with Podiatry Adults (care started 02 Mar 201

Third Party Share

The Specific Third Party Sharing page shows any Read codes related to consent or withdrawal of consent to share information with a third party. 

Home Sl Share SCR Local Data Specified 3rd partf 2nd Data use NHS Digitall NOAI 
Specific Third Party Sharing 
use this page to view and record patient wishes about sharing data with specified third parties 
such as relatives and carers 
It is preferable for the latest entry to show the full list of people with whom a share has been 
Consent to share information with third party 
14 Dec 2015 Consent given to share patient data with specified 
Notes 
Consents to disclosure of information to her 
husband John 
grantel 
Local Data Sharing 
Consent given to share patient data wth specified 3rd party (XaNwR) 
Consent wthdrawn to share pt data wth specified 3rd party (XaNw 
Declined consent to share pt data wth specified 3rd party (XaNwT)

Secondary use of Data

The Secondary Use of Data page shows any Read codes related to the patient’s wishes regarding secondary use of their personal data. 

ome Sl Share SCR Local Data specified 3rd 2nd Data usel NHS Digitall NOAI 
Secondary Use Of Data 
If data is extracted from a patient record for use that is not directly related to their medical care this 
is termed secondary use of the data 
In most circumstances: explicit consent should be sought for this release of data 
In some circumstances: such data can be released: without consent in the public interest when It 
Secondary Use of Data 
is not practicable to obtain explicit consent and anonymised data will not fulfil the purpose of the 
data releas4 
Such public interests might include research or educatiom These decisions will usually have gone 
through an ethics committe4 
The Read codes in this section can be used to record those patients who explicitly dissented to 
their data being used for secondary use purposes 
Secondary Use of Data 
Dissent from secondary use of GP patient identifiable data (XaZ8g) 
Dissent wthdrawn second use of GP patient identifiable data (XaZ8A)

NHS Digital Signature

The NHS Digital Share page shows any information relating to the patient’s wishes to withhold information from NHS Digital 

Home Sl Share SCR Local Data Specified 3rd partf 2nd Data usel NHS Digitall 
NHS Digital Sharing 
NHS Digital (formerly HSCIC) has the legal right to extract identifiable data (usually using the NHS 
number as the patient identifier) under the Health and Social Care Act They are allowed to use 
this data to help plan and improve the health servic4 
Such data will be shared unless the patient opts-out of the process (called a type 1 opt-out) 
Patients can also opt out of NHS Digital obtaining their data from any medical source called a type 
2 opt-out 
More information about this subject can be found here, 
NHS Digital Data Sharing 
NHS Digtal Sharing 
Dissent from disclosure of personal confidential data HSCIC (XaaVL) 
Dissent wthdrawn disclosure personal confidential dta HSCIC (Xam„ 
0 
Launch NHS Digtal Data Sharing Patient Info

National Diabetes Audit

The National Diabetes Audit page shows any Read codes relating to the patient’s preferences for allowing their data to be extracted for the NDA 

National Diabetes Audit 
The NOA collects identifiable information about patients with diabetes in order to try and improve 
diabetes car4 
No data is collected unless the practice opts-in to data 
If the practice has opted-in: individual patients can opt-out using the Read code in the radio box 
National Diabetes Audit Consent 
below 
What does it measure? 
The NOA answers four key questions based on the diabetes National Service Framework (NSF) 
Is everyone with diabetes diagnosed and recorded on a practice diabetes register? 
What percentage of people registered with diabetes received the nine National Institute of Health 
and Care Excellence (NICE) key processes of diabetes care? 
What percentage of people registered with diabetes achieved NICE defined treatment targets for 
glucose control: blood pressure and blood cholesterol? 
For people with registered diabetes what are the rates of acute and long term complications 
(disease outcomes)? 
Info for GPs can be found here. 
National Diabetes Audt 
Informed consent for diabetes national audt (XaJrD) 
Informed dissent for diabetes national audt (XaJrE) 
0 
Launch National Diabetes Audi Patient Info 
O NIDA FAQs
Data Sharing Patient Reports

A series of reports identifies patients who have opted out of: 

  • EDSM SystmOne sharing 
  • Local Data Sharing – MIG 
  • NHS Digital data extraction
  • National Diabetes Audit 

Opted in to:

  • Summary Care Record with additional information 
Data Sharing 
Name 
Count 
EDSM - SystmOne Sharing Out- Dissent 
Local Data Sharing - opted out 
200% 
National Diabetes Audit sharing 
000% 
NHS Digital sharing - opted out 
SCR Additional Consent 
opted out 
SCR Core Consent (explicit or implicit) 
SCR core Dissent 
68 
127 
5686 
85 
12% 
ga3% 
Last Run 
27 Nov 2016 231g 
27 Nov 2016 22:33 
27 Nov 2016 23:18 
27 Nov 2016 23:13 
27 Nov 2016 22:22 
27 Nov 2016 08:20 
27 Nov 2016 08:20 
Flags

External Resources

Useful Links
ICO websitehttps://ico.org.uk/ 
Confidentiality Guidelines ———————————————————————
NHS Digital Guide to  Confidentiality in Health and Social Care http://content.digital.nhs.uk/media/12823/Confidentiality-guide-References/pdf/confidentiality-guide-references.pdf 
DoH Confidentiality NHS Code of Practice 2003 https://elearning.nsahealth.org.uk/pluginfile.php/301049/mod_scorm/sfhrepository/1174/downloads/dh-confidentiality-nhs-code-of-practice.pdf 
GDPR———————————————————————
Regulationshttp://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32016R0679&qid=1490179745294&from=en 
12 initial steps https://ico.org.uk/media/1624219/preparing-for-the-gdpr-12-steps.pdf 
GDPR Checklist for data controllers https://ico.org.uk/for-organisations/resources-and-support/data-protection-self-assessment/data-controllers/ 
GDPR Checklist for data processors https://ico.org.uk/for-organisations/resources-and-support/data-protection-self-assessment/data-processors/ 
Data Sharing Guides ———————————————————————
ICO Guide to data sharing https://ico.org.uk/for-organisations/guide-to-data-protection/ 
ICO Data sharing code of practice https://ico.org.uk/media/for-organisations/documents/1068/data_sharing_code_of_practice.pdf 
IGA – sharing blueprint https://digital.nhs.uk/media/1325/Information-sharing-for-integrated-care-blueprint/pdf/Information_sharing_for_integrated_care_blueprint 
Data Privacy Impact Assessment ———————————————————————
ICO Privacy Impact Assessment Guidelines https://ico.org.uk/media/for-organisations/documents/1595/pia-code-of-practice.pdf 
Privacy Notices ———————————————————————
ICO – Privacy Notices https://ico.org.uk/for-organisations/guide-to-data-protection/privacy-notices-transparency-and-control/ 
Subject Access Requests ———————————————————————
ICO Checklist https://elearning.nsahealth.org.uk/pluginfile.php/301049/mod_scorm/sfhrepository/1174/downloads/foi-access-aware-checklist-health.pdf 
Freedom of Information ———————————————————————
ICO FOI Guidance https://ico.org.uk/for-organisations/guide-to-freedom-of-information/ 
ICO FOI Checklist https://elearning.nsahealth.org.uk/pluginfile.php/301049/mod_scorm/sfhrepository/1174/downloads/ico-flowchart_of_request_handling_under_foia.pdf 
Opt-outs ———————————————————————
Opt-outs – government review https://www.gov.uk/government/publications/review-of-data-security-consent-and-opt-outs 
Privacy Notices
ICO guidance on privacy notices https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/individual-rights/right-to-be-informed/?q=privacy+notices 
DPIA
ICO Checklist for DPIA https://ico.org.uk/for-organisations/guide-to-the-general-data-protection-regulation-gdpr/accountability-and-governance/data-protection-impact-assessments/ 

Referral Management

The CDRC provides referral management support through an expanding list of condition specific templates and protocols. 

VBCC

CDRC provides the infrastructure to support implementation of the North East and Cumbria Value Based Commissioning Scheme. 

Conditions covered by the VBCC policy are integrated into the clinical support templates. Some examples are provided below. 

The CDRC allows clinicians to find VBCC rules and criteria quickly and easily without needing to login to a website.  It also allows capture of the appropriate information needed for IFR and PAT referrals within S1 so they can be transcribed to the IFR or PAT websites by an administrator. 

Example Templates 

Home Asymmetry Augmentation Implants Mastopeky Nipple Inversion 
Non-Cancer Breast Surgery 
None of the policies below apply to patients having breast 
surgery as part of or following breast cancer treatment 
Asymmetry - not routinely funded 
Augmentation - not routinely funded 
Implant Removal - specific criteria 
Mastopexy - not routinely funded 
Nipple Inversion - not routinely funded 
Reduction - specific criteria 
Gyanecomastia - specific criteria 
Reduction

The non-cancer breast surgery template provides a quick overview of the available procedures and there funding status. 

81 
ome Asymmetry Augmentation Implants Mastopeky Nipple Inversion Reduction Page 
Breast Asymmetry 
CSI- Non-cancer Breast Sura 
Not routinely funded There are no specific criteria under which this procedure is funded 
Any referral must be accompanied by a PAT which documents the exceptional circumstance 
IFR Criteria- Breast Asvmmetn 
PAT Non-specifyci

Each page of the template describes in more detail the criteria with links to the IFR website to view the current ‘official’ guidance.  There is also a link to open a questionnaire to collect the information required to apply for a Prior Approval Ticket which can be transcribed by an administrator onto the IFR website, saving large amounts of clinician time and frustration. 

Referral with no specific criteria 
Procedure Requested 
Reason funding is being requested - as much detail as possible 
Detail all approved alternative treatments that have been tried and failed 
Patients' clinical history relevant to the requested treatment 
Detail any exceptional circumstances (only needed if patient does not meet the criteria above) 
Are there any other costs associated with this request outside the actual cost of treatment? (please provide details) 
Are you attaching a letter of support from a local consultant 
Yes 
Is the referral urgent? (life threatening request which requires a decision to be made within 1 week of receipt) 
Yes 
Has the patient been informed that their data will be shared with the IFR team at NECS? 
Yes 
Next Section
ome Asymmetry 
Implants 
Diagnosis 
Augmentatio 
Implants I 
Mastopeky 
1 81 
Nipple Inversion Reduction Page 
CSI- Breast Prosthesis Removal andjor replacement 
Background breast prosthesis may nave to be removed after some complications such as leakage ot silicone gel or physical intolerance 
This policy does not apply to breast reconstruction as part ot the treatment tor breast cancer 
Removal ot breast implants tor any ot the following in patients who nave undergone cosmetic augmentation mammoplasty that was performed either in 
the NHS or privately will be funded tor the following indications 
•Breast disease 
•Implants complicated by recurrent infections 
•Implants witn capsule formation that is associated witn severe pain 
•Implants witn capsule information that interferes witn mammography 
•Intra or extra-capsular rupture ot silicone gel tilled implants 
Surgery tor primarily cosmetic reasons is not eligible tor NHS funding 
IFR Criteria Implant RemovaljReplacement 
PAT Breast Prosthesis Removalfieplacement

For conditions with specific criteria, these are displayed on the template and included in the PAT questionnaire. If the specific criteria are satisfied, you will only need to complete the first section of the questionnaire (Qs 1-5 in the example below). If the criteria are not satisfied, and you wish to apply for exceptional funding, you will need to complete the rest of the questionnaire. 

Breast Prosthesis Removal and/or Replacement Referral Questionnaire 
Yes to either question 1 : 2: 3 14 or 5 
Does the patient have breast disease? 
Yes 
Are the implants complicated by recurrent infections? 
Yes 
Do the implants have capsule formation that is associated with severe pain? 
Yes 
Do the implants have capsule formation that interferes with mammography? 
Yes 
Do the implants have intra or extra capsular rupture of silicone gel filled implants? 
Yes 
If the criteria above are satisfied, you can obtain a PAT using the VECC PAT checker without the information below 
If they are not satisfied you will need to collect further information below and make an individual funding request using the IFR website 
Reason funding is being requested - as much detail as possible 
Detail all approved alternative treatments that have been tried and failed 
Patients' clinical history relevant to the requested treatment 
Detail any exceptional circumstances (only needed if patient does not meet the criteria above)
Trigger Finger njectio 
Trigger Finger 
Management 
Rest- 20% will get better without treatment 
Splinting - works well in 30% and partly in 50% 
Injection - 60% better after one injection: 80% after two 
O CSI- 
Triaaer Finaer 
O Print PIL 
Options Grid 
Trigger Finger Treatment 
30 Jan 2017 
Inject trigger fingernhumb (XagjL) 
Often more than one injection is needed to yield improvement It is worth trying 2 
injections in primary care before referring if patient willing to try again after failure of first 
injectiom 
Launch Trigger Finger Injection 
Launch Ref Physiotherapy 
Launch Ref Tier 2 MSX Service 
Surgery for trigger finger will only be funded if 
• Co-morbidities associated with an increased risk of trigger finger rheumatoid arthritis or diabetes mellitus) and the 
patient's symptoms have not improved with at least 4 months of conservative treatment NSAlDs: splintage: 
physiotherapyX 
• Symptoms have not resolved despite at least one steroid injection in the last 4 months 
O IFR criteria 
PAT Trigger Finger

For some conditions covered by VBCC, other management options might be useful, either in primary care or alternative referral pathways. These options and guidance are displayed on the templates with links to appropriate: 

  • Websites to provide more detailed information for professionals 
  • Information for patients that can be printed or emailed 
  • Templates to deliver and record interventions in primary care – in this example, trigger finger injection. 
  • Alternative referral pathways – in this example physiotherapy and tier 2 services 

Relevant information from the patient’s record is also displayed – e.g., previous treatment, medication, Read codes. 

Navigating to VBCC Resources 

Templates covering VBCC conditions can be reached in a number of ways: 

  • From the CDRC Index in the clinical tree. Follow the links to the required specialty. 
core 
Common Templates 
Sick and Follow 
Patient Characteristics 
New Ethnicit 
Commu 
Clinical Specialties 
Sr east 
F amily 
Dermat„ 
Neurolo 
Urinaly 
Religion 
dl 
Diabete 
Ophthal 
Mir ena 
s 
Shingle 
C Ma 
Marta' 
Elderly 
Plastics 
Sr east 
Info for 
Car er 
Endocri 
Pysch 
Cervica 
Fever 
9 
Emplo y 
ENT 
Cardiol 
Fractur 
Cancer 
Muscul„, 
Sepsis 
Military 
Gastro 
46 
Respira„ 
Gynae 
Urology 
Haemat 
Vascular 
Paediatrics and Women's Heatth 
Paediat„ Fever Safegu 
Vaccination 
Vaccin 
Rotavir 
Influen 
Contra m 
Pneuny 
Prevention 
ScreenL„ NHS Hem 
Medicines Management 
NSAlDs 
LESDES 
INR LES Minors 
care PI 
Dr ugs 
Administration 
Data sm 
Dcs Re 
IFR rule x
  • The IFR Index can be reached from the CDRC Index or could be added to your toolbar or any of your own master templates. 
IFR Index 
Overview of PAT system 
FR overview 
Dermatology and Plastics 
AbdominopIasty/Apronectomy 
Oko Benign Skin Lesions 
Slepharoplasty 
Carpal Tunnel Syndrome 
Dupuytren's Contracture 
Ear Lobe Repair 
Face / brow lift 
Ganglia 
Hair Grafting 
Hirsutism 
Hyperhidrosis 
Lipomas 
Liposuction 
Pinnaplasty 
Redundant Skin 
Skin Resurfacing 
Tattoos 
Thigh: Suttock: Arm Lift 
Trigger Finger 
Vaginoplasty Vulvoplasty 
IFR Website 
Musculoskeletal 
Autologous Cartilage Transplant 
Sack Pain Discectomy for Lumbar Spine Prolapse 
Sack Pain - Facet Joint Injections 
Sack Pain Injections for Radcular Leg Pain 
Sone Morphogenic Proteins 
Carpal Tunnel Syndrome 
Cervical Spinal Disc Prosthesis 
Dupuytren's Contracture 
Exogen Utrasound Sone Healing 
Ganglia 
Hallux Valgus 
Hip Replacement 
Knee Adhroscopy 
Knee Replacement 
Trigger Finger 
General Surgery 
Groin Hernia 
Complementary and Alternative Therapies 
Complementary and Aternative Therapies 
Breast 
Breast - Non Cancer Surgery 
Gynaecomastia 
Genitourinary 
Circumcision 
Fedlty Preservation Before Cancer Treatment 
Menorrhagia 
Reversal of Male Sterilisation 
Reversal of Female Sterilisation 
Subfedilty 
Vaginoplasty Vulvoplasty 
Ear Lobe Repair 
Pinnaplasty 
Tonsillectomy 
Chronic Ottis Media 
Ophthalmology 
Autologous Serum Eye Drops 
Excimer Laser for Cases wth Poor Refraction 
Vascular 
Varicose Veins
  • Type the relevant search term into the SystmOne search box (bottom left) 
B. PAT Tonsillectomy 
PIL Tonsillitis 
Print Template: Tonsillectomy 
Q Tonsillectomy 
tonsill
  • Use the F12 launcher. Press F12 then enter a search term into the search box. Any templates/protocols etc., that are used frequently can be dragged to a letter to allow quicker access using the keyboard alone in future. 
Launcher 
Favourites 
Breast- Non Cancer Surgery 
Fever in Children 
46 RTI 
SubfeNillty 
carpal 
Show templates 
Show auto consutations 
Name 
V; Carpal Tunnel Injection 
Carpal Tunnel Syndrome 
Show protocols 
Show questionnaires 
PAT Carpal Tunnel Syndrome 
PIL Carpal Tunnel Syndrome 
PIL Carpal Tunnel Syndrome
  • Some templates can be found from other templates to make it easy to find the appropriate information during routine consultations. For example, a link to the Tonsillectomy template can be found from the Sore Throat template. 
Sore Throatl persistent Sore Throa 
Sore Throat 
History 
Examination findings 
Cough 
Temperature 
Cervical lymphadenopathy 
Exudate on tonsils 
Centor score 
9 
Hx and Ex 
Fever in Children 
Launch Sepsis Assessment 
n 
Hx and Ex (page S) 
1 point if absent 
1 point if >38 
1 point if tender 
1 point 
Rmnkinn "ahit ha. nn "al 
Core Data Entry 
Acute pharyngtls 
Antibiotics 
Heath education - parental smoking 
Acute laryngtis 
Acute tonsilltis 
CONSIDER antibiotics or delayed script if Centor score 3 or 4 (not always needed) 
Treat with antibiotics if 
• Marked systemic upset 
• At increased risk of serious complications 
• Valvular heatl disease 
Low threshold for antibiotics if: 
• Diabetes or immunocompromised 
• DMARD or carbimazole 
• Hx of rheumatic fever 
Natural History - resolution in 7-10d 
Tonsillectomy 
O CKS sore Throat 
O sore Throat 
Persistent Sore Throat
Automatic Prompts

Automatic prompts are available that will detect Read codes or free text entered during consultations and offer a link to the relevant template, letter, protocol or information. 

Question 
There is information available about carpal tunnel syndrome 
Would you like to view it? 
Pause

Pressing enter clears the alert. 

As these prompts can be unwanted by some clinicians they will need to be ‘switched-on’ for any practice that wishes to use them. The full suite of prompts can be switched on or off for each practice. Each practice then has the option to switch off any prompts that it does not wish to use.  

The text prompts are relatively ‘clever’ in that they will look for synonyms and different ways to express the same concept e.g., The ear lobe repair prompt will be triggered by ‘The patient wants ear lobe repair’ as well as ‘the patient wants to consider repair of her ear lobe’ and the abdominoplasty prompt will be triggered by ‘tummy tuck’. 

Some prompts are triggered by free text, some by Read codes and some by either. 

Condition Text Read 
Abdominoplasty ✓ 
Breast implant ✓ 
Breast reduction ✓ 
Bunion (hallux valgus) ✓✓
Carpal Tunnel Syndrome ✓✓
Circumcision ✓ 
Dupuytren’s contracture ✓✓
Ear lobe repair ✓ 
Face lift ✓ 
Gynaecomastia ✓✓
Hirsutism ✓✓
Hyperhidrosis ✓✓
Liposuction ✓ 
Pinnaplasty ✓ 
Sterilisation reversal ✓ 
Tattoo removal ✓ 
Thigh/buttock/arm lift ✓ 
Tonsillectomy ✓ 
Vaginoplasty ✓ 
Varicose Veins ✓ 

Safety Netting

SystmOne has a number of functions that allow safety netting. Some of these systems need to be configured to work most effectively. Having these systems in place should reduce the risk of significant events, near misses and complaints.  It will also help to demonstrate to regulatory bodies such as the CQC that appropriate processes are in place. 

Identifying Incomplete Ordered Tests

This system allows the user to identify cases where a test has been recommended or carried out but there isn’t any evidence that the relevant result has been received by the organisation. 

To identify tests that have been ordered but do not appear to have been completed or received: 

Navigate to Workflow > Outstanding Pathology 

Workflow User 
Task List 
New Tasle 
System 
Help 
ctrl*T 
ctrl+K 
ctrl*Y 
Pathology Radiology Inbox 
Outstanding Pathology Radiology Requests 
Filed Pathology Radiology Search 
Document Management

Set the date range to identify tests ordered within a set time period. For example, type ‘-2m’ in the first date box and ‘-1m’ in the second to see tests ordered between one and two months ago. Click Run Report and a list of patients, tests and ordering clinicians will be displayed. 

Nun Repon 
Yiew Administration Page of Pathology System 
Search Options 
Show requests between 
Staff member Any 
03 Aug 2017 
06:38 
and 
04 sep 2017 
06:38
Clinician 
FORBES: Gareth (Dr) 
ROCHESTER: Glenn (Dr) 
LEVICK, Susan (Dr) (General Medic 
Tests 
Semen infertility (Requested) 
Helicobacter stool antigen (Postponed) 
US Abdomen (SBH) (Requested)

Right click on the patient and select Retrieve  to view the patient record. The Completed or Cancel options can then be used as appropriate. 

This method works more powerfully if investigations are requested on ICE at the time the clinician recommends them rather than when the investigations are taken. 

Ensuring Results are Dealt with Appropriately

This system allows the user to identify results where appropriate action has not been taken. For example, the patient has been asked to attend an appointment but has not attended. 

The method below is one way of dealing with results to ensure there is a system in place to ensure the appropriate action is taken. If you wish to use this system ensure the Results Setup steps have been followed. 

Results Setup

Ensure that results are not set to archive automatically. 

To change/check this setting:  

Navigate to User>User Preferences>Pathology>Filing OR  

When filing a result, click on the settings button 

r Send the following SMS preset message to the patient 
r Add to eWorkfIow 
Settings 
Cancel

Ensure that the Immediately archive report box in not ticked. 

r 
Patient to be informed of this report 
r 
Immediately archive report 
r Automatically create a task

This setting needs to be adjusted for every user 

Adjust settings so outstanding results are flagged 

To change/check home screen settings: 

Navigate to User>User Preferences>Patient Record>Patient Home OR 

Click on the cogwheel at the bottom right of the screen then click Dates, Initials and Colours 

Ensure the Show unarchived pathology as a table box is ticked and the Pathology/Radiology to Archive settings are set as shown.  This needs to be set for every user.  There is an option from the User Preferences screen to copy the settings from a different user to make this quicker and easier. 

Patient Home Settings 
Enter text to search 
user Settings 
Search 
Clear 
ates: Intials 8 Colours 
Organisation Settings 
Ordering 8 Expansion 
Show dates and intials after each tem 
Show empty headings 
Show unarchived pathology as text 
@ Show unarchived pathology as a table 
Automatically re-evaluate OOF alerts as Read codes are added 
Section 
Unconfirmed Medication 
!! Reminders 
High Priority Reminders 
Recalls 
Tasks 
Pathology/Radiology to File 
Pathology/Radiology to Archive 
r 
r 
r 
r 
Large 
r 
r 
r 
r 
r 
r 
r 
r 
r

This ensures that unarchived results are displayed prominently on the patient home screen 

Patient Home 
Continue 
Configure 
— Patholo 'Radiolo to Archive Inform or Archive Patholo and Radiolo 
Investigation 
Result 
Haemoglobin Alc level 
Abnormal 
Liver function tests;Serum lipid levels;urea and electrolytes;GFR calculated abbreviate„ Abnormal 
Message 
Need to speak tm 
seeing you soom Can you let her know that IGR has recurrel Recommend lifestyle m 
Make an appointmhas appt 
Informed 
Date 
02 May 2017 GF 
28 Jul 2017 GF

To change/check right hand alerts settings: 

Navigate to Setup>Users and Policy>Organisation Preferences>Clinical Policy>Patient Record>Patient Home OR 

Click on the cogwheel at the bottom right of the screen then click Ordering and Expansion 

Ensure the  Pathology/Radiology to Archive boxes are set as shown with a banner flash colour.  This only needs to be set once for the organisation. 

Patient Home Settings 
Enter text to search 
user Settings 
Dates: Intials 8 Colours 
Organisation Settings 
Orderng 8 Expansion 
Show recalls on the home screen if they are 
r Show tasks sent to other organisations 
Set Flash ColouÉ 
Clear Flash Colour 
Section 
Pathology/Radiologyto Archive 
High Priority Reminders 
!! Reminders 
Sensitivities & Allergies 
OOF Alerts 
days from their recall date 
Show 
Expand 
Banner Flashm„

This ensures that a flashing alert is displayed in the right alerts column (along with allergy, QoF alerts etc.) 

Machine generated alternative text:
Pharmacy 
Pathologyfiadiology to Archive

Showing Unarchived Results in the Clinical Tree 

Add the Results view to your clinical tree 

Machine generated alternative text:
Rel LPA./IMCA./Advocate 
Relationships 
01] Results 
RIP Checklist 
RIP Checklist 
Organisation Specific 
System Wide 
DCS 
North East Palliative Services Group 
North East Palliative Services Group

This allows unarchived results to be quickly and easily displayed along with the comments that were added to the results. This is particularly helpful for reception staff if patients are ringing for results. 

Machine generated alternative text:
Clinical 
lent Home 
@ Quick Glance 2 
Summary 8 Family History (7) 
Tabbed Journal 
Medication (s) 
Repeat Templates (6) 
Pathology 8 Radiology (34) 
Results 
Common Tests 
Cervical Screening 
Scheduled Tasks 
O 
Communications 8 Letters (99) 
Record Attachments 
Referrals (4) 
Read Code Journal (136) 
Results 
02 May 2017 1518 
Message 
Result Indicator 
Follow up Action 
Result Filed 
Patient Informed 
Repon Archived 
Specimen Collected 
Textual Investigations 
28 2017 1326 
Message 
Result Indicator 
Follow up Action 
Result Filed 
Patient Informed 
Repon Archived 
Specimen Collected 
Textual Investigations 
Haemoglobin Alc level 
seeing you soom Can you let her know that IGR has recurrel Recommend lifestyle measure. She alsc 
Abnormal 
Need to speak to nurse 
FORBES, Gareth (Dr) - 03 May 201 7 06:2g 
Patient not informed yet 
02 May 2017 15:18 
Clinical Information: TIRED 
Liver function tests;Serum lipid levels;urea and electrolytes;GFR calculated abbreviated MORO 
has appt 
Abnormal 
Make an appointment to see doctor 
FORBES, Gareth (Dr) - 31 dui 2017 08:18 
Patient not informed yet 
28 Jul 20171326 
Clinical Information: high bp

Filing the result 

When filing a result which needs some action that involves the patient, ensure the Patient to be informed of this report box is ticked.  

Old risk score 401 % 
New risk score 401% 
Comments patient 
message 
Message for patient's 
next prescription 
Please ask patient to make an appointment 
Presets 
Presets 
V Patient to be informed of this report 
Archive report 
Create a task

Informing the Patient 

When the patient’s record is retrieved the outstanding results will be displayed prominently on the patient home screen.

Patient Home 
Continue 
Configure 
— Patholo 'Radiolo to Archive Inform or Archive Patholo and Radiolo 
Investigation 
Haemoglobin Alc level 
Liver function tests;Serum lipid levels;urea and electrolytes;GFR calculated abbreviat4 
Result 
Abnormal 
Abnormal 
Action 
Message 
Need to speak tm 
seeing you soom Can you let her know that IGR has recurrel Recommend li 
Make an appointmhas appt

A flashing alert will appear in the right hand column.

Machine generated alternative text:
Pharmacy 
Pathologyfiadiology to Archive

More detailed information can be obtained by right clicking on the flashing alert – this will open the pathology/results screen where unarchived results will be shown in red. 

28 Jan 2015 XR Shoulder Lt 
22 coded 
27 Oct 2015 
02 May 2017 
02 May 2017 
02 May 2017 
02 May 2017 
28 dui 2017 
28 Jul 2017 
28 Jul 2017 
12 Aug 2017 
Sowel cancer 
screening 
programme: faecal 
occult blood result 
Haemoglobin Alc 
level 
Full blood 
count;Differential 
white blood cell 
count 
urea and 
electrolytes;GFR 
calculated 
abbreviated MORO 
Serum TSH level 
Full blood 
count;Differential 
white blood cell 
count 
Liver function 
tests;Serum lipid 
levels;urea and 
electroly1es;GFR 
calculated 
abbreviated MDRD 
Serum TSH level 
MRI Spine cervical 
27 Jan 2015 
02 May 2017' 
02 May 2017' 
02 May 2017' 
02 May 2017' 
28 dui 2017 
28 Jul 2017 
28 Jul 2017 
02 Aug 2017 
Serum globulin level [XE2eB) 
Serum lipid levels (XE2q7) 
Serum cholesterol level [XE2eD) 
Serum triglyceride levels (XE2qg) 
Serum HDL cholesterol level (44P5) 
Serum cholesterol/HDL ratio 
(XaEUq) 
Serum LDL cholesterol level (44P6) 
Serum non high density lipoprotein 
cholesterol level xabE1) 
urea and electrolytes CX77Wl) 
Serum sodium level (XE2q0) 
Serum potassium level [XE2pz) 
Serum chloride level CXE2q1) 
Serum urea level [XM01t) 
Serum creatinine level CXE2q5) 
GFR calculated abbreviated MORD 
rxaK8y) 
GFR calculated abbreviated MORD 
cxaK8y) 
31 g/L [20- 35] 
mmol/L 
1 mmol/L 
1 g mmol/L 
35 mmol/mmol 
Lipid target ranges 
total cholesterol <4JJ mmol/L 
triglyceride -1 mmol/L 
LDL cholesterol -20 
HDL cholesterol mmol/L for males: 
-1 M mmol/L for females 
4 mmol/L 
47 mmol/L 
135 mmoI/L [133- 146] 
mmoI/L [35 - 53] 
mmoI/L [g5 - 108] 
53 mmoI/L [25 - 
70 umol/L [50- 110] 
71 mumin/1 73m*2 
eGFR INFORMATION: Ifthe patient is of 
African-Caribbean ori in the eGFR result

Alternatively the Results view from the clinical tree will display the unarchived results with the recommended action/comments. 

Machine generated alternative text:
Clinical 
lent Home 
@ Quick Glance 2 
Summary 8 Family History (7) 
Tabbed Journal 
Medication (s) 
Repeat Templates (6) 
Pathology 8 Radiology (34) 
Results 
Common Tests 
Cervical Screening 
Scheduled Tasks 
O 
Communications 8 Letters (99) 
Record Attachments 
Referrals (4) 
Read Code Journal (136) 
Results 
02 May 2017 1518 
Message 
Result Indicator 
Follow up Action 
Result Filed 
Patient Informed 
Repon Archived 
Specimen Collected 
Textual Investigations 
28 2017 1326 
Message 
Result Indicator 
Follow up Action 
Result Filed 
Patient Informed 
Repon Archived 
Specimen Collected 
Textual Investigations 
Haemoglobin Alc level 
seeing you soom Can you let her know that IGR has recurrel Recommend lifestyle measure. She alsc 
Abnormal 
Need to speak to nurse 
FORBES, Gareth (Dr) - 03 May 201 7 06:2g 
Patient not informed yet 
02 May 2017 15:18 
Clinical Information: TIRED 
Liver function tests;Serum lipid levels;urea and electrolytes;GFR calculated abbreviated MORO 
has appt 
Abnormal 
Make an appointment to see doctor 
FORBES, Gareth (Dr) - 31 dui 2017 08:18 
Patient not informed yet 
28 Jul 20171326 
Clinical Information: high bp

Right click on the result(s) and choose Inform/Archive when the appropriate action is complete. 

Identifying Results That Have Been ‘Missed’ 

Navigate to Workflow > Filed Pathology/Radiology Search 

Set the report options as below using the date range you are interested in.

Run Repon 
Report Options 
Repon Filing 
date between 
r 
Also include reports archived between 
r 
Search for a specific owner 
Restrict to follow up actions 
sat dui 2017 
Take no action 
Make appointment to see doctor 
Make appointment to see nurse 
Speak to doctor 
Speak to nurse 
Repeat test 
Request notes 
Patient to pick up script 
Communicate wth patient 
Other

A list of unarchived results will then be displayed. 

LLLLLLLLI 
ااااااااا 
أاااااااا

Clicking on column headers will allow the list to be ordered e.g., by date/owner etc. The report can also be exported to Word/Excel in the usual way by right clicking on the report. 

These patient’s record can then be checked to ensure the appropriate action has been taken. 

Ensure that results are not set to archive automatically. 

To change/check this setting:  

Navigate to User > User Preferences > Pathology > Filing

OR  

When filing a result, click on the settings button.

r Send the following SMS preset message to the patient 
r Add to eWorkfIow 
Settings 
Cancel

Ensure that the Immediately archive report box in not ticked. 

r 
Patient to be informed of this report 
r 
Immediately archive report 
r Automatically create a task

This setting needs to be adjusted for every user.

Adjust settings so outstanding results are flagged 

To change/check home screen settings: 

Navigate to User > User Preferences > Patient Record > Patient Home 

OR 

Click on the cogwheel at the bottom right of the screen then click Dates, Initials and Colours.

Ensure the Show unarchived pathology as a table box is ticked and the Pathology/Radiology to Archive settings are set as shown. This needs to be set for every user. There is an option from the User Preferences screen to copy the settings from a different user to make this quicker and easier. 

Patient Home Settings 
Enter text to search 
user Settings 
Search 
Clear 
ates: Intials 8 Colours 
Organisation Settings 
Ordering 8 Expansion 
Show dates and intials after each tem 
Show empty headings 
Show unarchived pathology as text 
@ Show unarchived pathology as a table 
Automatically re-evaluate OOF alerts as Read codes are added 
Section 
Unconfirmed Medication 
!! Reminders 
High Priority Reminders 
Recalls 
Tasks 
Pathology/Radiology to File 
Pathology/Radiology to Archive 
r 
r 
r 
r 
Large 
r 
r 
r 
r 
r 
r 
r 
r 
r

This ensures that unarchived results are displayed prominently on the patient home screen.

Patient Home 
Continue 
Configure 
— Patholo 'Radiolo to Archive Inform or Archive Patholo and Radiolo 
Investigation 
Result 
Haemoglobin Alc level 
Abnormal 
Liver function tests;Serum lipid levels;urea and electrolytes;GFR calculated abbreviate„ Abnormal 
Message 
Need to speak tm 
seeing you soom Can you let her know that IGR has recurrel Recommend lifestyle m 
Make an appointmhas appt 
Informed 
Date 
02 May 2017 GF 
28 Jul 2017 GF

To change/check right hand alerts settings: 

Navigate to Setup> Users and Policy > Organisation Preferences > Clinical Policy > Patient Record > Patient Home 

OR 

Click on the cogwheel at the bottom right of the screen then click Ordering and Expansion.

Ensure the Pathology/Radiology to Archive boxes are set as shown with a banner flash colour. This only needs to be set once for the organisation. 

Patient Home Settings 
Enter text to search 
user Settings 
Dates: Intials 8 Colours 
Organisation Settings 
Orderng 8 Expansion 
Show recalls on the home screen if they are 
r Show tasks sent to other organisations 
Set Flash ColouÉ 
Clear Flash Colour 
Section 
Pathology/Radiologyto Archive 
High Priority Reminders 
!! Reminders 
Sensitivities & Allergies 
OOF Alerts 
days from their recall date 
Show 
Expand 
Banner Flashm„

This ensures that a flashing alert is displayed in the right alerts column (along with allergy, QoF alerts etc.) 

Machine generated alternative text:
Pharmacy 
Pathologyfiadiology to Archive

Showing Unarchived Results in the Clinical Tree 

Add the Results view to your clinical tree.

Machine generated alternative text:
Rel LPA./IMCA./Advocate 
Relationships 
01] Results 
RIP Checklist 
RIP Checklist 
Organisation Specific 
System Wide 
DCS 
North East Palliative Services Group 
North East Palliative Services Group

This allows unarchived results to be quickly and easily displayed along with the comments that were added to the results. This is particularly helpful for reception staff if patients are ringing for results. 

Machine generated alternative text:
Clinical 
lent Home 
@ Quick Glance 2 
Summary 8 Family History (7) 
Tabbed Journal 
Medication (s) 
Repeat Templates (6) 
Pathology 8 Radiology (34) 
Results 
Common Tests 
Cervical Screening 
Scheduled Tasks 
O 
Communications 8 Letters (99) 
Record Attachments 
Referrals (4) 
Read Code Journal (136) 
Results 
02 May 2017 1518 
Message 
Result Indicator 
Follow up Action 
Result Filed 
Patient Informed 
Repon Archived 
Specimen Collected 
Textual Investigations 
28 2017 1326 
Message 
Result Indicator 
Follow up Action 
Result Filed 
Patient Informed 
Repon Archived 
Specimen Collected 
Textual Investigations 
Haemoglobin Alc level 
seeing you soom Can you let her know that IGR has recurrel Recommend lifestyle measure. She alsc 
Abnormal 
Need to speak to nurse 
FORBES, Gareth (Dr) - 03 May 201 7 06:2g 
Patient not informed yet 
02 May 2017 15:18 
Clinical Information: TIRED 
Liver function tests;Serum lipid levels;urea and electrolytes;GFR calculated abbreviated MORO 
has appt 
Abnormal 
Make an appointment to see doctor 
FORBES, Gareth (Dr) - 31 dui 2017 08:18 
Patient not informed yet 
28 Jul 20171326 
Clinical Information: high bp
Specific Safety Netting

CDRC includes several specific safety netting systems e.g. identification whose new diagnosis of diabetes or non-diabetic hyperglycaemia has been missed; identifying patients whose drug monitoring is overdue. 

If there is a particular action that requires safety netting, the scheduled task is a very powerful tool. This allows a task to be sent to a user or user group at a specified time. There is also the ability to set the scheduled task to recur.  

For example, if a patient with a learning disability is asked to attend a follow up appointment in two weeks where assessment is needed to exclude serious illness,  a scheduled task can be set to send a task in three weeks to prompt the user to ensure the patient has attended the appointment. 

Other potential use examples include: 

  • Asking a patient to return for repeat renal function after three months to assess for the presence of CKD 
  • Prompting ordering of distant investigations e.g. follow up DXA scan in 3 years time 
  • Prompting ordering of infrequent, recurrent, specialist investigations e.g. annual echocardiogram to monitor aortic root diameter. 

A scheduled task can be set in a number of ways: 

The Scheduled Task button could be added to your individual or organisation toolbar.

Add the Scheduled Tasks node to your individual or organisation clinic tree. Clicking on this node allows you to see previous and current scheduled tasks. Right clicking allows you to add a new scheduled task.

Clinical 
g Patient Home 
9 Dcs Index 
@ Quick Glance 2 
Summary 8 Family History (16) 
Tabbed Journal 
Medication 
Repeat Templates (3) 
Pathology 8 Radiology (54) 
Resuts 
Common Tests 
Cervical Screening 
Tasks 
Communications 8 Letters (87) 
Scheduled Tasks 
organisation Leadgate Surgery: NHS North Durham CCG 
New Scheduled Task Amend Schedule Cancel Schedule 
Created 
10 May 2013 
03 sep 2013 
17 2015 
Status 
Scheduled Task Creation 
(Completed) 
Scheduled Task Creation 
(Completed) 
Scheduled Task Creation 
(Completed) 
Details 
Miscellaneous task (Patient needs blood test in 3 month TFT. 
) to be sent to Reception on 02 Aug 2013 
Miscellaneous task (tn level needs checked req sl) to be sent to D'NORTHWOOD: Rachel 
Miscellaneous task (bloods see previous task) to be sent to Reception on 07 Oct 201 5

Add the Scheduled Task button to your master template.

Template Master 
0717 q 
x 
Other Details 
Changing the consultation date will affect all other data enterel To avoid this: cancel and press the 'Next button 
Core Data kntry% 
Sick Notes 
New Scheduled Task L TC Master 
Care Plan Creation (old) 
0 
Info for Patients 
Influenza Vac„ 
New Patient Check 
Care Planning Core 
Fraity Dcs 
Pneumococca„ 
s 
Shingles Vac„ 
A Men ACv"vYV
Delayed Treatment

This module allows structured recording and management of delays to treatment/assessment/intervention. 

The delayed treatment module in CDRC provides a structured way to capture any intervention that is delayed. This might include referral (including 2ww), investigation, treatment, assessment.  This system is not designed to manage patient choice to decline an intervention altogether. 

Setup requirements – Add the following recall type Delayed Treatment. 

Recording a Delay 

When a delay is noted, open the Delayed Treatment template. This can be done from the CDRC Template Master, by adding the template to your own master template or toolbar, or by typing ‘delay’ into the search box in the bottom left corner of the screen.

The Delayed Treatment template shows relevant clinical codes, previous entries and recalls and allows you to record the reasoning behind the delay, the plan for follow up and to add a recall. 

Click the Record Treatment Delay button and complete the short questionnaire. Question 4 about the outcome is mandatory. 

There are three outcomes – either the patient, your organisation or another organisation will take responsibility for follow up.  If ‘your organisation’ is chosen, a prompt will recommend the addition of a recall. 

When the questionnaire is finished close it by using Save for Future Editing (this will allow updating in future).

The user is then offered the chance to add a clinical code……. 

…. And then the option to add a Delayed Treatment recall. 

Following Up Delayed Treatment 

There is a search to identify the recalls as they become due. Organisations may choose to add this search to a batch reporting process where a member of staff or group will receive a task at set intervals. 

When the record is reviewed, as the recall falls due, the information in the questionnaire can be updated by right clicking on the answers and choosing Amend Questionnaire. 

NB if the questionnaire was previous saved as ‘final version’ you will not be able to amend it but you can choose Copy Questionnaire to create a new copy that can be edited. 

To amend the recall date, right click on the recall. Use Follow-on/supersede to move the date, use Seen or Cancel once the recall is no longer needed. 

If the recall is cancelled or marked as seen, the following warning prompts the use to check to see if there are any other outstanding delayed treatments that require ongoing recall. 

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