NHS database takes step towards ‘seamless care’ in Wales

A major upgrade to digital infrastructure in the Welsh NHS will improve the continuity of nursing care between health boards, according to senior nurses leading the project.

The Welsh Nursing Care Record, a digitised database for note taking to replace paper records, was implemented across Wales in 2021.

Its introduction also sparked the creation of a clinical nursing informatics lead at all health boards across the country.

“This latest iteration of [the record] has paved the way for unity of clinical systems in Wales.”

Luke Ashton

Under the system, when patients are discharged from a ward that uses the record, nurses perform digital assessments that are made available on an online portal, which can then be accessed across the country.

Around 80% of eligible wards in Wales are currently using the system, with 10.3m inpatient nursing notes having been created since it was set up.

Digital Health and Care Wales (DHCW), the NHS organisation in charge of the system, announced earlier this week that it had now been unified to allow better information sharing between health boards.

Previously, each of the seven health boards in Wales, plus Velindre University NHS Trust in Cardiff, had their own version of the record.

This situation meant that, when a problem was found with the system, eight different versions of the fix would need to be applied.

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The upgrade has unified the eight databases into one, improving the speed at which fixes can be implemented and, it is hoped, means patients receiving care at multiple boards do not need to repeat information to clinicians.

Fran Beadle, chief nursing information officer at DHCW, said the system had already “transformed nursing” in Wales, through the standardisation of documents and phasing out paper nursing notes.

“[The record] standardised documents and provided a digital solution in practice, to enhance patient safety and experience,” she said.

“Collaboration and engagement have been the true success of this project. This has been evidenced once again in supporting the availability of information for healthcare professionals across Wales,” she added.

The upgrade, Ms Beadle said, was the next step to modernising the Welsh health service.

Judith Bowen, lead clinical informatics nurse at Hywel Dda University Health Board, described the single database improvement as a step towards “seamless patient care” for those receiving care from more than one authority.

Luke Ashton, senior systems support manager at Velindre Cancer Centre, said: “This latest iteration of [the record] has paved the way for unity of clinical systems in Wales.

“As the first of the DHCW systems to operate as one ‘single instance’, this will allow teams supporting the Welsh Nursing Care Record to focus their efforts on one version of the system rather than per health board,” he said.

Improvements to the digital infrastructure in NHS Wales are set to continue, with £1.7m also handed to DHCW from the devolved government to improve the record further.

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This money, the organisation said, would be used to expand the care record to capture children’s inpatient assessments, further working towards the total replacement of paper nursing notes.

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