In September 2015, Clarks Archive Storage (CAS), was approached by Cambridgeshire Community Services NHS Trust to undertake a project to relocate and digitise over 20,000 confidential client health care files. The files were for the Children & Young Person’s Unit and included information about all children receiving care and support from across the catchment area.
Cambridgeshire Community Services NHS Trust (CCS), provides high-quality care to diverse communities across Cambridgeshire, Norfolk, Suffolk and Bedfordshire. The Trust has an annual budget in excess of £110 million and employs more than 2,200 staff. The Children and Young Person’s Unit provides care and support across the region for children aged up to 19. This includes the Family Nurse Partnership, health visiting, hearing services, hospital-based paediatrics, the Safeguarding Children Service, school age immunisation, school nursing and other specialist services.
Many of the records in question were for the Safeguarding Children Service, which provides dedicated nurses and administrators who work in two teams. These are the Child Protection Team and a Looked After Children team.
The Child Protection team provides advice, support and training to all staff employed by the Trust to ensure, promote and safeguard the welfare of children and young people throughout the area. Working in partnership with the Office of Children and Young People Service, the Looked After Children (Health) team ensures that children in the care system receive health services that are equitable to that received by any other child. Both teams work with other agencies such as police, social care, education and other health providers to meet the Every Child Matters outcomes.
Previously these services had been provided by the Clinical Commissioning Group for Great Yarmouth?and Waveney. As part of this service, all client files were held at Lowestoft Hospital. The records were managed manually and required NHS staff from across the region to travel to Lowestoft to retrieve and reference files prior to each and every client visit.
This became untenable once the service provision passed to CSS, which has its base near Peterborough. The old system was uneconomical for the Trust, requiring significant administration and multiple trips for caregivers to access records. Of course, each journey took time that caregivers could have more profitably offered to their clients. Furthermore, the old process was entirely manual. Files had to be retrieved from the library by hand, checked-out by the attending health care professional, reviewed and then returned. This could result in human error leading to the risk of lost patient records in an area of critical care delivery.
Paperless Health Service
The Trust took the decision to improve the system dramatically by moving to a new storage facility and at the same, time took the opportunity to digitise the files. The digitisation of medical records is one of the most significant recent developments in the NHS.
A paperless health service is a high-profile agenda?that has largely been driven by the government, who challenged the NHS to go paperless by 2018. A number of NHS Trusts have already achieved the move, but many others are still in the process. Effective and appropriate systems must be put in place ahead of the digitisation process, which itself must be handled by ISO certified providers.
“It was essential for us to find a supplier that not only demonstrated exceptional standards around security and confidentiality but who could also tailor their service to meet our specific and challenging requirements. CAS excelled in each of these areas.” CCS
CAS hold a number of certifications from the International Organization for Standardisation (ISO):
ISO 15489, Information and Documentation – Records Management. CAS are the only document storage company in the Industry to hold this ISO. It demonstrates that we are meeting all the requirements for the Records Management Industry, and appropriate attention and protection is given to the processing and management of document and file storage.
ISO 9001:2015 Quality Management. We recently introduced Radio Frequency Identification (RFID). This is a new electronic system which provides levels of accuracy and efficiency far beyond standard barcode management.
ISO 14001, Environmental Management. CAS have consistently met management processes that reduce our impact on the environment and contribute to sustainability on both a regional and national level.
ISO/IEC 27001, Information Technology, Security Techniques and Information Security Management. This ISO reassures you that CAS are compliant with every International regulation on surveillance, security and staff confidentiality.
Working closely with senior stakeholders within the Trust, CAS proposed to enable increased effectiveness of record keeping and retrieval through three work streams: secure storage of records, digitising records and online access to files.
Secure file storage
The first task was to transfer the files to the CAS storage facility at Sudbury. The files were boxed in date-order for efficient on-demand retrieval later.? Each file and the box in which it is stored has an individual barcode. The code identifies the specific records contained in that box making retrieval easy and accurate. The barcodes are scanned using state- of-the-art RFID technology. Each box is scanned when being deposited or removed from storage and the information is catalogued providing an accurate audit which can itself be accessed 24/7.
CAS continually strive for the highest levels of security. As well as document-handling staff, all team members at the storage facility have been through?the DBS checking process. The storage facility in Sudbury, Suffolk has a gated perimeter fence, 24/7 security patrol and advanced CCTV. Gate staff require identification for anyone entering the facility and only authorised personnel are admitted. CAS has a dedicated fleet of GPS-tracked vehicles to control all document transport to and from storage. Physical records can also be requested on a scheduled basis.
“At CAS we take our responsibility ?to protect confidential records very seriously, our staff are highly trained and dedicated to playing our part in supporting clients to deliver their much- needed services” Danny Clark
CAS offers an on-demand scanning service. Once requested each file is prepared for scanning by an experienced document management professional. They remove extraneous items such as paper clips and staples, and individually scan each page including any additional items such as added notes and post-its. The files are then scanned, coded and the digital record added to the virtual record library. The original records are then returned to their storage box.
CAS are fully compliant with the Data Protection Act 1998. All CAS document-handling staff have been checked by the Disclosure and Barring Service (DBS). DBS is the new name for the Criminal Records Bureau (CRB) and DBS checks have now replaced the old CRB checks. This process enables CAS to comply with the 2014 NHS England Confidentiality Policy which states: “All employees working in the NHS are bound by a legal duty of confidence to protect the personal information they may come into contact with during the course of their work. This is not just a requirement of their contractual responsibilities but also a requirement within the common law duty of confidence and the Data Protection Act. It is also a requirement within the NHS Care Record Guarantee, produced to assure patients regarding the use of their information.”
Online access to records
The most important aspect of this project was the need for an efficient ‘live-file’ storage system. Many of the records are for clients who are currently being supported by CSS. This means the records are in constant use and may need to be retrieved, updated and returned to storage 24/7.
CAS offer a fully hosted, online system with customised search criteria that enables authorised CCS personnel to access records remotely from anywhere in the UK. This requirement is facilitated through an advanced and totally secure, password-protected online portal.
The relocation to a secure storage facility and digitisation of active files has enabled primary care?staff to deliver increased support to children and?young people across Cambridgeshire, Norfolk, Suffolk and Bedfordshire. Administration time and costs have been reduced significantly, particularly the time care professionals have to spend travelling to the old facility to review and manage records. This has resulted in increased productivity, essential at a time when all NHS teams are under budget pressure. The secure storage facility also delivers an enhanced level of security for the confidential records offering peace-of-mind for patients, carers and families.
“During the process of scanning the records we will handle thousands of pages of private information, we take care to ensure that any ‘added notes’ are included to ensure a complete record has been digitised.” CAS document handler
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