How it may be possible to use a single EPR LIVI Hub to support all NHS PCN and Population contracts
It is possible to use a single EPR hub (EMIS or SystmOne) to service all LIVI NHS contracts, both PCN and population. The only challenge will be electronic prescribing and how NHS North East London ICB (the parent ICB of LIVI's Prescribing Cost Centre code) could be reimbursed for any medication costs.
Would be interesting to find out what percentage of prescriptions are paid for by the ICB. The majority of NHS patients pay for their own medication.
As mentioned above, LIVI has its own Prescribing Cost Centre code (PCC), Y06658, which was issued by NHS North East London ICB (NEL) in March 2020. This would enable NEL (or another registration authority - would recommend NHS South, Central and West CSU) to create smartcard roles under this organisation. This setup would allow all LIVI staff—clinical, operational, and administrative—to access NHS Spine services with a single smartcard role, including access to the Patient Demographic Services (PDS), Electronic Prescription Services (EPS), and e-referral services (e-RS). A single EPR (e.g., EMIS Web Clinical Services) could then be configured against Y06658, enabling a single hub to access all patients registered at a GP practice in England via GP Connect.
However, it would also mean that any electronic prescriptions completed against PCC Y06658 would be directed to NHS North East London ICB. If there were a mechanism or process in place to reimburse NHS North East London ICB for medications for patients in other ICB footprints, all prescribing clinicians could use a single EPR.
GP Connect, which now has a national data-sharing agreement with all GP practices in England, will enable any patient registered at a GP practice in England to be traced into the LIVI hub and provide an HTML view of their entire GP practice record. It will also enable consultations to be sent back to the patient's GP practice via GP Connect Send Document. More detail on GP Send Document here.
If EMIS Web Clinical Services was the EPR of choice, it can be configured with multiple locations, services, and slot types to distinguish and support (e.g., reporting) all the different PCN and population contracts.
The only other unknown at the moment is e-referrals and how they would work with a single smartcard role under PCC Y06658.
The diagram below represent the potential flow of providing care to a patient for both PCN and Population.
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