IEG4’s Digital CHC solution helps Integrated Care Boards (ICBs) to drive the NHS Continuing Healthcare assessment process from digital form submission through to reviews and reassessment (where required) mirroring the NHSE National Framework.

The Digital CHC solution includes digital forms that trigger workflow based cases. Digital CHC provides workflow management to help drive and monitor the completion of the assessments and provide an audit trail of the process stages themselves.

The Workflow processes accelerate communications with stakeholders working on Standard and Fast Track CHC processes. Digital CHC reduces administration effort and improves transparency to accelerate eligibility decisions and improves patient service. IEG4’s Digital CHC is a cloud-based solution which is accessible only to authorised users.

Introduction

Any authorised healthcare professional is able to use Digital CHC to enter the patient data required by the existing paper-based Fast Track Pathway Tool.

Once signed in, you will be able to click on the “New” button on the right-hand side of the screen which allows you to complete a new digital Fast Track form.

This will present the first page of the digital Fast Track form “About the patient”:

Once the patient’s details have been recorded, click on the “Next” button at the bottom of the page and this will take you to the “Equality” page. Data from the patient’s details will be used to pre-populate the first two questions on this page. All other fields can be manually completed.

Click on the “Next button” and this will move you on to the “Documents” page where you have the ability to upload and attach any supporting documents e.g. consent form, nursing assessment etc.

The first time you use the digital Fast Track form you may have to allow “pop-up blockers” which will appear as an icon in the toolbar of your browser.

Once you have uploaded any documents, click on the “Next” button in the bottom right-hand corner of the screen and you will be taken to the “Recommendation” page:

If you are completing the digital Fast Track form on behalf of a referring clinician, you can answer “No” to the question “Are you the referring clinician?”. This will then present fields for you to record details of the referring clinician. You must also answer the question “Use as referring clinician in PDF?” so you can record if their details should appear as the “referring clinician” and not yours.

These fields are not presented when the answer is “Yes” to the question.

You must complete all fields on the “Recommendation” page. Once all fields have been completed you must click on the “Submit” button at the bottom of the page:

Once the digital Fast Track form has been submitted you will be presented with a screen that allows you to click on a button to download a PDF copy of the Fast Track Pathway Tool:

You will also receive an email confirming that the digital Fast Track form has been submitted to the ICB that will contain a unique reference number.

Introduction

Any authorised healthcare professional is able to use Digital CHC to enter the patient data required by the existing paper-based Checklist.

The user is able to record if the patient’s representative was invited to attend the CHC assessment meeting and whether they did.

The patient’s consent is explicitly captured so that the Checklist can be shared with those professionals who will subsequently be drawn on to assess them.

The patients GP can be identified and details added, based on a drop-down list of surgeries served by the ICB. This reduces the need for manual address look-up and delivers speed and accuracy of data to the information entered.

Once signed in, you will be able to click on the “New” button on the right-hand side of the screen which allows you to record a new eChecklist.

This will present the first page of the eChecklist “When not to screen”:

Once you have read through the “When not to screen page” you can then click on the “Create a new checklist” button, which will take you to the Patient Details page. Mandatory fields have an *.

The Digital Consent Page will appear where the answer to the consent question on the “Patient” page is “Yes”.

Patients with mental capacity (Part 1):

Relevant questions are displayed:

Statement of Consent from Individual section - Click the last paragraph according to their Consent to sharing of information:

Then click Next to move on to rest of Digital Checklist.

Where the individual lacks capacity different questions are displayed (Part 2):

Once the Consent page had been completed, click on the “Next” button at the bottom of the page and this will take you to the “Documents” page where you have the ability to upload and attach any supporting documents e.g. nursing assessment etc.

The first time you use the eChecklist you may have to allow “pop-up blockers” which will appear as an icon in the toolbar of your browser.

Once you have uploaded any documents, click on the “Next” button in the bottom right-hand corner of the screen and you will be taken to the first Domain “Breathing”. When you click on a description the score will be automatically highlighted. You also have the option to add text in the “Brief description of need and source of evidence to support the chosen level” box. There is no limit on the amount of text that can be recorded here.

Once that Domain is completed, click on the “Next” button at the bottom of the page and this will move you on to the next Domain to be completed. Repeat this until you reach the “Equality” page.

Equality page

Data from the patient’s details will be used to pre-populate the first two questions on this page. All other fields can be completed.

Click on the “Next button” and this will move you on to the “Outcome page. At the top of this page will be a summary of the C, B, A scores against each of the Domains you have completed.

You can record if any other professionals contributed to this assessment. If you respond Yes, you will be asked “How many?”. Click on the drop down and select the number e.g. 1 and you will then be asked to record their details:

You must then respond to the question “Refer for full assessment” and then complete add in text to the “Rationale for decision” field. You will then be able to submit the eChecklist to the ICB by clicking on the “Submit” button at the bottom of the page.

Once the eChecklist has been submitted you will be presented with a screen that allows you to click on a button to download a PDF copy of the Checklist.

You will also receive an email confirming that the eChecklist has been submitted to the CCG that will contain a unique reference number.

Once a digital form has been submitted, it appears in the “back office” as a new case.

As part of the Digital CHC back-office product there are standard built-in Workflow processes.

As a case progresses, according to the decision recorded the relevant Workflow process and steps within it will be triggered.

To complete an electronic MDNA click on the link from your email that has asked you to complete an electronic assessment:

You will need to log in with your username and password.

You will then be presented with the electronic MDNA:

The patient details will be pre-populated from the eChecklist that was submitted.

All domains are listed on the navigation bar on the left-hand side. You can simply click on the name of the domain that you wish to assess and then record your comments in the “Evidence in Records” field. There is no limit imposed as to the amount of text that can be recorded. You can cut and paste text in to this field too.

Once you have added text click on the “Save” button. This will then indicate on the navigation bar on the left-hand side of the screen that you have responded to this domain with a tick:

There is a “Save for later” option so that you can save any data entered, but access the MDNA again later should you wish to add more information before you submit it.

Once you have responded to all the domains you need to, click on the Outcome page on the navigation bar on the left-hand side of the screen:

This gives you a summary of the domains you have responded to and allows you to add any additional comments.

You can then click on the “Submit” button and then the electronic MDNA is submitted to the CCG linked to the case reference. An email will be automatically sent to the user that requested the assessment be completed advising them that you have now completed it:

The Digital Consent Page will appear where the answer to the consent question on the “Patient” page is “Yes”.

Patients with mental capacity (Part 1):

Relevant questions are displayed:

Statement of Consent from Individual section - Click the last paragraph according to their Consent to sharing of information:

Then click Next to move on to rest of Digital Checklist.

Where the individual lacks capacity different questions are displayed (Part 2):

Digital Mental Health Referral

Once signed in, you will be able to click on the “New” button on the right-hand side of the screen which allows you to record a new Referral.

This will present the first page of the Referral for NHS contribution under the Mental Health Act:

Once you have read through the “Information” you can then click on the “Next” button, which will take you to the Patient Details page. Mandatory fields have an *.

Once all Patient details have been recorded click on the “Next” button at the bottom of the page:

This will take you to the “Care Details” page. Mandatory fields have an *.

Once all Care details have been recorded click on the “Next” button at the bottom of the page:

This will take you to the Documents page where you have the ability to upload and attach any supporting documents:

The first time you use the digital Referral form you may have to allow “pop-up blockers” which will appear as an icon in the toolbar of your browser.

Once you have uploaded any documents, click on the “Next” button in the bottom right-hand corner of the screen and you will be taken to the Equality page.

Equality page:

Data from the patient’s details will be used to pre-populate the first two questions on this page. All other fields can be completed.

Click on the “Next button” and this will move you on to the “Submit” page:

Click on the Submit button on the right hand side of the screen to submit the digital Referral form to the ICB.

Once the Referral has been submitted you will be presented with a screen that allows you to click on a button to download a PDF copy of the Referral form.

You will also receive an email confirming that the Referral has been submitted to the ICB that will contain a unique reference number.

To access the electronic CYP DST and to view all evidence linked to the case click on the Joint Assessment tab for the case:

Click on the Meeting code and this will drill you down into the meeting details:

On this screen, you can choose which documents that have been linked to the case should be visible during the Joint Assessment meeting. You can select any documents you feel should be visible during the meeting by clicking on the document and then clicking on the “Save changes” button.

Please Note - if you are attending a Joint Assessment Meeting where access to the internet might be limited it is advisable to download the documents prior to the meeting. You may also wish to use a blank CYP DST template during the meeting to record what is discussed with a view to copying and pasting your notes in once you are back in an area where you can access the Digital CHC system.

Click on the “Open DST” button in the top right-hand corner and this will open the meeting for the case:

Click on the “Connect” button and this will take you to the digital CYP DST:

You will see the Patient details on the first page. All other sections are listed down the left-hand side of the screen. To move between sections simply click on the name of section you want to move to.

You need to scroll down the page and complete all other Patient fields which are mandatory:

The Documents section will allow you to view all documents that you had agreed (on the previous step) could be shared during the Joint Assessment meeting.

All other sections mirror the paper CYP Decision Support Tool (CYP DST) with 10 domains listed. You need to respond to all 10 domains and all fields on the Decision page.

As the person running the meeting you can score the “level of need” by clicking on the letter of the score e.g. M (which is then highlighted in yellow) and then by clicking on the appropriate standard paragraph(s) that describes the need:

You can then add in comments in the “Describe the child or young person’s specific needs relevant to this domain” text box.

All domains on the CYP DST must be completed, even if it is to state there are no needs.

Once all domains have been responded to click on the “Summary” page on the navigation bar on the left-hand side of the screen. This will give you a summary of the scoring assigned to each of the domains:

When all fields are completed, at the bottom of the page, the “Submit” button:

The status of the Joint Assessment Meeting will now show as “under review”:

A new workflow has now been started “CYP Decisions”. Click on the Workflow tab:

You will see the active Workflow is “CYP Decisions”.

Introduction

Any authorised healthcare professional is able to use the digital Children and young people’s continuing care pre-assessment checklist to enter the patient data required by the existing paper-based Checklist.

Once signed in, you will be able to click on the “New” button which allows you to record a new CYP Checklist.

This will present the first page of the CYP Checklist “Patient Details”. Mandatory fields have an *.

The Digital Consent page will then need to be completed:

Then click Next to move on to rest of the Digital CYP Checklist.

Once the Consent page had been completed, click on the “Next” button at the bottom of the page and this will take you to the “Pre-assessment details” page:

Once the “Details of pre-assessment” page had been completed, click on the “Next” button at the bottom of the page and this will take you to the “Documents” page where you have the ability to upload and attach any supporting documents.

The first time you use the eChecklist you may have to allow “pop-up blockers” which will appear as an icon in the toolbar of your browser.

Once you have uploaded any documents, click on the “Next” button in the bottom right-hand corner of the screen and you will be taken to the first Domain “Breathing”. When you click on a description the score will be automatically highlighted. You also have the option to add text in the “Brief description of need and source of evidence to support the chosen level” box. There is no limit on the amount of text that can be recorded here.

Once that Domain is completed, click on the “Next” button at the bottom of the page and this will move you on to the next Domain to be completed. Repeat this until you reach the “Equality” page.

Equality page

Data from the patient’s details will be used to pre-populate the first two questions on this page. All other fields can be completed.

Click on the “Next button” and this will move you on to the “Outcome page. At the top of this page will be a summary of the scores against each of the Domains you have completed.

Enter the date the assessment was completed and then click on the “Submit” button.

Once the digital CYP Checklist has been submitted you will be presented with a screen that allows you to click on a button to download a PDF copy of the Checklist.

You will also receive an email confirming that the eChecklist has been submitted to the ICB that will contain a unique reference number.

The Reviews Workflow process is used for 3 month, 12 month or ad-hoc Reviews of CHC cases.

As per the National Framework the outcome of an NHS Continuing Healthcare review will determine whether:

a) The individual’s needs are being met appropriately, and

b) Whether eligibility should be reconsidered through reassessment for NHS Continuing Healthcare.

There are three potential outcomes to the Reviews Workflow process:

a) No change needed existing in care package

b) Changes to existing care package

c) Change in individual’s needs resulting in the need to reassess for CHC funding

Workflow Stages

1. Assign Caseworkers

It is mandatory to assign a Case Reviewer e.g. CHC nurse who will conduct the Review. Once a user has been selected click Progress to trigger next stage “Schedule Review”.

2. Schedule Review

Enter date/time/location of planned review.

Invite participants. The Case Reviewer is automatically brought through from the previous stage in the process.

Click on “Create notification” to call the email template to the screen:

Click on the Save button to save content of email that will be sent to advise review will be taking place.

Click on Progress and then email is sent with review details:

On the day of the Review the Reviewer can click on the Reviews tab on the case:

The user clicks on the meeting code to access the digital review:

The user clicks on the “Open Review” button to access the digital review form:

The user clicks on the “Connect” button:

All relevant case data is pre-populated on to the digital Review form.

Data from the previous DST or Review is displayed in read-only alongside the fields on the Review form that the user has to complete:

Against each domain the user can see the “level of need” scores, the paragraphs previously chosen and comments recorded:

The user can then record the level of need during the review and add any comments:

Every domain has to be reviewed.

Once all domains have been reviewed the Recommendation page displays a summary of the level of need scores.

The digital Review form can then be submitted.

The Review status is then changed to “Complete” and this is displayed on the Reviews tab:

This triggers the next step in the Workflow process “Check care plan needs amending”.

Check Care Plan Needs Amending

This is a decision stage in the Workflow process.

If the user clicks on the Progress button underneath “No” then the next stage is “Is there evidence of change in needs potentially affecting eligibility” is triggered.

If the user clicks on the Progress button underneath “Yes” the next stage “Amending Care Pan” is triggered.

Amending Care Plan

Once the care plan has been amended the user clicks on the Progress button to complete the stage in the process. This triggers the “Is there evidence of change in needs potentially affecting eligibility” stage.

Is there evidence of change in needs potentially affecting eligibility?

Clicking on “Progress” underneath “Yes” triggers the “Reassess” Workflow process.

Clicking on “Progress” underneath “No” completes the Workflow process.

Reassess Workflow

The first stage in the Workflow process is “Assign to Locality Team” and then the process follows all the same stages that are in the “Checklist to MDT” Workflow process from this point onwards enabling a full reassessment of eligibility for NHS Continuing Healthcare.

You will receive an email with a link on it that allows you to upload patient information.

The wording of the email will look like this:

Secure Upload Link

The link contained in the email is secure and will not expose you to any risk of downloading any viruses or malware.

The document request facility is secured during transit using industry standard TLS 256-bit encryption.

The upload facility is only available through the unique link in the email which can only be used a single time, specifically for the document requested in the email for the specific patient.

All documents submitted are encrypted during transport, and encrypted 'at rest' inside a Microsoft Azure cloud data vault.

No files are transmitted to your browser, and no central data can be download using the upload facility.

You can verify the integrity of the web site by viewing the security information inside your web browser, commonly accessed by clicking on a padlock icon.

All usage of the unique links are logged by IP address, timestamp and browser.

Microsoft Azure

The document that you upload is stored in Microsoft Azure. Microsoft conforms to global standards in security and compliance to deliver on both technology and trust.

Create a New Case

You can create a case manually by clicking on the Cases screen and clicking on the “New” button in the top right-hand corner of the screen:

You will then be presented with a blank screen to record case details:

All fields are mandatory.

Please note that the option selected in the Funding Eligibility field will control which Care Package Approval Workflow process can be started.

Once all fields have been completed click on the Save button to create the case. The screen will refresh and you will see the details on the Summary tab of the case:

You will need to click on the Edit button to complete other relevant fields (including Broadcare id, address, telephone number and email address):

Click where the edit icon appears to add any missing data. Click Save for each data item you are adding/amending:

Once all patient summary details have been recorded the relevant Workflow process can then be started from the Workflow tab:

Simply click on the “New Workflow” button and then select the Workflow process that you want to start:

A Workflow has been created to allow “Initial Contact” to be recorded.

When creating a manual case there is a new “Referral Pathway” for “Initial Contact”:

Once the case has been created the “Initial Contact” Workflow can be started:

The first step is “Does the individual require a Checklist?”:

If Yes, click on the progress button underneath “Yes – checklist is required” which triggers the step “complete checklist”.

When the checklist is submitted the user will need to complete the “Complete checklist” step by recording the “Date checklist completed” so that the Workflow process is complete:

If No, click on the progress button underneath “No – checklist is not required” which triggers the next step “Checklist not required” where a mandatory free text reason needs to be recorded:

When a reason has been recorded, click on the “progress” button so that the Workflow process is complete.

Business Requirement

New Referral Pathway and Funding Eligibility option to record ABI Rehab (not CHC) cases so that Finance can code the care packages correctly.

When these options are chosen the system will only allow a Care Package Approval Workflow to be started (not CYP, FNC, S117 or Fast Track Care Package Approval Workflows).

Changes to Create Case Manually screen

There is an additional option for "ABI Rehab (not CHC)" for these two fields:

Referral Pathway

Funding Eligibility

The Eligibility for ABI Rehab (not CHC) will then be displayed on the Finance coding step in the Care Package Approval Workflow:

Change to Care Package Approval – Complete Funding Request Form:

An additional option for Commissioning Pathway:

Care Package Approval – Funding Eligibility:

Where the care to be provided is to be paid for by a PHB which is a Direct or Third Party the system will:

- In place of the create care package step of the workflow, which is used for Notional PHBs, the system has an alternative create care package step that:

o Allows a set of documents to be uploaded and attached (instead of the Individual Placement Agreement)

o Records the weekly amount to pay

o Has a drop-down field that allows the user to:

§ select a PHB company e.g. Virtual Wallet or Disability, or

§ mark that payments are going direct to the patients bank account

Once a referral has been assessed and a decision made that the patient is eligible for CHC funding then the relevant Care Package Equipment Approval Workflow process can be started.

As part of the Digital back-office product there are four standard built-in Care Package Equipment Approval Workflow processes:

1. Care Package Equipment Approval

2. Fast Track Care Package Equipment Approval

3. S117 Aftercare Care Package Equipment Approval

4. CYP Care Package Equipment Approval

As a case progresses, according to the outcome recorded the relevant Workflow process and steps within it will be triggered.

1. Complete funding review form

The first step is “Complete funding review form”:

All fields are mandatory.

Please note that the Commissioning Pathway field is used to control whether details of any jointly funded care packages can be recorded. Select Joint if you want to record details of the other parties contributing to the funding of the Care Package.

Once you have completed all fields the click on the “Progress” button and the next step is triggered “Complete Care Package”.

2. Complete Care Package

You must type in the “start date” in the format dd/mm/yyyy.

To add equipment to the care package click on the “Add Service” button and this will take you in the search screen:

You can filter on searching for equipment using the text field, distance, and commissioned cost only.

Click on the “Go” button and you will be presented with a list of services to select:

You can click on the Filters on the right-hand side of the screen if you wish to filter on the search results:

To add equipment to a package click on the “Add To Package” button.

You will then see the commissioned price and the unit of measure for the service you have selected. The “Use custom price” field allows you to overtype the commissioned price if the price differs.

The quantity needed and Description/details/specification of equipment needed are mandatory fields.

The equipment will then appear on the “Complete Care Package” screen:

You can add other equipment by repeating the steps above.

Once all services for the care package have been added, type in “Brief rationale” and then click on the “progress” button to trigger the next step “Nurse Approval”:

3. Nurse Approval

All fields are mandatory.

Once all fields have been completed click on the “progress” button to trigger the next step “Contract Team Review”.

4. Contract Team Review

The Contract Team can review Care Package details by clicking on the “Equipment” tab of the case where they can click on the four tabs; Package Details, Funding Review Form, Nurse Declaration and Approval History to see Care Package Details:

Once you have viewed the Equipment details, click on the Workflow tab to complete the step in the process:

Click on the Name of the Workflow step:

You can then click on the drop-down to Approve or reject the care package.

If it is approved then the case moves on to the next step “Confirm Start Date”.

If the equipment is NOT to be paid via IEG4 then the checkbox can be ticked.

If it is to be paid via IEG4 then DO NOT tick the checkbox.

If it is rejected then then you must record the reason rework is needed and add comments:

The case will then be sent back to the CHC nurse to change the Equipment Care Package:

The above steps would then be repeated until the Equipment Care Package is approved by the Contract Team.

5. Financial Approval

Depending on the total cost different levels of users may need to approve the Care Package. In this example because the equipment cost is over £1000 then the Care Package needs separate approval by users in a specified Security Group.

The users in the Security Group will also receive an email alerting them to the need for the Care Package to be approved or rejected:

An Equipment Care Package can go through up to 3 different levels of financial approval, which are configured in the Settings area of the system:

6. Confirm Start Date

The system will automatically display the start date that was typed in on the “Complete Care Package” step earlier on in the process, but this date can be changed if the actual start date of the care package is different.

7. Purchase Orders

Click on the “Create Notification” button and that will call the Template for the Purchase Order:

The system will do a mail merge of relevant data into the Purchase Order Template.

Once any relevant changes have been made click on the “Save” button to save the actual wording that will be then be generated in the PDF of the Purchase Order.

Click on the “progress” button to trigger the next step in the process “Finance Review”.

8. Finance Review

You must also record the “Pay from date” in the format dd/mm/yyyy (this is to cater for cases that are being migrated from your previous system to ensure there is no duplication of payment).

This step will display key information about the case to help Finance staff add the correct:

· Cost centre

· Analysis 1 (auto-derived from Place the GP Practice is linked to)

· Subjective

· Analysis 2

When all fields have been complete click on the “progress” button to complete the last step in the Workflow process. The Care Package Equipment Approval Workflow will now show as complete:

Once a referral has been assessed and a decision made that the patient is eligible for CHC funding then the relevant Care Package Approval Workflow process can be started.

As part of the Digital back-office product there are four standard built-in Care Package Approval Workflow processes:

1. Care Package Approval

2. Fast Track Care Package Approval

3. S117 Aftercare Care Package Approval

4. CYP Care Package Approval

As a case progresses, according to the outcome recorded the relevant Workflow process and steps within it will be triggered.

From the Case click on the “Workflow” tab. This will show any active or completed (click on All to view completed) Workflow processes for the case:

To start a new Care Package Approval Workflow on the case click on the “New Workflow” button in the top right-hand corner.

Select the Care Package Approval Workflow and click on the “Start this Workflow” button:

Fast Track Care Package Approval

If the case is a Fast Track case then there will be an option for the user to start the “Fast Track Care Package Approval” Workflow:

The steps are exactly the same but the process will show as Fast Track Care Package Approval to help users distinguish the case from normal CHC cases. 

1. Complete funding review form

The first step is “Complete funding review form”:

All fields are mandatory.

Please note that the Commissioning Pathway field is used to control whether details of any jointly funded care packages can be recorded. Select Joint if you want to record details of the other parties contributing to the funding of the Care Package.

Once you have completed all fields the click on the “Progress” button and the next step is triggered “Complete Care Package”.

2. Complete Care Package

You must type in the “start date” in the format dd/mm/yyyy.

To add services to the care package click on the “Add Service” button and this will take you in the search screen:

You can filter on searching for services using the text field, distance, and commissioned cost only.

Click on the “Go” button and you will be presented with a list of services to select:

You can click on the Filters on the right-hand side of the screen if you wish to filter on the search results:

To add a service to a package click on the “Add To Package” button.

You will then see the commissioned price and the unit of measure for the service you have selected. The “Use custom price” field allows you to overtype the commissioned price if the negotiated price differs.

If the service is not weekly then you can set the days the service will be commissioned for by choosing either Regular daily visits, or Flexible weekly visits:

Click on the “Add Visit” button for the relevant day:

Then record the visit details using “Time of visit”, “Length of visit” and “No of carers):

Please note that length of visit cannot be less than 1.

If the same visits are required on other days click on the “Copy to Other Days” button and then select the days:

Click on the “Save Changes” button to copy the visits to the other days.

Scroll to the bottom of the page and then click on the “Save” button:

The service will then appear on the “Complete Care Package” screen:

You can add multiple services by repeating the steps above.

Once all services for the care package have been added, type in “Brief rationale” and then click on the “progress” button to trigger the next step “Nurse Approval”:

3. Nurse Approval

All fields are mandatory.

Once all fields have been completed click on the “progress” button to trigger the next step “Contract Team Review”.

4. Contract Team Review

The Contract Team can review Care Package details by clicking on the “Care Plan” tab of the case where they can click on the four tabs; Package Details, Funding Review Form, Nurse Declaration and Approval History to see Care Package Details:

Once you have viewed the Care Package details, click on the Workflow tab to complete the step in the process:

Click on the Name of the Workflow step:

You can then click on the drop-down to Approve or reject the care package.

If it is approved then the case moves on to the next step “Provider Letters”.

If it is rejected then then you must record the reason rework is needed and add comments:

The case will then be sent back to the CHC nurse to change the Care Package:

The above steps would then be repeated until the Care Package is approved by the Contract Team.

5. Financial Approval

Depending on the total weekly cost different levels of users may need to approve the Care Package. In this example because the weekly care cost is over £600 then the Care Package needs separate approval by users in a specified Security Group.

The users in the Security Group will also receive an email alerting them to the need for the Care Package to be approved or rejected:

A Care Package can go through up to 3 different levels of financial approval, which are configured in the Settings area of the system:

6. Provider Letters

Click on the “Create Notification” button and that will call the Template for the IPA:

The system will do a mail merge of relevant data into the IPA Template.

Once any relevant changes have been made click on the “Save” button to save the actual wording that will be then be generated in the PDF of the IPA.

Click on the “progress” button to trigger the next step in the process “Confirm Care Package Start Date”.

7. Confirm Care Package Start Date

The system will automatically display the start date that was typed in on the “Complete Care Package” step earlier on in the process, but this date can be changed if the actual start date of the care package is different.

Click on the “progress” button to trigger the next step “Finance Review”.

8. Finance Review

You must also record the “Pay from date” in the format dd/mm/yyyy (this is to cater for cases that are being migrated from your previous system to ensure there is no duplication of payment).

This step will display key information about the case to help Finance staff add the correct:

· Cost centre

· Analysis 1 (auto-derived from Place the GP Practice is linked to)

· Subjective

· Analysis 2

When all fields have been complete click on the “progress” button to complete the last step in the Workflow process. The Care Package Approval Workflow will now show as complete:

Once an eChecklist has been submitted, it appears in the “back office” as a new case.

As part of the Digital CHC back-office product there are two standard built-in Workflow processes:

1. Checklist to DST

2. Decisions

As a case progresses, according to the decision recorded the relevant Workflow process and steps within it will be triggered.

Checklist to DST Workflow

Click on the “Workflow” option on the left-hand side of the screen. This will display a list of cases that you have access to according to their current stage:

You can click on the briefcase icon and this will drill you down into full case details:

You can view the submitted Checklist data by clicking on the Checklist tab:

The Documents tab shows any documents linked to the case, including a PDF copy of the submitted eChecklist and any supporting documentation:

You can view a Document by clicking on the icon that appears before the “description” field. This includes a pdf of the eChecklist that was originally submitted:

The Timeline tab shows the audit trail:

The Notes tab displays any notes that have been added to the case. You can also add Notes by typing in the notes and then clicking on the “Save” button:

You can progress the Checklist by clicking on the Workflow tab and clicking on the “Checklist to DST” workflow that has been auto-generated:

Once you have clicked on the “Checklist to DST” workflow you drill down into the process. The first step is “Responsible Commissioner Checks”.

1. Responsible Commissioner Checks

This is a decision stage in the process where you can click on one of three options:

No - Not Responsible CCG

If necessary, you can enter or amend the NHS number here (if the NHS number is missing or if an incorrect number was recorded on the eChecklist).

If you click “Progress” underneath “No” this triggers the “Not Responsible CCG Notification” step where you can generate a notification that is sent back to the user who submitted the eChecklist:

Click on “create notification” button and this calls the standard template.

Click on the “Save” button in the bottom right hand corner of the screen, which takes you back to the previous screen.

Click on the “progress” button to complete the step and this triggers the email back to the referrer.

This is then the end of the process.

Requires Investigation

If the responsible commissioner checks are going to take some time then you can click “Progress” underneath “Requires Investigation”. This keeps the case at this stage.

Yes – Responsible CCG

If necessary, you can enter or amend the NHS number here (if the NHS number is missing or if an incorrect number was recorded on the eChecklist).

You need to select which CCG is the responsible commissioner by clicking on the drop-down arrow and selecting the CCG.

Once you have selected the CCG click “Progress” underneath “Yes” the next step is triggered “Supplementary Information Checks”.

2. Supplementary Information Checks

This step allows any supplementary information to be recorded, the example here is “Is the individual subject to section 117?”

You must select the patient’s GP surgery from the drop-down list.

Click on “Progress” to trigger the next step “Pass to CHC Review Nurse”.

3. Pass to CHC Review Nurse?

Yes

If you are happy with the information on the eChecklist, click on the “Progress” button underneath “Yes” the next step is triggered “Refer for full assessment for NHS Continuing Healthcare”.

No

If you are not happy with the information on the eChecklist and you don’t want to progress to the next step click on “Create notification” and this calls the email template where you can record the reason(s) why you don’t want to pass the case on to the CHC Review Nurse.

Once you have added the reasons why you don’t want to pass the case on to the CHC Review Nurse click on the “Save” button in the bottom left hand corner, which takes you back to the previous screen. Then click on the “Progress” button underneath. This sends an email to the user who submitted the eChecklist and triggers the step “checklist requires fixing”:

The referrer is able to add to the previously submitted checklist if they need to and this will allow them to re-submit the checklist using the same case reference number.

4. Refer for full assessment for NHS Continuing Healthcare?

Yes

If you want to refer the patient for a full assessment, click on the “Progress” button underneath “Yes” the next step is triggered “Assign to Locality Team”.

No

If you don’t want to refer the patient for a full assessment you can type in the rationale for decision, select the reason for rejection and then click on the “Progress” button underneath.

This calls the “Nurse rejected notification” step:

Click on the “create notification” button and this generates the standard email template which you can add to:

Once amended, click on the “Save” button, which takes you back to the previous screen:

Click on the “Progress” button to complete the step, which generates the email to be sent back to the referrer. This is then the end of the process.

5. Assign to Locality Team

You can select the Locality Team from a drop-down list and then click on the “Progress” button which triggers the next step in the process “Assign Caseworkers”.

6. Assign Caseworkers

You can choose a Lead Admin person and a Lead Co-ordinator (e.g. CHC Nurse) and a Social Worker.

Underneath each Caseworker type you can click on the “Choose” button which launches the “User Selection” search:

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Team

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

You can then click to select the record you want to assign as the Caseworker. Once all caseworkers have been selected they are then displayed:

Once selected you can click on the “Progress” button to trigger the next step in the process “Schedule MDT”.

7. Schedule MDT

Type in the date of the meeting, time of meeting, location and then add participants.

To add a participant click on the + next to Participants:

This then allows you to select an “invite method” which is either:

· select user

· type in email address of a person you would like to invite e.g. patient’s relative

· type in person’s name (who isn’t a user and doesn’t have an email address)

Select User

To select a user click on the “Select user” option which calls the “User Selection” search.

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Teams

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

Once you have selected the user you must also record the user’s relationship to the patient using the drop-down list of options.

Type In Email Address

To enter an email address of a person that is not a user click on the drop-down list underneath “invite method” and select “email” and then type in the email address in the “Person” field. You must also record the person’s relationship to the patient using the drop-down list of options.

Type In Person’s Name

To enter a person’s name that is not a user nor has an email address click on the drop-down list underneath “invite method” and select “other” and then type in the person’s name in the “Person” field. You must also record the person’s relationship to the patient using the drop-down list of options.

Once all participants have been selected you can then generate a patient notification document by clicking on the “create notification button” at the bottom of the page:

Known data from the case will be pre-populated automatically into the document. You are able to add in any additional required information.

Once you have made changes to the document you click on the “Save” button in the bottom right hand corner of the screen. This saves the changes you have made and takes you back to the previous screen.

Click on the “Progress” button at the bottom of the page and this triggers the next step “Request Assessments”.

This generates emails to all users and participants with email addresses with details of the MDT Meeting:

8. Request Assessments

You can record which people need to do assessments prior to the MDT meeting and what type of assessment e.g. GP summary, specialist assessments etc.

The system will automatically display the email address of the patient’s Medical Practice so that a GP summary is requested.

To request an assessment click on + next to Assessments:

This then allows you to either select an existing assessor or type in an email address of a person you would like to carry out an assessment.

To select an assessor, click on the “Select assessor” option:

To type in an email address of a person that is not a user click on the email icon:

For each person click to select whether they are required to either upload an external assessment (document) or to complete an electronic assessment by choosing the assessment type:

When choosing “File Upload” you are able to select the document type:

Once all assessors have been selected/added click on the “Progress” button at the bottom of the page which triggers the next step “Waiting For Assessments” and generates the requests for assessments:

Assessment Type “Assessment” generates an email with a link for the assessor to complete an MDNA:

Assessment Type “File Upload” will allow the assessor to upload a different type of assessment e.g. dietary assessment, GP summary etc. An email is sent to the assessor with the “File Upload” link on it so they don’t’ need to log in as a formal user:

9. Waiting for Assessments

As assessments are completed/submitted the user that requested the assessments will receive email confirmations:

The email confirmation also includes details of how many assessments are outstanding for the case.

Once all requested assessments have been completed you can click on “Progress” (to confirm that you are happy for the MDT Meeting to go ahead) which triggers the next step in the process:

10. Waiting for MDT Outcome

This step will automatically be completed once the MDT meeting has taken place and the DST has been submitted.

MDT Meeting

To access the electronic DST and to view all evidence linked to the case click on the MDT tab for the case:

Click on the Meeting code and this will drill you down into the meeting details:

On this screen, you can choose which documents that have been linked to the case should be visible during the MDT meeting. You can select any documents you feel should be visible during the meeting by clicking on the document and then clicking on the “Save changes” button.

Please Note - if you are attending an MDT Meeting where access to the internet might be limited it is advisable to download the documents prior to the meeting. You may also wish to use a blank DST template during the meeting to record what is discussed with a view to copying and pasting your notes in once you are back in an area where you can access the Digital CHC system.

Click on the “Open DST” button in the top right-hand corner and this will open the meeting for the case:

Click on the “Connect” button and this will take you to the digital DST:

You will see the Patient details on the first page. All other sections are listed down the left-hand side of the screen. To move between sections simply click on the name of section you want to move to.

You need to scroll down the page and complete all other Patient fields which are mandatory:

The Documents section will allow you to view all documents that you had agreed (on the previous step) could be shared during the MDT meeting.

All other sections mirror the paper Decision Support Tool (DST) with 12 domains listed. You need to respond to all 12 domains and all fields on the Decision page.

Where assessors have completed electronic MDNAs their name and their responses will be displayed in each of the relevant domains.

As the person running the meeting you can score the “level of need” by clicking on the letter of the score e.g. M (which is then highlighted in yellow) and then by clicking on the appropriate standard paragraph(s) that describes the need:

You can then add in unlimited comments in the Rationale text box, including details of any disagreements on the level of need.

Where there is a disagreement this can be recorded by clicking on the “i” icon next to the “collaborative level of need” field:

This dynamically calls in an additional row to record the dispute in the score:

The “Rationale” text box can be used to record details of the disagreement.

All domains on the DST must be completed, even if it is to state there are no needs.

Once all domains have been responded to click on the “Decision” page on the navigation bar on the left-hand side of the screen. This will give you a summary of the scoring assigned to each of the domains:

When all fields are completed, at the bottom of the page, the “Submit” button:

The status of the MDT will now show as “under review”:

A new workflow has now been started “Decisions”.

Click on the Workflow tab:

You will see the active Workflow is “Decisions”.

All suppliers of block contract services and services paid by other methods will need to be set up as providers in Directory of Services (DOS).

The Care package approval workflow remains as it is for all care packages, so the care package is built out of DOS with unit prices etc and the approval is based on cost of package etc.

New List in Settings

The other methods are set up in the Lists area in Settings of the system as “Care Package External finance agreements”:

Care Package Approval Workflow

A new checkbox has been added to the Contract Team Review step, where the Contracts Team can select relevant services that will NOT be paid via IEG4 Payment Schedules.

When the services are selected that will NOT be paid via IEG4 Payment Schedules then the user has to select how the service will be financed from a drop-down list:

If all services in a package are flagged as NOT to be paid via IEG4 Payment Schedules then the letters to the provider stage is skipped and it goes to “confirm start date” stage in the Workflow and then on to the Funding Review stage to input codes:

Please Note

Any services marked as “Paid by Other Method” will not appear in the IP file. Payment of money to these providers will be paid outside of the IEG4 system.

Any services marked as “Paid by Other Method” will be ignored by the process for generating service confirmations or when producing payment schedules

In the care package approval workflow, the SFI level for these services will be the lower level limit that the nurse can approve.

The SFI level used will include costs for these services.

There is no requirement to generate a purchase order for these services.

Once the MDT meeting has finished the electronic DST is completed by the Lead Co-ordinator and is then sent to the Local Authority for agreement. The Lead CHC Co-ordinator selects the Social Worker that should review the DST which triggers an email to be sent with a link:

The Social Worker will click on the “click here” link on the email and that will call a read-only view of the completed DST. This will show all the comments recorded for every field on the DST.

At the bottom of the page the Social Worker must record their response (agree or disagree), enter their name in the “Signature” field and add comments (even if it’s “no comments”). The response can then be submitted by clicking on the “Submit” button:

Once submitted a “Thank you” message will appear acknowledging that you have submitted your response.

The COPDOL Workflow is started by the system automatically when these Care Package Approval Workflow processes are started:

• Care Package Approval

• S117 Care Package Approval

1. Deprivation of Liberty Consideration

If Care setting where the commissioned care/support will be provided is Own Home/Supported Live, system triggers next step “Is the individual subject to continuous supervision and control, and are not free to leave?”

In the Provider Portal, click on Manage Users:

You will see a list of existing Users that have access to the Provider Portal for that Provider.

To add a new user who will have access to the Provider Portal for the specific Provider, click on “Add User”:

Type in the user’s email address and click on “Continue”:

You can then tick the Permissions that you want to give to that user:

The Permissions are used to control which users can:

· Approve service confirmations for payment

· View remittance advice

· View patients

· Update patient account number

· Confirm acceptance of service package contract

· Manage users

Once you have ticked the required Permissions click “Save” and the user is created.

The patient deceased workflow can be started manually by a user on a case. This will then stop the case at the point it’s reached in it’s current workflow.

Once a digital CYP Checklist has been submitted, it appears in the “back office” as a new case.

As part of the Digital CHC back-office product there is a standard CYP Decisions Workflow process.

As a case progresses, according to the outcome recorded the relevant Workflow process and steps within it will be triggered.

CYP Decisions Workflow

Click on the “Workflow” option on the left-hand side of the screen. This will display a list of cases that you have access to according to their current stage:

You can click on the briefcase icon and this will drill you down into full case details:

You can view the submitted CYP Checklist data by clicking on the CYP Checklist tab:

The Documents tab shows any documents linked to the case, including a PDF copy of the submitted digital CYP Checklist and any supporting documentation:

You can view a Document by clicking on the icon that appears before the “description” field.

This includes a pdf of the CYP Checklist that was originally submitted:

The Timeline tab shows the audit trail:

The Notes tab displays any notes that have been added to the case. You can also add Notes by typing in the notes and then clicking on the “Save” button:

You can progress the Referral by clicking on the Workflow tab and clicking on the “CYP Decisions” workflow that has been auto-generated:

Once you have clicked on the “CYP Decisions” workflow you drill down into the process. The first step is “CYP Recommendation”.

1. CYP Recommendation

Type in recommendation into the Recommendation field.

Click on the “Progress” button and the next step is triggered “CYP Quality Assurance”.

2. CYP Quality Assurance

All questions are mandatory.

Click on “Progress” to trigger the next step “CYP Further Work Required?”.

3. CYP Further Work Required?

If further work is required, record details in the Rationale text box, then click “Progress” underneath “Yes, further work is required”. The CYP DST will then be sent back to the Nurse for further work.

If no further work is required click on the “Progress” button underneath “No, not required” which triggers the next step in the process “Notify Panel Administrator”.

4. Notify Panel Administrator

To select a Panel Administrator click on the + next to Panel Administrator:

This then allows you to select a person:

Click on “Select person” which calls the User Search:

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Teams

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

Once you have selected the user they will be displayed as the Panel Administrator:

Click on the “progress” button and the next step which triggers the next step in the process “CYP Awaiting Panel Administrator Response”.

An email is sent to the Panel Administrator prompting them to complete the step in the process:

The link in the email allows the Panel Administrator to view and download the DST and supporting evidence for panel:

The Panel Administrator can then click on the Workflow tab on the case:

The Panel Administrator will then click on the Workflow stage “CYP Awaiting Panel Administrator Response” to record the Panel Meeting details:

Once all fields have been completed click on the “progress” button which triggers the next step in the process “CYP Panel Meeting Details”. 

5. CYP Meeting Details

This step allows the user to invite Participants to the CYP Panel Meeting. The meeting details are pulled in from the previous step in the process where the Panel Administrator has set up the meeting.

To add a participant click on the + next to Participants:

This then allows you to select an “invite method” which is either:

· select user

· type in email address of a person you would like to invite e.g. patient’s relative

· type in person’s name (who isn’t a user and doesn’t have an email address)

Select User

To select a user click on the “Select user” option which calls the “User Selection” search.

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Teams

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

Once you have selected the user you must also record the user’s relationship to the patient using the drop-down list of options.

Type In Email Address

To enter an email address of a person that is not a user click on the drop-down list underneath “invite method” and select “email” and then type in the email address in the “Person” field. You must also record the person’s relationship to the patient using the drop-down list of options.

Type In Person’s Name

To enter a person’s name that is not a user nor has an email address click on the drop-down list underneath “invite method” and select “other” and then type in the person’s name in the “Person” field. You must also record the person’s relationship to the patient using the drop-down list of options.

Once all participants have been selected you can then click on the “progress” button which triggers the next step in the process “Joint Eligibility Decision”.

A CYP Panel Meeting scheduled email is automatically sent to all meeting participants:

6. Joint Eligibility Decision

Select the Decision, type in the Rationale for Decision.

Click on the “progress” button which triggers the next step in the process “CYP LA Review”.

7. CYP LA Review

This step allows the Local Authority to review the Joint Eligibility Decision. It pulls in the Joint Eligibility Decision and the date of the CYP Panel meeting automatically;

To record which LA Worker should be sent the link to review the Joint Eligibility Decision click on the + icon, then click on “select person” which calls the “User selection” search:

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Teams

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

Once you have selected the user click on the Progress button:

This triggers the step “CYP Decisions: Awaiting LA Response”:

An email is sent to the user requested to review the Joint Eligibility document:

The link on the email allows the user to view the Joint Eligibility Decision that was recorded:

This allows the user to review the document and then record their response. The user (LA Worker) must record their response, enter their name and add comments. The response can then be submitted.

Once submitted the system records details of the LA Worker’s response against the step in the process:

The next step in the process is triggered “Decision Letter”.

8. Decision Letter

The Decision Letter will either be CYP Eligible or CYP Not Eligible based on the decision recorded on the Joint Eligibility Decision step in the process.

Click on the “Create Notification” button:

The Template can be added to if required. Click on the “Save” button:

Click on the “progress” button which completes the CYP Decisions Workflow:

Once a digital Mental Health Referral form has been submitted, it appears in the “back office” as a new case.

As part of the Digital CHC back-office product there is a standard Mental Health Referrals Workflow process.

As a case progresses, according to the outcome recorded the relevant Workflow process and steps within it will be triggered.

Mental Health Referrals Workflow

Click on the “Workflow” option on the left-hand side of the screen. This will display a list of cases that you have access to according to their current stage:

You can click on the briefcase icon and this will drill you down into full case details:

You can view the submitted Referral data by clicking on the Referral tab:

The Documents tab shows any documents linked to the case, including a PDF copy of the submitted digital Referral and any supporting documentation:

You can view a Document by clicking on the icon that appears before the “description” field.

This includes a pdf of the Referral that was originally submitted:

The Timeline tab shows the audit trail:

The Notes tab displays any notes that have been added to the case. You can also add Notes by typing in the notes and then clicking on the “Save” button:

You can progress the Referral by clicking on the Workflow tab and clicking on the “Mental Health Referrals” workflow that has been auto-generated:

Once you have clicked on the “Mental Health Referrals” workflow you drill down into the process. The first step is “Responsible Commissioner Checks”.

1. Responsible Commissioner Checks

This is a decision stage in the process where you can click on one of four options:

No - Not Responsible CCG

If necessary, you can enter or amend the NHS number here (if the NHS number is missing or if an incorrect number was recorded on the digital Referral).

If you click “Progress” underneath “No” this triggers the “Not Responsible CCG Notification” step where you can generate a notification that is sent back to the user who submitted the Referral:

Click on “create notification” button and this calls the standard template.

Click on the “Save” button in the bottom right hand corner of the screen, which takes you back to the previous screen.

Click on the “progress” button to complete the step and this triggers the email back to the referrer.

This is then the end of the process.

Requires Investigation

If the responsible commissioner checks are going to take some time then you can click “Progress” underneath “Requires Investigation”. This keeps the case at this stage.

Yes – Responsible CCG

If necessary, you can enter or amend the NHS number here (if the NHS number is missing or if an incorrect number was recorded on the Referral).

You need to select which CCG is the responsible commissioner by clicking on the drop-down arrow and selecting the CCG.

Once you have selected the CCG click “Progress” underneath “Yes” the next step is triggered “Supplementary Information Checks”.

Responsible Commissioner at dispute

Once you have selected the CCG click “Progress” underneath “Responsible Commissioner at dispute” the next step is triggered “Supplementary Information Checks”.

2. Supplementary Information Checks

You must select the patient’s GP surgery and the Local Authority from the drop-down lists.

Click on “Progress” to trigger the next step “Anything Missing?”.

3. Anything Missing?

No

If you are happy with the information on the Referral, click on the “Progress” button underneath “Yes” the next step is triggered “Eligible for NHS funding under the MHA?”.

Yes

If you are not happy with the information on the Referral and you don’t want to progress to the next step click on the “Progress” button underneath “No” and this calls the “Request Missing Information” stage in the process.

You can select which person you want to request missing information from, e.g. the Referrer, and specify the type of information that is missing:

Once you have listed the missing information you are requesting click on the “Progress” button. This will trigger emails to be sent to the users (people) you are requesting the missing information from.

The case is then at a holding stage in the Workflow process called “Waiting for missing information”:

The user(s) will receive an email requesting the missing information. The email contains a link where they can click and then upload the requested information.

Once the missing information has been provided you will receive an email and you can then complete the “Waiting for missing information” stage in the process and the case will then be moved on to the “Eligible for NHS funding under the MHA?” stage.

4. Eligible for NHS funding under the MHA?

If “Yes” click on the progress button underneath and that will trigger the next step in the process “Assign to Lead Coordinator”.

If “No” click on the progress button underneath and that will trigger “Clinical Triage by PAT Clinical Review Nurse”.

5. Clinical Triage by PAT Clinical Review Nurse

If further clarity is required add some comments underneath the “Yes option which are mandatory, click on “progress” to complete the step and that will trigger the next step “Clinical Triage by Clinical Lead MH & LD/Clinical Strategic Lead”.

If No further clarity is required, click on the “progress” button underneath No to complete the step and that will trigger the next step “Assign to Lead Coordinator”.

6. Clinical Triage by Clinical Lead MH & LD/Clinical Strategic Lead

The user will see PAT Nurse comments that had been added in the previous step in the process.

At this stage the referral can either be Accepted or Rejected.

If Accepted, add comments underneath “Accept Referral” which are mandatory and then the next step is triggered “Assign to Lead Coordinator”.

If Rejected, add comments underneath “Reject Referral” which are mandatory and then the Workflow process is completed and no further steps will be generated.

7. Assign to Lead Coordinator

The individual’s date of birth and age are displayed here.

Click on the “Choose” button to search for the Lead Coordinator:

Once a user has been selected they will then be shown as the Lead coordinator:

Click on “Progress” to trigger the next step “Senior Commissioning Nurse Review”. 

8. Senior Commissioning Nurse Review

There are two options.

If no further information is required, complete the “Summary of needs” box and then click on the “progress” button. The workflow process is then complete.

If any further information is required, click on the + against “Required additional information”:

You can select which person you want to request additional information from, e.g. the Referrer, and specify the type of information that is missing:

Once you have listed the missing information you are requesting click on the “Progress” button. This will trigger emails to be sent to the users (people) you are requesting the missing information from.

The case is then at a holding stage in the Workflow process called “Waiting for further information MH”:

The user(s) will receive an email requesting the additional information. The email contains a link where they can click and then upload the requested information.

Once the missing information has been provided you will receive an email and you can then complete the “Waiting for additional information MH” stage in the process and the case will then be moved on to the “Senior Commissioning Nurse Review” stage (repeat of earlier step in process until the case can be progressed to Care Package Approval).

Prior year codes are used to change the finance coding of a payment where the service is delivered in one financial year but paid in the following year. When this happens the subjective code part of the finance code for the service confirmation is replaced with the prior year code.

For example a DOM care style service is delivered on 28/03/2024 but the payment run happens the following Friday (05/04/2024) then the service confirmation will be coded against the prior year code.

The prior year code is only substituted in at the point a payment schedule is finalized - the draft schedule will show the original subjective code for the service. This is because there is no way to know when a schedule will be finalized e.g. at year end, a schedule could be drafted in the same financial year as the service confirmation, but not finalized until the following year - in which case the codes in the draft transaction would be incorrect.

Where a service covers a week (e.g. nursing home care) the system normally produce a single service confirmation covering the whole week. However, when the week spans a financial year e.g. 27/03/2023 - 02/04/2023 the system will generate 2 service confirmations for the week, one for the period 27/03/2023 - 31/03/2023 and one for the period 01/04/2023 - 02/04/2023.

In this case, assuming the payment schedule is finalized in the new financial year (i.e. on or after 01/04/2023) the prior year code will be applied to the service confirmation covering the period 27/03/2023 - 31/03/2023. The service confirmation covering the 2 days 01/04/2023 - 02/04/2023 will use the normal subjective code as this part of the service was delivered and paid in the same financial year.

PHB services work as described above (for DOM care style services) but because these service confirmations are generated on a month by month there is no need to split service confirmations across year end.

The prior year code to use is controlled by a configuration file that is setup as part of the project implementation. The following snippet provides an example of this

This file is ued to map cost centres to prior year codes. For example if the service confirmation is coded against cost centre 946045 or 946084 use 52161094 as the prior year code. If the service confirmation is coded against cost centre 946141 or 946165 use 52161075 as the prior year code. For any other cost centre use the 'priorYearSubjectiveCodeFallback' code of 52161078. It is possible to just use the priorYearSubjectiveCodeFallback and map all cost centres to the same prior year code using the following setup.

Once a digital CYP Checklist has been submitted, it appears in the “back office” as a new case.

As part of the Digital CHC back-office product there is a standard CYP Checklist to Joint Assessment Workflow process.

As a case progresses, according to the outcome recorded the relevant Workflow process and steps within it will be triggered.

CYP to Joint Assessment Workflow

Click on the “Workflow” option on the left-hand side of the screen. This will display a list of cases that you have access to according to their current stage:

You can click on the briefcase icon and this will drill you down into full case details:

You can view the submitted CYP Checklist data by clicking on the CYP Checklist tab:

The Documents tab shows any documents linked to the case, including a PDF copy of the submitted digital CYP Checklist and any supporting documentation:

You can view a Document by clicking on the icon that appears before the “description” field.

This includes a pdf of the CYP Checklist that was originally submitted:

The Timeline tab shows the audit trail:

The Notes tab displays any notes that have been added to the case. You can also add Notes by typing in the notes and then clicking on the “Save” button:

You can progress the Referral by clicking on the Workflow tab and clicking on the “CYP to Joint Assessment” workflow that has been auto-generated:

Once you have clicked on the “CYP to Joint Assessment” workflow you drill down into the process. The first step is “Responsible Commissioner Checks”.

1. Responsible Commissioner Checks

This is a decision stage in the process where you can click on one of three options:

No - Not Responsible CCG

If necessary, you can enter or amend the NHS number here (if the NHS number is missing or if an incorrect number was recorded on the digital Referral).

If you click “Progress” underneath “No” this triggers the “Not Responsible CCG Notification” step where you can generate a notification that is sent back to the user who submitted the Referral:

Click on “create notification” button and this calls the standard template.

Click on the “Save” button in the bottom right hand corner of the screen, which takes you back to the previous screen.

Click on the “progress” button to complete the step and this triggers the email back to the referrer.

This is then the end of the process.

Requires Investigation

If the responsible commissioner checks are going to take some time then you can click “Progress” underneath “Requires Investigation”. This keeps the case at this stage.

Yes – Responsible CCG

If necessary, you can enter or amend the NHS number here (if the NHS number is missing or if an incorrect number was recorded on the Referral).

You need to select which CCG is the responsible commissioner by clicking on the drop-down arrow and selecting the CCG.

Once you have selected the CCG click “Progress” underneath “Yes” the next step is triggered “Supplementary Information Checks”.

2. Supplementary Information Checks

You must select the patient’s GP surgery and the Local Authority from the drop-down lists.

Click on “Progress” to trigger the next step “Assign to CYP Nurse”.

3. Assign to CYP Nurse

Click on the “Choose” button to search for the CYP nurse:

Once a user has been selected they will then be shown as the Lead coordinator:

Click on “Progress” to trigger the next step “Clinical Checklist Triage”.

4. Clinical Checklist Triage

You are prompted to answer the question “Does the Checklist contain enough information to inform a pre-assessment decision?”

Yes

If you are happy with the information on the Referral, add comments in the Rationale text box then click on the “Progress” button underneath “Yes” the next step is triggered “Refer for full assessment for CYP CC Funding?”.

No

If you are not happy with the information on the Referral and you don’t want to progress to the next step click on the “Create Notification” button to call the email template where you can type in what information you need:

Once you have added the information click on “Save” and then click on the “Progress” button under the “No” option:

The referrer will receive an email with a link where they can add additional information and re-submit the CYP Checklist to the ICB.

5. Refer for full assessment for CYP CC Funding?

If “Yes” add comments in the Rationale for decision text box, then click on the progress button underneath “Yes” and that will trigger the next step in the process “Create Positive Outcome Letter”.

If “No” add comments in the Rationale for decision text box, then click on the progress button underneath “No” and that will trigger the next step in the process “Create Negative Outcome Letter”.

6. Create Negative Outcome Letter

Click on the “Create Notification” button which calls the Negative Outcome letter template:

Add any additional wording if required, then click Save:

Click on the “progress” button to complete the step. The letter will be generated and will be displayed on the Documents tab to be printed.

The Workflow process will now be complete and no further steps will be generated.

7. Create Positive Outcome Letter

Click on the “Create Notification” button which calls the Positive Outcome letter:

Add any additional wording if required, then click Save:

Click on the “progress” button to complete the step. The letter will be generated and will be displayed on the Documents tab to be printed.

The next step in the process is triggered “Schedule Joint Assessment Meeting”.

8. Schedule Joint Assessment Meeting

Type in the date of the meeting, time of meeting, location and then add participants.

To add a participant click on the + next to Participants:

This then allows you to select an “invite method” which is either:

· select user

· type in email address of a person you would like to invite e.g. patient’s relative

· type in person’s name (who isn’t a user and doesn’t have an email address)

Select User

To select a user click on the “Select user” option which calls the “User Selection” search:

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Teams

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

Once you have selected the user you must also record the user’s relationship to the patient using the drop-down list of options.

Type In Email Address

To enter an email address of a person that is not a user click on the drop-down list underneath “invite method” and select “email” and then type in the email address in the “Person” field. You must also record the person’s relationship to the patient using the drop-down list of options.

Type In Person’s Name

To enter a person’s name that is not a user nor has an email address click on the drop-down list underneath “invite method” and select “other” and then type in the person’s name in the “Person” field. You must also record the person’s relationship to the patient using the drop-down list of options.

Once all participants have been selected you can then generate a patient notification document by clicking on the “create notification button” at the bottom of the page:

Known data from the case will be pre-populated automatically into the document. You are able to add in any additional required information.

Once you have made changes to the document you click on the “Save” button in the bottom right hand corner of the screen. This saves the changes you have made and takes you back to the previous screen.

Click on the “Progress” button at the bottom of the page and this triggers the next step “Request Assessments”.

This generates emails to all users and participants with email addresses with details of the Joint Assessment Meeting:

9. Request Assessments

You can record which people need to do assessments prior to the Joint Assessment meeting and what type of assessment e.g. GP summary, specialist assessments etc.

The system will automatically display the email address of the patient’s Medical Practice so that a GP summary is requested (if required).

To request an assessment click on + next to Assessments:

This then allows you to either select an existing assessor or type in an email address of a person you would like to carry out an assessment.

To select an assessor, click on the “Select assessor” option:

To type in an email address of a person that is not a user click on the email icon:

For each person click to select whether they are required to either upload an external assessment (document) or to complete an electronic assessment by choosing the assessment type:

When choosing “File Upload” you are able to select the document type:

Once all assessors have been selected/added click on the “Progress” button at the bottom of the page which triggers the next step “Waiting For Assessments” and generates the requests for assessments:

Assessment Type “Assessment” generates an email with a link for the assessor to complete an MDNA:

Assessment Type “File Upload” will allow the assessor to upload a different type of assessment e.g. dietary assessment, GP summary etc. An email is sent to the assessor with the “File Upload” link on it so they don’t’ need to log in as a formal user:

10. Waiting for Assessments

As assessments are completed/submitted the user that requested the assessments will receive email confirmations. The email confirmation also includes details of how many assessments are outstanding for the case.

Once all requested assessments have been completed you can click on “Progress” (to confirm that you are happy for the Joint Assessment Meeting to go ahead):

The next step in the process is triggered “Waiting for Joint Assessment Outcome”.

10. Waiting for Joint Assessment Outcome

This step will automatically be completed once the Joint Assessment meeting has taken place and the CYP DST has been submitted.

Joint Assessment Meeting

To access the electronic CYP DST and to view all evidence linked to the case click on the Joint Assessment tab for the case:

Click on the Meeting code and this will drill you down into the meeting details:

On this screen, you can choose which documents that have been linked to the case should be visible during the Joint Assessment meeting. You can select any documents you feel should be visible during the meeting by clicking on the document and then clicking on the “Save changes” button.

Please Note - if you are attending a Joint Assessment Meeting where access to the internet might be limited it is advisable to download the documents prior to the meeting. You may also wish to use a blank CYP DST template during the meeting to record what is discussed with a view to copying and pasting your notes in once you are back in an area where you can access the Digital CHC system.

Click on the “Open DST” button in the top right-hand corner and this will open the meeting for the case:

Click on the “Connect” button and this will take you to the digital CYP DST:

You will see the Patient details on the first page. All other sections are listed down the left-hand side of the screen. To move between sections simply click on the name of section you want to move to.

You need to scroll down the page and complete all other Patient fields which are mandatory:

The Documents section will allow you to view all documents that you had agreed (on the previous step) could be shared during the Joint Assessment meeting.

All other sections mirror the paper CYP Decision Support Tool (CYP DST) with 10 domains listed. You need to respond to all 10 domains and all fields on the Decision page.

As the person running the meeting you can score the “level of need” by clicking on the letter of the score e.g. M (which is then highlighted in yellow) and then by clicking on the appropriate standard paragraph(s) that describes the need:

You can then add in comments in the “Describe the child or young person’s specific needs relevant to this domain” text box.

All domains on the CYP DST must be completed, even if it is to state there are no needs.

Once all domains have been responded to click on the “Summary” page on the navigation bar on the left-hand side of the screen. This will give you a summary of the scoring assigned to each of the domains:

When all fields are completed, at the bottom of the page, the “Submit” button:

The status of the Joint Assessment Meeting will now show as “under review”:

A new workflow has now been started “CYP Decisions”. Click on the Workflow tab:

You will see the active Workflow is “CYP Decisions”. Click on the name of the Workflow and this will drill you down into the first step in this Workflow:

Sign-in page

Users (patients/family/advocates) can quickly and easily create and sign-in to their Patient Portal account.

To create a Patient Portal account users can click on options such as “Sign in with Facebook” or “Sign in with Google” which then uses the credentials in those accounts. Alternatively, a user can create a Patient Portal account using their email address or mobile number.

If the user wants to create an account using their Email address or Mobile number they will be presented with the “register for an account” screen to fill in their details:

When all mandatory fields have been completed they will click on the “submit” button to create the account.

A validation email is sent that contains a link for the use to verify their account. This may go into their Spam or Junk folder.

In addition, users can create a Patient Portal account using their mobile number, which will then trigger a validation text message to verify their account.

Signing In

Once the new account has been verified they can sign in to the Patient Portal:

When they sign in they will be taken to the Get Answers Fast Page:

To view the progress of their NHS Continuing Healthcare application they will click on the first tile.

If this is their first time accessing their application via the Patient Portal they will need to complete “registration” fields for verification purposes. The three verification fields are:

· Application reference (case reference in Digital CHC)

· Last name (this is automatically prepopulated from their Patient Portal account, but can be changed if different last name in Digital CHC)

· NHS Number (without any spaces)

Once all three fields have been completed they will then click on the “Register” button.

The system will then check that all three fields match to the case in the Digital CHC system.

If they do not match an error message will be given and the user can try again.

If the three fields do match they will be able to view the Frequently Asked Questions (FAQs) in context of their application:

Directories of Services:

Click on Users menu option:

You will see a list of existing users.

To create a new user click on “Add an Existing User”, you will be prompted to type in the email address of the user:

Click Search, if the user exists their details will be displayed:

Then click on the “Allow Access” button. You will then need to assign the user to a Group:

Click on the “Change” button and then tick the Group(s) you want to assign the user to:

Then click “Save”. The user will then show as being assigned to the Group(s):

At any time you can change the Group(s) the user is assigned to by clicking on the “Change” button.

You then need to assign the User to your Organisation. Click on Organisations on the menu. You will then see Organisations that you have access to as a system administrator:

Click on the name of the Organisation:

Then click on “Manage users”. You will see a list of existing users that have been assigned to the Organisation:

Click on “Add an Existing User” to assign the user, you will be prompted to type in the email address of the user:

Click Search, if the user exists their details will be displayed:

Click on “Allow access”:

Click on the “Change” button to assign the user to the Group(s):

Click on the Save button. The user will then show as being assigned to the Group(s):

At any time you can change the Group(s) the user is assigned to by clicking on the “Change” button.

Service Custodian

Click on Users on the menu:

You will see a list of existing users.

To create a new user click on “Add an Existing User”, you will be prompted to type in the email address of the user:

Click Search, if the user exists their details will be displayed:

Then click on the “Allow Access” button. You will then need to assign the user to a Group:

Click on the “Change” button and then tick the Group(s) you want to assign the user to:

Then click “Save”. The user will then show as being assigned to the Group(s):

At any time you can change the Group(s) the user is assigned to by clicking on the “Change” button.

In order to create a care package in Digital CHC details of Care Providers and Services need to be recorded in the Directory of Services module.

A Company can be recorded if you want to hold details of a Parent Company for a Provider.

A Provider can be added once and then linked to multiple services.

Please note that there is a one-to-one relationship between Services and Providers. You cannot create a service and link it to more than one Provider.

Once the Provider and the Service has been created a ‘Commissioned Price’ can be recorded. Commissioned prices can be an agreed contracted rate or a standard rate e.g. FNC.

In Directory of Services, click on Providers:

Existing Providers will be listed.

To add a user who will have access to the Provider Portal for the specific Provider, click on the name of the Provider:

You will see two tabs; Services and Users. Click on Users:

You will see a list of existing Users that have access to the Provider Portal for that Provider.

Click on the “Add a User” button:

Security Groups can contain a collection of users, and it is the Security Group itself that is granted permission(s) for the system.

All users need to be assigned to at least one Security Group. Security Groups are configurable.

To create a Security Group, click on Create (in top right-hand corner):

Type in the name of the Security Group and click on the “Create” button underneath:

Once the Security Group has been created, click on the name of the Security Group and this will drill you down into the Group Detail:

Signing In

Once the Care Provider’s user’s account has been verified they can sign in to the Provider Portal with their username (email address) and password.

There is a “forgot password” option in the event that the user has forgotten their password:

An email will then be sent with a link for the user to reset their password.

For each ICB it is possible to set:

• A special character as required

• At least one number as required

• Both upper and lower case letters as being required

Digital CHC Reportal

The reports are as follows:

Reports for a Single CCG

• Referrals Received (YTD). All graphs on this report are over the last 12months and can be broken down by month or quarter. The graphs are:

This is a template to guide the project team through the configuration of Security Groups, Teams, Organisations and the set up and maintenance of Users within the Digital CHC product. 

1. Security Groups

Security Groups can contain a collection of users, and it is the Security Group itself that is granted permission(s) for the system.

All users need to be assigned to at least one Security Group. Security Groups are configurable.

To create a Security Group, click on Create (in top right-hand corner):

In Settings click on the Users screen:

Click on the “Create” button in the top right-hand corner:

Type in the user information and then click on the “Create” button at the bottom of the screen. This will trigger a validation email

Once the user has been created you will need to assign the user to the relevant Security Group(s) that control the access permissions:

Click on the “change” button underneath “Security Group Membership”:

Select the Security Group(s) you want to assign to the user and the click on “Save changes”:

The screen will then refresh and display the Security Group(s) that have been assigned:

Confirming Email Address

The new user will receive an email with a link prompting them to “confirm your account”:

The user clicks on the “Confirm your account” link and then they will see a message “Email confirmed”. The account has now been confirmed in Digital CHC.

The user then clicks on the “Login” button and that link will show a screen like below. The user can now close this browser window.

The user will receive a separate email confirming they have been set up as a user with their username and initial password:

The user should then open a Web browser and login to Digital CHC using the URL for the CCG. The user will see a screen like this:

The user will type in the email address and their initial password in their welcome email and click Sign-in.

The user must take care if copying and pasting from the email to ensure they do not include any spaces after the email address or password.

As this is the first time they will have signed in they will need to change their password to something more memorable:

The user enters the existing password, then sets a new password and then clicks “Continue” to sign-in to the system.

Change Password

Users can change their password inside the application by clicking on their name at the top right corner and then clicking the “Change password” button:

The user types in the new password, confirms the new password and then clicks on the “Update” button:

Accessing Documents in Emis Web from IEG4’s Digital CHC system

An authorised user (e.g. CCG staff) will be signed into the Digital CHC system, and subject to their permissions, can click on the Documents tab on a case and they will see documents held against the patient (using NHS number) under the heading EMIS Documents. The user can click on the download icon to download and view the document.

This is the area where the wording on the “built-in templates” can be customised.

The built-in templates are:

1. Assessment request email body

This is used to prompt an assessor to complete an electronic Multi-Disciplinary Needs Assessment (MDNA). This email includes a link to the required electronic MDNA. This is automatically generated when a user selects “assessment” against an assessor in the “Request assessments” step in the process.

2. Checklist incomplete email template

This is used to advise the user (who submitted an eChecklist) that additional information is required in order for the CCG to further process the eChecklist. This is automatically generated when a user selects “No” to the “Is there enough accurate information in order to pass the checklist to the Duty CHC nurse” step in the process.

3. Checklist outcome negative appeal

This is used to advise the person/representative that they do not meet the indicated threshold for full NHS CHC. This is automatically generated when a user selects “No” to the “Refer for full assessment” step in the process.

4. Checklist outcome negative FNC eligible

This is used to advise the person/representative that they do not meet the indicated threshold for full NHS CHC, but that they are eligible for FNC. This is automatically generated when a user selects “No” to the “Refer for full assessment” step in the process, but ticks the field “Yes” under FNC.

5. Checklist positive referral template

This is used to advise the patient that their eChecklist has a positive outcome and they will be referred for a full assessment for NHS Continuing Healthcare. This is automatically generated when a user selects “Yes” to the “Refer for full assessment” step in the process.

6. Checklist received email template

This is used to advise the user (who submitted the eChecklist) that the eChecklist has been received by the CCG and includes the case reference. This is automatically generated when a user submits an eChecklist.

7. Document received notification email template

This is used to advise the lead coordinator when a document has been received linked to a case they are working on. This is automatically generated when a document has been uploaded by an assessor.

8. Document request email template

This is used to prompt an assessor to upload an assessment document. This email includes a link to allow the person to upload a document. This is automatically generated when a user selects “upload” against an assessor in the “Request assessments” step in the process.

9. DST LA Review request email body

This is used to send an email to the Local Authority/Social Worker confirming that they had recently attended a MDT meeting with a link to view the DST document completed by the CHC co-ordinator.

10. GP patient data request

This is used to request a summary record from the patient’s GP. This is automatically sent to the email address recorded against the GP’s surgery that is held in the CCG configuration area.

11. MDT Meeting arranged

This is used to advise all MDT participants of the date, time and location of the MDT Meeting. This is automatically generated when a user adds participants in the “Arrange MDT” step in the process.

12. Not responsible CCG template

This is used to advise the user (who submitted the eChecklist) that the patient is not covered by the CCG. This is automatically generated when a user says “No” to the “Are we the responsible CCG?” step in the process.

13. Standard signature template

Standard signature applied at the footer of all generated documents.

14. User added email template

This is used to advise an existing OneVault user that they been granted access to the Digital CHC system.

15. User created email template

This is used to advise a new OneVault user that they been granted access to the Digital CHC system.

16. User password reset template

This is used to advise the user that their password has been reset.

Amending Templates

To amend the wording on the standard templates, click on Templates on the left-hand side of the screen, then click on “Built-in templates” which displays the list of the built-in templates:

To amend any of the built-in templates simply click on the name of the template and this will drill you down into the template.

Once changes have been made click Save.

Document Type Collection is a group of document types e.g. assessments, forms.

Click on Assessments:

This is where you can add the document types that you want to request from parties completing assessments. These will be displayed on the Request Assessments stage of the Checklist to MDT Workflow process.

To add a new assessment type click on the Add document type button:

Type in the name of the Document Type and then click on the Create button.

There are a number of in-built Workflow processes in the Digital CHC product:

To access the specific Workflow, click on the name of the Workflow:

This shows an overview of the Workflow and whether it is currently enabled (Yes/No):

Click on the Stages tab:

Click on the name of a Stage and this will show the Decision points and the target completion time, which can be changed:

Click on a Decision and that will show which Groups of users have the access to make that decision:

For each workflow stage you must assign the User Security Group(s) that can view cases at that specific stage, and where relevant, can make the decision(s) per stage.

When creating a Care Package financial codes will be generated. The codings for each segment of the financial code need to be set up.

Financial codes are made up of:

Cost Centre/Subjective/Analysis 1/Analysis 2/Other

Other is automatically set to 000000 so does not require setting up.

Setting up Cost Centres

Settings-CCG

Click on name of CCG:

That will drill down into:

To add required Cost Centres, click on “New Cost Centre”:

Name will be the description of the Cost Centre e.g. CHC Adult Fully Funded and Value will be the coding e.g. 946141

Click Submit and then the Cost Centre will be listed:

Repeat steps above to add all required Cost Centres.

Setting up Subjective Codes

Settings-Lists

Click on Subjectives:

To add a new Subjective type in the first field the Subjective coding e.g. 52161071, and in the second field type in the Description e.g. Funded Nursing Care Allowance:

And then click on the “Add” button. The new Subjective code will then be displayed under “Items”:

Repeat steps above to add all required Subjective Codes.

Setting up Analysis 1 Codes (Place)

Places Codes are linked to each individual Medical Practice.

Settings-CCG

Click on name of CCG

Click on name of Medical Practice:

The Finance code field holds the Place code.

Setting up Analysis 2 Codes

Settings-Lists

Click on Analysis 2 Codes:

To add a new Analysis 2 Code type in the first field the Analysis 2 coding e.g. PRCAHO, and in the second field type in the Description e.g. PRIVATE CARE HOME:

And then click on the “Add” button. The new Analysis 2 code will then be displayed under “Items”:

Repeat steps above to add all required Analysis 2 Codes.

1. Settings – Users – click on User, takes you into User Detail page; click on “Reset password” button:

2. Type in new password and confirm new password, then click on “Reset” button:

3. The screen refreshes and will take you back to User Detail page:

4. An email will be sent to you showing you the email that has been sent to the user confirming their CHC password has been reset:

The CCG screen lists the CCGs and is maintained by IEG4.

Click on one of the CCGs which drills you down into further details where you will see a list of the GP practices linked to the CCG:

Click on one of the Practices and this shows the email address of where requests for patient summaries will be sent:

To add a new Practice, click on the “New Practice” button:

Complete all fields for each Practice:

Click Submit to save the New Practice details.

1. Lists

There are drop-down list types that can be maintained within here:

There are drop-down list types that can be maintained within here:

1. Care Package Approval – reasons re-work needed

2. Checklist to MDT – reason checklist rejected

3. Decisions – Care groups

4. Decisions – care settings (only needed if implementing Finance Review Workflow)

5. Decisions – providers list (only needed if implementing Finance Review Workflow)

6. Decisions – Reason for delay

7. Decisions – reason for request (only needed if implementing Finance Review Workflow)

8. Fast Track Review – Reason review not required

9. Personal health budget types (only needed if implementing Finance Review Workflow)

10. Supplementary Information – Local Authorities

Click on any of the Lists:

This displays the list of values that will appear in the drop-down field.

To add new items to the list, fill in the code and description fields underneath “Add Item” and then click on the Add button alongside.

To access the electronic DST and to view all evidence linked to the case click on the MDT tab for the case:

Click on the Meeting code and this will drill you down into the meeting details:

On this screen, you can choose which documents that have been linked to the case should be visible during the MDT meeting. You can select any documents you feel should be visible during the meeting by clicking on the document and then clicking on the “Save changes” button.

Please Note - if you are attending an MDT Meeting where access to the internet might be limited it is advisable to download the documents prior to the meeting. You may also wish to use a blank DST template during the meeting to record what is discussed with a view to copying and pasting your notes in once you are back in an area where you can access the Digital CHC system.

When completing the digital Checklist, once you have uploaded any documents, click on the “Next” button in the bottom right-hand corner of the screen and you will be taken to the first Domain “Breathing”. When you click on a description the score will be automatically highlighted. You also have the option to add text in the “Brief description of need and source of evidence to support the chosen level” box. There is no limit on the amount of text that can be recorded here.

Once that Domain is completed, click on the “Next” button at the bottom of the page and this will move you on to the next Domain to be completed. Repeat this until you reach the “Equality” page.

When completing the digital Checklist, click on the “Next button” and this will move you on to the “Outcome page. At the top of this page will be a summary of the C, B, A scores against each of the Domains you have completed.

You can record if any other professionals contributed to this assessment. If you respond Yes, you will be asked “How many?”. Click on the drop down and select the number e.g. 1 and you will then be asked to record their details:

You must then respond to the question “Refer for full assessment” and then complete add in text to the “Rationale for decision” field. You will then be able to submit the eChecklist to the ICB by clicking on the “Submit” button at the bottom of the page.

Once the eChecklist has been submitted you will be presented with a screen that allows you to click on a button to download a PDF copy of the Checklist.

Once the eChecklist has been submitted you will be presented with a screen that allows you to click on a button to download a PDF copy of the Checklist.

Once a digital form has been submitted to the CCG if any of the basic patient details are incorrect, e.g. name spelling, NHS number, date of birth, an authorised user has the ability to “Edit” the details:

The “Edit” button will appear on the Summary tab (see above). When you click on that button pencil icons will appear against the details you can edit:

In the screen shot below you can see that I have changed the last name from Brown to Gill:

On the “Summary” tab for a case, where a user has the new Security Permission “Can edit General Practitioner details” set, this will allow them to edit the GP Practice and GP name:

This function is controlled in Settings – Security Group – Manage Permissions – “Can edit General Practitioner details”:

You can view the submitted Checklist data by clicking on the Checklist tab:

We have a Permission that can be set for relevant Security Groups where users in that group are able to “rewind a workflow”:

When this enabled the authorised users will see the “rewind” icon on the top right-hand side of the Workflow Stage screen:

The “rewind” icon will appear only on the latest Workflow stage that the case is at.

The Documents tab shows any documents linked to the case, including a PDF copy of the submitted digital form and any supporting documentation:

You can view a Document by clicking on the icon that appears before the “description” field.]:

There is a function to enable authorised users to delete a case. This is controlled by permissions linked to the user's Security Group.

The Linked Cases tab will show if the NHS number is linked to any other cases in the Digital CHC system.

The Timeline tab shows the audit trail:

The Workflow tab will show the Workflow process the case is currently going through (Active Only) and/or has been through:

The Notes tab displays any notes that have been added to the case. You can also add Notes by typing in the notes and then clicking on the “Save” button:

The Summary tab shows basic case data:

To access the electronic DST and to view all evidence linked to the case click on the MDT tab for the case:

Click on the Meeting code and this will drill you down into the meeting details:

On this screen, you can choose which documents that have been linked to the case should be visible during the MDT meeting. You can select any documents you feel should be visible during the meeting by clicking on the document and then clicking on the “Save changes” button.

Please Note - if you are attending an MDT Meeting where access to the internet might be limited it is advisable to download the documents prior to the meeting. You may also wish to use a blank DST template during the meeting to record what is discussed with a view to copying and pasting your notes in once you are back in an area where you can access the Digital CHC system.

Click on the “Open DST” button in the top right-hand corner and this will open the meeting for the case:

Click on the “Connect” button and this will take you to the digital DST:

You will see the Patient details on the first page. All other sections are listed down the left-hand side of the screen. To move between sections simply click on the name of section you want to move to.

You need to scroll down the page and complete all other Patient fields which are mandatory:

The Documents section will allow you to view all documents that you had agreed (on the previous step) could be shared during the MDT meeting.

All other sections mirror the paper Decision Support Tool (DST) with 12 domains listed. You need to respond to all 12 domains and all fields on the Decision page.

Where assessors have completed electronic MDNAs their name and their responses will be displayed in each of the relevant domains.

As the person running the meeting you can score the “level of need” by clicking on the letter of the score e.g. M (which is then highlighted in yellow) and then by clicking on the appropriate standard paragraph(s) that describes the need:

You can then add in unlimited comments in the Rationale text box, including details of any disagreements on the level of need.

Where there is a disagreement this can be recorded by clicking on the “i” icon next to the “collaborative level of need” field:

This dynamically calls in an additional row to record the dispute in the score:

The “Rationale” text box can be used to record details of the disagreement.

All domains on the DST must be completed, even if it is to state there are no needs.

Once all domains have been responded to click on the “Decision” page on the navigation bar on the left-hand side of the screen. This will give you a summary of the scoring assigned to each of the domains:

When all fields are completed, at the bottom of the page, the “Submit” button:

The status of the MDT will now show as “under review”:

A new workflow has now been started “Decisions”.

Once an eChecklist has been submitted, it appears in the “back office” as a new case.

As part of the Digital CHC back-office product there are two standard built-in Workflow processes:

1. Checklist to DST

2. Decisions

As a case progresses, according to the decision recorded the relevant Workflow process and steps within it will be triggered.

1. MDT Recommendation

This step is to record the recommendation agreed during the MDT meeting. The step also automatically displays the number of days between the date the checklist was accepted to the date the referral was completed.

The recommendation is recorded at the bottom of the screen:

Once a recommendation has been selected click on the “Progress” button to move on to the next step “LA Review”:

2. LA Review

This step allows the Local Authority 48 hours to review the recommendation:

To record which Social Worker should be sent the link to review the DST click on the + icon, then click on “select person” which calls the “User selection” search:

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Teams

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

Once you have selected the user click on the Progress button:

This triggers the step “Awaiting LA Response”:

An email is sent to the user requested to review the DST document:

The link on the email allows the user to view the DST that was submitted:

This allows the user to review the document and then record their response:

The user (Social Worker) must record their response, enter their name and add comments. The response can then be submitted.

Once submitted the system records details of the Social Worker’s response against the step in the process:

The next step in the process is triggered “Comprehensive Assessment Check”.

3. Comprehensive Assessment Check

Once all questions have been responded to, click on “Progress” which triggers the next step in the process “Further work required?”.

4. Further Work Required

If further work is required, click Yes underneath “Yes, further work is required” and then record details in the Rationale text box, then click “Progress”.

If no further work is required click on the “Progress” button underneath “No, not required” which triggers the next step in the process “2nd opinion required?”.

5. 2nd Opinion Required?

If a 2nd opinion is required click on the “Choose” button underneath “User to notify” to call the user search:

In here you can search by:

· Organisation e.g. Local Authority, CCG etc.

· Group e.g. Social Workers

· Teams

· and/or Name

From the search criteria you will be presented with a list of matching records to choose from:

Once you have selected the user click on the Progress button.

If a 2nd opinion is not required click on the “Progress” button underneath “No, not required” which will trigger the next step in the process “CCG Decision”.

6. CCG Decision

Click to select the Decision and then click on the “Progress” button to complete the step which triggers the next step “Decision letter”.

7. Decision Letter

To generate the decision letter document, click on the “Create notification” button:

This calls the template where the document can be edited. Once changes have been made click on the “Save” button and then click on “Progress” to complete the step in the process.