This Business-As-Usual successor group to the Task & Finish group decides on extra functionality/scope of the MyCare App, provided by EPIC for the encompass programme using their MyChart app.

Clinical Specialty leadership, Job planning, service governance and regional representation

Consultant Physician in Endocrinology & DiabetesLead, Managed Clinical Network Diabetes, WHSCTWHSCT Staff Recognition Award Safety & Quality 02/12/2015From 2009-2012 I led the Acute Medical Unit in this hospital, directly reporting to the Clinical Director for Unscheduled Care and sitting on Directorate Lead Meetings with formal leads. With the AMU team I helped organise the Unit. Overall patient throughput improved by >30%, with further improvement of 30% on moving into the new AMU in 2011. Electronically generated discharge summaries were introduced. I was able to apply my speciality training to increase awareness and confidence of AMU staff in diabetes-related presentations. As a result management of DKA became localised to AMU rather than the base ward. With my speciality colleagues we reduced length of stay for DKA in particular by focusing on critical parts of the care process. The process of acute medical care delivery was organised using the experience and skills of middle grade doctors and the nursing and allied healthcare professions. The improvements were from team effort, mutual support, organisation and communication rather than external investment. There remains much to do. Developments remain limited by staff recruitment and funding. Despite this, the Unit has gone further since I left and is ever more the centre and foundation stone of this hospital, where it belongs.In 2012 the loss of speciality colleagues, through retirement and moving to another Trust, I had to move into full time specialty practice in endocrinology and diabetes. I inherited the legacy organisation of the diabetes network from my colleague and continue to develop it. I have worked with the Trust to plan introduction of patient tracking systems by representation of the Trust at regional ICT meetings. I believe organisation and communication are the keys to safe and efficient patient care and a better patient and healthcare professional experience.

I started as CCIO at WHSCT at an important time, as we adapt to physically-distanced clinical work and to using new tools like video clinics. The next few years post-covid will be a period where we are adapt towards taking on encompass EPIC EHCR, named encompass. This will replace the PAS systems of all 5 acute Trusts in NI and add all the functionality of EPICs enterpirise healthcare record.I am an accredited EPIC Clincian Builder and am. looking forward to refreshing and building on what I have learnt when we Go Live with the system in our Trust in Spring 2025.

Working our way through outpatient processes and systems to improve the experience of people attending as patients, referring GPs and staff at clinics

One of a team of three ADs responsible for operational matters and clinical governance for acute services at Altnagelvin Hospital. This was a challenging role with wide responsibilities, covering Emergency Medicine, Medical Specialities, Surgical Specialities, Anaesthetics and Critical Care. I managed medical staff and services and reported directly to the Director of Acute Services and Medical Director. This post was new, and the first and only with this wide a remit. I learnt a huge amount and definitely developed, but it was punishing. The post no longer exists, divided along smaller Directorates now. Take from that what you will.

Lead Clinician for consultation and implementation of NIECR in Western Trust. I acted as a clinical contact for NIECR Development Team within this Trust and since 2015 Chair the WHSCT NIECR Project Board.I represented our Trust on Clinical Reference Group meetings for NIECR development which advised on the strategic clinical direction for NIECR and on specific points for development. I was a member of the Digital Results Signoff Group which advised and helped develop processes for digital results acknowledgement in NI. I was in the group involved in development of the NIECR Diabetes Pathway with clinical colleagues, the NIECR development team and Orion Healthcare.In 2017 this appointment rolled forward to become Electronic Healthcare Record (EHCR) Lead for WHSCT. It took us to the next stage in the NI Healthcare e-maturity journey.

When NIECR moved from Project status to Business as Usual, the Clinical Content Group was dissolved and the Steering Group formed. This was smaller, with clinician, information governance and NI BSO representatives. We stand over ongoing operation of NIECR, considering infrastructure matters, access requests, clinical and information governance issues as well as development requests. We are actively managing beyond Business as Usual to the next phases - Transition and Archive.Transition is the period from the first EPIC / encompass Go Lives in NI in 2023, after which PAS instances in each of the 5 Acute Trusts will shut down sequentially, till the final acute Trust moves to encompass. After that, it is anticipated that NIECR will be accessible using an archiving solution only. I sit on regional encompass Board in this role. NIECR is crucial to Clinical practice in NI and will remains so for day to day practice even in Trusts live with encompass, provided by EPIC. To this end, we drove forward an in-context link from encompass to NIECR, facilitating medicines list and allergy record checks in live Trusts and also providing missing functionality yet to be replaced by encompass as yet on October 2024: electronic Medical Certificates of Cause of Death and the Regional Mortality & Morbidity System.Ultimately, after the final encompass Go Live in Western and Southern Health & Social Care Trusts, the PAS for all 5 acute Trusts will be provided by EPIC as one instance. NIECR will be needed for many years to come, as an accessible, decades-long legacy clinical record for each patient in NI.

Delivering Lectures on Endocrinology to year 1 and 2 Graduate Entry Medical Students each Autumn.

Chair of regional task & finish group for MyCare App for encompass programme. This is the NI instance of EPIC MyChart app, the patient portal, allowing viewing of HSC appointments, outpatient letters, after-visit summary letters after discharge from hospital and many outpatient results and reports. This was a multi-disciplinary group, with multiple clinician and social care professions, Trust operational and access managers and, crucially, patient/client / service- user representation. As challenging as chairing this group was, I took it on as I feel very strongly about sharing information with people to help their care. I also felt strongly that this information should be contextualised and explained for the person by their clinical or social care professional. One of the crucial activities early on prior to the first NI Go Live with EPIC-encompass in November 2023, was to work on the legal basis for Proxy access to a healthcare record, eg by a parent or Guardian of a child or next of kin of a vulnerable adult or someone who lacks capacity to consent to this access but it is in their best interests and legitimate. As NI has its own legal framework, separate from the other UK nations, our social work leads were instrumental in the draft, that was intensively, thoroughly worked through by the Department of Legal Services. This was a remarkable piece of work and it was edifying to witness it.

Delivering Endocrinology & Diabetes teaching to QUB 3rd Year Undergraduate Medical Students

By nomination.The group met on a few occasions to agree the direction of the ICP. We also consulted with other ICP groups to harmonise our efforts and have produced a number of pathways and guidelines aiming to reduce admissions, support primary care and make access to secondary care support for patient care more flexible and accessible. Ultimately this will mean less people with diabetes attending secondary care clinics, but we are strengthening links with primary care to allow care to be maintained in other ways. Diabetes related care takes up 10% of the NHS budget, but diabetes has a prevalence of only 4% of the NI population, so measures to like we are carrying out to make diabetes care more cost effective are important for the NHS as a whole. Quality assurance, carried out with the local Primary Care Federation was critical to validation of our approach. The systems evolved since then are still in place on 2023-2024. Our feedback from our colleagues is positive, mentioning our responsiveness, positivity and clear educational correspondence style.

This group represents each of the five Trusts in Northern Ireland and was constituted by the Health & Social Care Board to standardise the Diabetic Ketoacidosis protocols across the Trusts in accordance with with the Joint British Diabetes Societies guidelines which were issued in 2011. The role was allocated by nomination within the group. I drew up the HSC guidance as a 2-sided summary document for ease of reference which refers to the original JBSD document as well. The two sided format was already becoming the standard and was used in at least three Trusts already. It has been accepted throughout the group and will be applied throughout Northern Ireland on recommendation of the HSC in NI. I extended its remit by also proposing a similar document for the Hyperglycaemic Hyperosmolar State which is for discretionary application by the Trusts but which followed the JBSD 2012 guidance.