To serve these different operational requirements, the PCN created a detailed technical model that described the specification and ensured the technology serving the hub reflected the individual needs and circumstances of its network. This interactive wireframe diagram above summarises how the system fits together. You can download the full PCN system solution configuration and considerations log here.

All seven constituent PCN practices continue to be supported by the EMIS web primary care system. Within the PCN hub, staff now connect to the EMIS Web clinical service, which comprises:

• PCN federated online consultation delivery
• Message Exchange for Social and Health (MESH) delivery to PCN hub, which enables online consultations from all seven practice websites to be delivered directly to the PCN hub via MESH. This puts them straight into the EMIS Web workflow to be dealt with.
• Details of the national spine services e.g. PDS, EPS and Summary Care Records (SCR)
• The deployment of full suite of Ardens templates and searches into the PCN hub
• Third party integrations configured with the PCN hub e.g. AccuRx, CCG SMS+ contract on-boarding for PCN hub
• Integration of EMIS Community Pharmacy Consultation Service (CPCS) – a module that is integrated into EMIS that provides a pathway to seamlessly refer suitable minor illness patients to a community pharmacy for a consultation
• Full integration of eConsult Smart Inbox online consultation triage tool to manage workflows between practice and hub-based teams

Technical prerequisites

The technical pre-requisites for an organisation to develop this solution are as follows:

• An EMIS Clinical Service (now being marketed as an EMIS “PCN hub”)
• A dedicated PCN-level smart card service and associated support contract
• PDS services enabled within the EMIS Clinical Service
• EPS module enabled within the EMIS Clinical Service
• A PCN-level prescribing cost centre issued by NHS England Business Services Authority (BSA) and agreed by the local Integrated Care Board

Workarounds and limitations

While the technical solution meets the majority of the PCN’s needs, there are still some unresolved technical issues that are reliant on actions by the suppliers, including some key functionalities that the EMIS clinical system cannot yet deliver for PCNs. These need to be factored into early discussions about the scope and operating model for hub-based services as they will apply to all PCNs using an EMIS-based system. Download the EMIS PCN hub clinical system functionality issues log which tracks the technical limitations and workarounds that the PCN is working to resolve.

In particular, there are several issues related to the consultation write-back functionality which EMIS is currently working to resolve (see p12 for more detail). Other technical challenges involve electronic referrals via ERS, pathology services managed via the DART system currently used in Kent and Medway, and difficulties integrating third-party suppliers that lack EMIS accreditation for their products to be used within an EMIS Clinical Service.

“An important lesson we’ve learnt is that you need to be mindful of what is and isn’t possible with the systems and third-party products you use. There are always going to be some limitations to what a hub-based system is capable of – make sure you know what they are and factor them into the scope and design of your operating model from the outset.”

Andy Gove, Digital Transformation Manager, Folkestone, Hythe and Rural PCN

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