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Not well thought through

Posted By KennethCountyAntrim

"Not well thought through"

About: Belfast Health & Social Care Trust Health and Social Care Northern Ireland Northern Health & Social Care Trust

(as the patient),

My Care, Encompass (HSC Northern Ireland) has been a long time coming, but is a step in the right direction ... however ... in its current form it is not well thought through ...  

I need to engage with primary, secondary and consultant services regularly because I have multi-comorbidities. My medical practice in Ballymena merged with two other practices in April 2024 - now accessing the practice by phone is a challenge. When it makes more sense to speak directly to my consultants' office, I do this, and have at moments of desperation and pain emailed the consultants. Now I been advised by Belfast Complaints to desist.

In December 2024 January 2025, I queried Encompass's messaging feature, which is advertised, but which is currently non-functional. Why is the messaging service not available to patients? I use my medical practice's Patient Access, which also offers a messaging feature. It is not active. Why?

I find My Care, Encompass not well thought through for these reasons: before each consultant/ clinician/ service appointment I have been asked to complete pre-appointment checks and complete patient notes (presumably so that the clinician can read and be ready for the patient appointment) at few appointments has the clinician read my notes, or even been aware that I as a patient have access to this online patient account. At least this is my assumption because the mention of pre-notes and Encompass generates bemused looks. I understand that clinicians will want to ask me their own questions and base their diagnoses on my responses, but why then ask me to complete pre-appointment notes?

Via the My Care app, as well as prepare for appointments (which no one then reads) I can read my test results, but not up date/ correct my current medications list. I cannot access my scans/ X Rays/ images. I can access my patient notes from 2025 and after a given date in 2024, but not before, and this is limiting - I have been under-going medical assessment with the BHSCT/NHSCT for over five years, but can only get access to a fraction of my notes.

When I receive an email alert from the My Care app to read the appointment follow up summary ... there is no summary. I can read that I have an appointment, which Encompass calls 'visit' on line, but I then also receive a paper appointment, and with the Belfast Trust sometimes the same appointment letter in triplicate, and sometimes even with a map of the venue ... even when the appointment is a telephone appointment! And the Trusts constantly highlight lack of funds.

My Care, Encompass is not linked to my GP's practice Patient Access ... why? It does not allow me to access links between Primary and Secondary Care. Why? Given the difficulty I face telephoning my GP practice and many of the Belfast Trust's services - an e link between Primary, Secondary, Consultant and Patient would make sense ... at least to a patient.

In all, the My Care app is a step in the right direction, but currently it offers a service that is only partly functional, partly of use to the patient. Why?

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Responses

Response from Clare Forsythe, Patient and Client Experience Manager, Belfast Trust Wide, Belfast Health and Social Care Trust 2 months ago
Clare Forsythe
Patient and Client Experience Manager, Belfast Trust Wide,
Belfast Health and Social Care Trust

Submitted on 02/05/2025 at 11:47
Published on Care Opinion at 12:00

picture of Clare Forsythe

Dear KennethAV

My name is Clare Forsythe and I am the Patient and Client Experience Manager for the Belfast Health and Social Care Trust.

Thank you for sharing your story regarding Encompass and MyCare on Care Opinion.

I apologise for the delay in responding to you, I have been liaising with colleagues here in the Belfast Trust who have the expertise in Encompass and MyCare to ensure you receive a thorough response, which they will be providing to you very soon.

In the interim I have included the link to information available about MyCare that I hope you will find informative.

http://https://dhcni.hscni.net/digital-portfolio/encompass/my-care/

Kind Regards

Clare Forsythe

Patient and Client Experience Manager

Belfast Health and Social Care Trust

PatientExperience@belfasttrust.hscni.net

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Response from Co Director Public Health, Belfast Health and Social Care Trust 2 months ago
Belfast Health and Social Care Trust

Submitted on 29/05/2025 at 19:44
Published on Care Opinion on 30/05/2025 at 09:17

Thank you for your comments uploaded onto Care Opinion in relation to My Care. You have made a number of valid points and I have discussed them with my colleague Patricia Ferguson.

You will appreciate that the introduction of Encompass has been a major change process within the health service and we are now in a position were all five Health Trusts are now live. My Care has significant potential but at this point the emphasis has been on system go live but as we move forward we expect a more speedy roll out of functions e.g. the option remains to turn off paper communication but until things settle the decision has been taken to continue with both.

The Regional My Care Governance and Decision Making Group, which has representatives from all Trusts, Encompass staff and service users and carers has the responsibility for roll out and the group are working to pilot new functions.

Unfortunately, General Practice has not been part of the roll out however; there are good links between Primary and Secondary Care.

I agree that we are moving in the right direction and would hope that as functions roll out, we will be able to take advantage of the them to the benefit of the patient and services.

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Update posted by KennethCountyAntrim (the patient)

Thank you for your response. When Care Opinion offers only a binary response: yes/ no there is no room for nuance. No one has addressed the specifics - for example - Post appointment summary notification when there is actually no summary.

I disagree that there are good links between GP and Secondary level care. On several occasions I have sat for months in the belief that my GP has communicated with a consultant; the GP has followed HSC guidelines, referred me locally (I think because of postcode politics within the DoH) and I have had to make my own arrangements for private, and costly treatment. This could have been resolved much faster with a patient-GP-consultant e link.

Response from Veronica Meenan, Engagement Manager, Involvement Team, NHSCT last month
Veronica Meenan
Engagement Manager, Involvement Team,
NHSCT

Submitted on 06/06/2025 at 08:20
Published on Care Opinion at 08:22

Dear KennethAV,

My name is Veronica Meenan I work in the Involvement Team, where we support both staff and the public to share feedback and get involved in shaping and improving our services. We value all types of feedback, as it helps us understand what’s working well and where we need to make improvements.

Firstly, I’d like to apologise about the delay in getting back to you. We don’t currently have staff from Encompass on Care Opinion, so I needed to liaise with them directly to ensure I could provide you with an accurate response. Thank you for your patience.

It is clear that you’re a strong advocate for Encompass, and we really appreciate your engagement. We understand your disappointment that it’s currently only partly functional, and we’ve shared your feedback with the relevant teams to ensure your concerns are heard and considered as the system continues to develop.

You’re absolutely right to highlight this. As the introduction of Encompass represents a significant change, it was agreed that functionality would be rolled out gradually to give everyone time to transition and adjust effectively.

My colleagues from the Encompass team have provided the following responses to each of the issues you raised. I hope this helps clarify why some aspects may not be working as you had expected.

Why is the messaging service not available to patients?

Clinician initiated messaging to patients is currently available in HSCNI. Patient initiated messaging is currently turned off. Clinicians are adjusting to the new encompass system and we will explore turning on further functionality in future.

Why am I asked to complete pre appointment checks/notes?

This is an optional ask for patients/service users at present. As our teams get more familiar with the new system we hope to use this functionality more.

I cannot update my current medications.

Patients can currently update their medication list on My Care. If you let your clinician know that you have completed this, they can reconcile this information to add it fully to your record.

I cannot access notes before 2024

The system contains only information from when encompass was switched on in NHSCT; previous information was on paper and other ICT systems.

Receipt of appointments via paper and via the App.

Currently most appointments are sent both on paper and via the App, to ensure patients are aware of their upcoming appointments. As we become more mature in our use of the system we will be exploring ways to avoid duplication.

App is not linked to GP information system.

GPs use a different information system than encompass, and the two are not fully integrated. A single app therefore does not provide a view into both systems.

If you have any further questions or would like to discuss anything in more detail, please get in touch.

Best Wishes

Veronica Meenan

Engagement Manager

Involvement Team

Northern Trust.

InvolvingYou@northerntrust.hscni.net

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