Bradford District Care NHS Foundation Trust’s specialist nursing team supports around 1600 children in care (birth-18 years) and care leavers (18-25 years - optional service). These young people, often with complex health needs stemming from trauma, require statutory health assessments. A Government statutory requirement for those aged 16+ is to have a health passport, designed to equip them with essential health information and improve health literacy as they prepare for adulthood.  The team wanted to enhance their service, complementing the traditional paper-based system with a dynamic digital version.

Hear from the team, in the short video below, about how and why they have moved to a digital solution and the benefits of doing so.

The traditional paper-based health passport, while fulfilling a statutory duty, has some significant limitations. It is:

• Vulnerable & Static: Easily lost, less confidential and difficult to update with new information.
• Communication Barrier: Contact with young people is often indirect, routed through carers or Social Workers, hindering open dialogue.
• Lacked Transparency: Young people are often unaware of any follow-up actions post-assessment.
• Lack of knowledge about health history: Young people were often unaware of their health history and where they had previously received care.
• Limited Empowerment: It offers minimal control to young people over their own health information. Feedback from young people indicated a desire for both paper and digital options, prompting a reform of the system.
• Limited Digital Maturity: The Children in Care services did not have a solution that would support the business problem or meet the NHS England Digital Capability Framework (DCF).
• Resistance to change: Some members of staff and service users were not confident about their level of IT skills and were nervous about using a new system.

The Trust looked at a number of solutions and implemented a digital Health Passport using Patients Know Best’s (PKB) Care Plan functionality, to complement the existing paper booklet. They also deployed the direct Messaging functionality and Library features from within PKB. Key aspects of the solution include:

• Dual System & Consistency: The PKB-built Health Passport (using the care plans functionality) matched the paper version, offering live, updatable digital access alongside the physical copy of the passport.
• Direct, Secure Communication: PKB enabled private messaging between young people and nurses, fostering direct dialogue and timely updates (e.g., referral confirmations). This offered an asynchronous message exchange, with clear boundaries, for this non-emergency communication channel.
• Centralised Information & Resources: PKB provides a live resource library with trusted health information which can be accessed for support 24/7 by the young people.
• Enhanced Record Keeping: Digital messages can be accurately transferred to official medical records.
• Young Person Control & Confidentiality: Young people manage their own secure PKB accounts, controlling who views their information – a significant privacy improvement over paper copies. Safeguarding protocols ensure concerns are appropriately escalated.

Implemented in September 2024, the PKB system is in its early stages but shows promising results:

• Improved Engagement & Voice: Some vulnerable young people are using PKB to communicate directly and feel safer doing so.
• Increased Empowerment: Young people report feeling more in control of their health information, giving them a voice and providing them with access to their record 24/7.
• Enhanced Communication: Direct updates on care progress provides reassurance.
• Efficient Processes: Concerns about message overload have not materialized; record-keeping is more accurate and more auditable.
• Future Vision: The aim is for PKB to become a central health information hub, controlled by the young person, and potentially shared with other professionals involved in their care (with consent), further embedding the "voice of the child."
• Improved Staff Moral: Staff in the Children in Care service are championing this as a solution.
• Positive User Acceptance: Young people are actively using the solution and in some cases, this has improved service user engagement and trust.

The PKB initiative marks a significant step in modernising support, better equipping care-experienced young people for adulthood by giving them greater agency over their health journey.

The Children in Care Team's work on the Digital Health Passport using PKB has been shortlisted for the 2025 HSJ Digital Awards in the Empowering Patients Through Digital category.