Managing the Social Care Information Agenda

Date
Thursday 8 November 2001

Venue:
The Board Room, Moorfields Eye Hospital, City Road, London, EC1V 2CD

Speakers:

Roger Stanton, Head of Social Care Information Strategy, Planning and Development, Department of Health

Nick Davey, Information and Planning Manager, Brent Social Services, Portsmouth City Council - seconded to Department of Health

The LMSG BCS has, for the most part, focused attention on the workplace context of the NHS. With the shift in Public Sector policy of this Government toward provision of 'joined up' services, an alignment of health and social care is being sought. In this session Roger Stanton gave an outline of how an information strategy has been developed for Social Care, Information for Social Care (IfSC). This development has been built on collaboration with Social Services departments and within the context of both the e Government and NHS information strategy (Information for Health / Building the Information Core).

The context: Good information is seen as fundamental to developing high quality 'citizen focused' services. There are a number of related drivers behind the need for a strategy such as public expectation of improvement, a series of 'Modernising' initiatives of the Government and the 'Best Value' context of local Government - the need to market test internal service provision against potential external providers. Social Services are managed and, in part, resourced locally. There is far greater variety, autonomy and less central direction compared to the NHS.

Framework report: The IfSC strategy is consistent with Quality Strategy for Social Services and the e-Government programme, a national framework was established for information management and local actions required to support this and an investment programme was established for future work. A national Road Show allowed the framework to be shown and to support a local understanding of what is required of Social Service departments.

The Electronic Social Care Record (ESCR): The key building block for the strategy is an electronic record for the client. This is a computer index linked to letters, emails, pattern of visits, social worker case notes and any other relevant material. A conceptual pyramid is build on this with a shared minimum data set for local and national use supporting, at its tip, Performance Indicators to allow comparison between different Social Service departments.

Strategic development programme: The ESCR is seen as closely related to concepts of the Electronic Patient Record and the same framework of explicit client consent and managed information transfer and use is intended (as for the NHS Caldicott Guardian).

Demonstrator programme: Just as the NHS has a small investment programme to develop early demonstrations of how we can all work in the future, so there is an even smaller set of 6 centrally funded local Social Service projects. These are set to report quickly and cover subjects such as VPNs, encryption and a Borough-wide information exchange agreement - further details on www.doh.gov.uk/scg. For Leeds and Cambridge an integrated health and social care record is being sought.

Local information plans: Each Borough and Social Services produced a response to IfSC.

Investment programme: Funding has been made available (2001/2 £2.5m and capital funding over 2002/3/4 of £50m). This will be distributed on the basis of the plans and progress of the demonstrators.

Suppliers market: There is a even smaller number of Suppliers for Social Service departments than for the NHS.

Nick Davey continued with the 'worms eye view' from underground in Social Services departments.

IfSC is widely seen as inspiring, however the barriers to change are seen as greater than within the NHS. Funding and local installed IT base, for example vary greatly and local accountability means budget cycles are even shorter focused. Legacy client-based applications present great barriers to change being organisation specific. It is also unclear which NHS patient / Social care client or groups offer initial or greatest reward, but Mental Health is the area where most shared work is in progress. It may require the development of a new generation of systems across health and social care without these inherent barriers if service transformation is to be achieved.

There are similarities to the policy overload experienced within the NHS (multiple NSFs for disease and patient groups) and a strong prioritisation is sought.

Prior to IfSC, innovation was localised and we now have a shared framework with a devolved approach to meet local complexity. With the new NHS structures of Primary Care Trusts (Borough based) and with explicit formal frameworks for openness of systems (the eGIF standards) and for the re-engineering of the care process for patient and client care across organisational boundaries, the scene is set for a renewed phase of co-ordination and partnership. Patient care pathways and citizen focussed care can be seen as linking concepts. This will doubtless start with a shared search for additional funds!

Nick opened up discussion across the group and this is summarised below:

Q: Where can we find out about the best practice / demonstrator sites?

A: A database is being prepared and will soon be available - see web site above.

Q: For the NHS in terms of the development of information strategy, there is a tension for any player between waiting uncomfortably for central definition of standards and going early with a local standard, what of Social Services?

A: The 'centre' is less prescriptive than the NHS and only now is guidance sought from it. Also Social Services are more like 'greenfields' so there is less to through away in any move to a centrally defined standard.

Q: The emphasis tonight has been on Social Services, but where does Education, Housing and other Local Authority functions fit?

A: Although the man focus for IfSC is Social care (e.g. Children), all client groups cannot really be separated in terms of functional use of services. Social Services is not self contained.

Q: We have seen a history of 'dead' pilot projects in the NHS as funding dries up - what will happen to the IfSC Demonstrators?

A: They will either have transferable lessons and some solutions can be distributed if successful. There will also be failures and these will be welcomed again for the lessons offered to others.

Q: Where is success in use of ESCR likely to be first seen?

A: Where data quality on systems is already good, probably where scheduling of care is already 'electronic' and where sharing of information with the client is already routine, since both uses are dependent on and foster gathering and maintaining high quality information.

Q: Are client participation in Care Plans the key concept for Social Service systems?

A: Social Care has led in the development of individual care plans and client participation, they are at the heart of present systems.

Q: Data quality is essential for success with all information systems, the NHS has great problems in this respect and is at present starting a new initiative, what of IfSC?

A: IfSC is included within the new data quality initiative.