Features: April 9th, 2010

By Gayna Hart, MD, Quicksilva

Customer focus is the aim of all public services. The importance of this approach is very clear in health and social care. Several agencies can be involved in providing support and they all have different processes and systems. The author describes how connecting the health and social care information systems can bring a range of benefits.

For most people, their knowledge of the UK’s social services comes from media reports on cases where something has gone wrong. The common denominator at the heart of many of these cases is a breakdown of communication, often between different agencies involved in providing care. These issues overshadow another truth – that thousands of people across the UK benefit from the work of social care professionals as they improve and protect the lives of others.

Social care in England is provided by local authorities, who in turn are regulated by the Care Quality Commission. Daily liaison with both local NHS trusts and the police is an essential part of the job, along with the sharing of information with social services teams in neighbouring boroughs and districts. Information sharing at this level is complicated; it needs to be secure, involves a range of computer systems – some local, some national – and is also achieved by the exchange of paper-based documents. With data held in silos, it is very easy to see how vital information could be missed. But what can be done to prevent this? How can we ever achieve a joined-up social care system?

In fact, small steps are already being made. As part of the Government’s NHS Connecting For Health (CFH) programme – the world’s largest civilian IT project – social services teams across England will be able to better communicate with hospitals, GP surgeries and pharmacies. NHS CFH is digitising and streamlining the NHS in order to save time, money, increase accuracy and enhance patient care. Ultimately it will computerise medical records in a central database and link up more than 30,000 GPs to nearly 300 hospitals. Already it has enabled real-time appointment booking, easier access to medical records, electronic prescriptions and high speed computer network links between NHS organisations.

The common misconception of the NHS CFH programme is that it only affects a limited medical community – doctors, hospitals, NHS Trusts and pharmacies. In fact, the project is not so restrictive. It’s a huge undertaking that will impact many bodies across the public sector, including those in social care. It is this facet of the programme that will ultimately help prevent vulnerable people slipping through the gaps and ensuring that workers within social services have access to up to date, valuable information.

So, how does CFH affect social services?

The process of integrating the NHS CFH programme with the social services has already begun, under the title of The Health and Social Care Integration Programme. This is designed to improve the services for people using both health and social care.

The programme relies on an individual providing consent for their information being shared between the National Care Records Service (NCRS) and adult electronic social care records systems. By enabling a more seamless service delivery between the NHS and adult social services we can radically improve a patient’s care – visibility from both sides means that decisions can be made faster and services can be more efficiently allocated depending on the patient’s needs.

This information sharing is primarily intended to support people needing multi-disciplinary health and social care, for example, those with complex and long-term conditions. Linking social care systems to counterparts in the NHS also ensures that both services are talking about the same patient, with the same records, and thus reduce the possibility of identity mix-up.

The programme will also mean that people receiving both health and social care services do not have to repeatedly give the same information to all agencies when, for example, they change their address or other demographic information and that all staff have the latest information available to them.

Hurdles to be overcome

It is clear that before the health and social services start exchanging information there will need to be an IT overhaul and a sharing of technical standards – similar to the successful provisioning of the Electronic Prescriptions Service.

With this in mind and given the sensitivity of information being accessed, it is essential that all bodies within the social services go through stringent processes before becoming compliant.

System suppliers will need to demonstrate compliance with the information governance requirements for the NHS National Care Records Service in order to implement links between their social care systems and the NHS Personal Demographics Service. This will include going through a compliance procedure operated by NHS CFH, known as the Common Assurance Process.

Where are we now?

The integrated NHS and social care programme is currently being piloted in a small number of early adopter communities, with the aim of developing a model for wider national roll-out. The sites and suppliers selected as early adopters are:

o Cheshire County Council and Esprit
o London Borough of Greenwich and Core Logic
o Torbay Care Trust and In4Tek

When the early adopters go live with links to the Personal Demographics Service, it will allow social workers to more accurately identify individuals for whom they are providing care jointly with the NHS and then also share their demographic information with their medical counterparts.

Health and Social Care Integration Programme: today, tomorrow and the future

The benefits of the programme are clear, with up to date patient information being made available to all those who need it, meaning that patients won’t have to repeat changes to all those professionals involved in their care. However the roll out must be phased to ensure that information is being shared accurately.

The early adopters will provide valuable lessons so that people from the social services and the NHS can identify, investigate and where possible resolve any issues involved in linking social care systems to the NHS.

One thing is for sure – next time we spot a headline that criticises social care or the NHS CFH programme, we would all do well to remember that sharing information between authorised bodies will ultimately benefit the patient and improve their care. Now that’s an aim we can all agree upon.