Lend a hand

Fiona Barr

Joining up health and social care and the information systems that underpin them has been on the ‘to do’ list for more years than most would care to remember. It is an objective, however, that will be reached, at least according to the man leading some of the key initiatives.

David Johnstone, chair of working groups on both the Electronic Social Care Record (ESCR) and the electronic Single Assessment Process (e-SAP), is very optimistic.

“There is an inevitability about it,” he says “and I mean that in a very positive way.”

Building a structure

Things were not always quite so rosy in relations between health and social care. Just two years ago the Association of Directors of Social Services wrote to the then NHS chief executive Sir Nigel Crisp to complain that there was no structure for engaging social care in the National Programme for IT.

At that time Johnstone told E-Health Insider that NHS IT policy “would appear to demonstrate little recognition that there is a social care information world.”

Since then Johnstone has been invited to work with NHS Connecting for Health and is a member of their national programme board. He also plays a key role as co-chair of the Care Record Development Board’s Electronic Social Care Record Implementation group and as chair of the project board for e-SAP.

Implementation of e-SAP, which will feed into both health and social care records, has been fragmented around the country although Johnstone’s own region, covering the former South-West Peninsula Strategic Health Authority, is setting up a single e-SAP across 19 NHS trusts and four local authorities.

It was the range of pace and approach to implementing e-SAP around the country which prompted Connecting for Health and the ESCR Implementation Board to set up the project board to develop a consistent national framework.

That board has just completed a report on the future direction for implementation and news on how that will work is expected within a few weeks.

Survey

In the meantime Johnstone is about to embark on a similar exercise covering another part of the health and social care information jigsaw, the Electronic Social Care Record.

Next month a survey will go out to all local authorities asking about their progress so far on ESCR and from that the implementation group hopes to develop national standards and guidance to ensure everyone is singing from the same hymn book.

Johnstone says: “The survey will be looking to see how ESCR has been developed around the country and what are the strengths and weaknesses of that.”

He says that in some areas the ESCR is well developed but in others it is not and that national guidance and standards are essential. He adds: “It’s all very well to have timetables for implementation but we need consistency in what’s being developed otherwise we’re going to have systems that don’t talk to each other.”

Other workstreams will look at the interface between health and social care systems and how social care staff might access the NHS Care Records Service in future. “There’s such a huge amount of development work gone on around issues like confidentiality and accreditation which means that a lot can be built on and we will be pulling things together rather than starting from scratch.”

He sees the proposals in Commissioning a Patient led NHS, which will in most cases align social care with primary acre trusts, as a key step in the right direction and is enthusiastic about the creation of joint health and social care teams.

He adds: “There are already some very good initiatives with health and social care working together, that is the way forward and I believe it will happen.”