Health and social care records ‘need framework’

Social services directors are calling for a national framework for care record standards across health and social care, after their survey found limited progress on implementation of the Electronic Social Care Record (ESCR).

A survey conducted by the Association of Directors of Social Services found that although 94% of local authorities have made progress in implementing the ESCR there was still several obstacles before they could be fully implemented.

The four key problems identified were reliance on out-of-date guidance, lack of a national framework and standards for care records, cultural issues for staff moving from paper to electronic records and funding for implementation and to raise the level of IT literacy among some groups of staff.

David Johnstone, who leads on the issue for the new Association of Directors of Adult Social Services (ADASS), told EHI Primary Care that there were “still some leadership problems at government level” and that a national framework was needed to ensure coordination between the ESCR, the NHS Care Records Service and the Children’s Index.

He said: “If government don’t do that we would have these three major developments that can’t talk to each other and that’s a big risk.”

Johnstone said part of the problem was that there was no social care equivalent to the NHS Information Standards Board. He said the solution would be to either set up a separate body to cover adult social care or extend the remit of the NHS Information Standards Board.

Johnstone, who chairs the Care Record Development’s Board’s ESCR implementation group, said that local authorities were also working to old guidance written before the emphasis switched to multi-agency information sharing.

He added: “Local authorities have made a certain amount of progress on ESCRs but haven’t gone the full way to complete implementation which in our view is a good sign and they can’t take the final steps until we have consistent guidance from central government.”

Johnstone said there some “worrying trends” in the work being done on the Children’s Index and the electronic social care record for children, the Integrated Children’s System (ICS), which could mean that the children’s record would not be compatible with the adult social care record.

However Johnstone said he was very optimistic the problems would be fixed and said the introduction of information standards was not difficult or expensive to address.

He added: "What we are doing is identifying where we have got gaps in the tapestry. It’s easy to resolve if people are willing to resolve it.”

The survey, which was conducted with the support of the ESCR implementation board, had responses from 134 out of 150 local authorities. The full survey results will be available by the end of the month.

The ADASS says it will report its findings to the Director General of Social Care with an action plan to achieve consistent implementation of the ESCR, taking account of the requirement for information exchange between electronic personal care records in health and social care irrespective of age.