Expert view: Gayna Hart

Gayna Hart

In recent years, the image of the UK’s social services has suffered badly as a result of negative media coverage of high profile failures. Yet thousands of people across the UK are benefiting from the work of agencies delivering frontline social care, with a responsibility to safeguard those most at risk.

With Britain’s population ageing fast, the strain placed upon the UK’s social services will only continue to increase. Long-term conditions currently affect the lives of one in three people (or six in 10 adults), in England.

The burden of illness is particularly severe among older people, affecting two thirds of those aged over 75, 45% of whom have more than one long-term condition. These conditions also have a significant impact on the NHS, accounting for 80% of GP consultations, 40% of outpatient activity and 80% of hospital bed days.

To alleviate both of these pressures, there has to be a focus on providing single, integrated, patient-focused pathways, in which both the social services and NHS work together. Daily liaison and the ability to share information with local NHS trusts, other local authorities and even the police is an essential component of a social worker’s job.

However, with data held in silos, and little interaction occurring between agencies, it’s easy to see how vital information is inaccessible and how difficult that makes integrated care.

Small steps to the future

Small steps are already being made. As part of the National Programme for NHS IT, run by NHS Connecting for Health, social services teams across England will be better able to communicate with hospitals, GP surgeries and pharmacies.

The common misconception of the 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 support the problems associated with an ageing population, prevent vulnerable people slipping through the gaps and ensure that workers within the social services and NHS have access to the up-to-date, valuable information they need to carry out their roles.

CFH and its impact on integrating health and social care

The process of integrating the NHS IT programme with 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 to be 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 speedier 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.

Connecting and integrating

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.

Timeline to delivery

The integrated NHS and social care programme is about to be 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:

• Cheshire County Council and Esprit
• London Borough of Greenwich and Core Logic
• Slough Borough Council and LiquidLogic
• Torbay Care Trust and In4Tek
• Newham and OLM.

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, social service and healthcare professionals will be able to make better, more informed decisions about the care given to their patients.

However, the roll-out must be piloted to ensure that information is being dealt with in a way that meets the requirements of Information Governance and clinical safety.

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 – the next time we spot a headline that criticises social care or the CfH programme, it would be good to remember that sharing information between authorised bodies will ultimately benefit us all.