How can information and technology support integrated care?

ISCG Open House, 21 January 2014

Paul Rice, Head of Technology Strategy, NHS England Charlotte Buckley, Deputy Director, People Communities and Local Government DH

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Introductions and context

Today’s workshop

• Set out the vision and context to the integrated digital care programme

• Outline the work on integrated digital care that is currently underway

• Group discussion about the goals of the programme, best practice, challenges and the shape of the future programme

• Summary

What is our goal?• In the future, we want to see much more joint working across health and social

care, with services wrapped around the user and with the citizen at the very heart of the system.

• To do this we are investing in technology and creating information systems that help professionals and individuals share information about their health and care more easily.

• We are building a programme around what people have told us that they want: – Better co-ordinated and joined up services, so service users only need to tell

their story once and all professionals caring for the individual are fully informed

– Access to their records, in a user friendly format, so they are more in control of their care

– When individuals move or a new team is in place there is a smooth transition– There is safer, higher quality care– Innovation and continuous improvement in service delivery

• Our ambitions are not about introducing more technology for technologies sake but about improving the organisation and delivery of care to improve outcomes, using technology as one of the means to achieve this

The Drivers of Change

• Integration – Better Value Fund and Pioneers accelerating joint working and new models of care to deliver better outcomes to individuals and manage pressures on services better

• Safer Hospitals Safer Wards/Integrated Care Technology Fund - providing investment to increase the underpinning information technology capability in health and social care and to support increased movement of information between systems - interoperability

• Personalisation – increasingly putting the citizen at the heart of the system, in control of their health and care

• Quality and Outcomes – seeking continuous improvement in the quality and experience of health and care

• Prevention – exploring ways to reconfigure services to manage increasing demand better

• Care Bill – delivering the most significant change in the legal framework, funding and provision of adult social care for over 50 years

What are our foundations?• The quality of information captured in the systems that support delivery of care in

primary care (predominantly GP practices) is good. There is more that can be done to ensure that the most important items of information can be shared more easily and accessed by professionals/users/carers when and where this matters for decision making.

• Much of the information that is captured in secondary care (predominantly hospitals) is captured still on paper records that make the sharing of that information within hospitals and beyond significantly more difficult and incomplete. Much of the information also captured to support the delivery of care within hospitals is condition or context specific and we need to support treatment and care of the whole person in control.

• Much of the information captured in social care is in information systems that also don’t easily enable sharing or is for particular purposes.

• Capturing an individuals NHS number at the point of care provides assurance that the information being shared between professionals, users and carers relates to the same person. 6

What are our challenges?• There are technical barriers to the movement of information between systems but

these are surmountable

• The small and medium enterprise sector has struggled for market share when they offer innovative and dynamic approaches to the capture/presentation of information

• The informatics leadership community has been undervalued and marginalised with scare skills in high demand in other sectors

• The public sector has lacked commercial expertise to specify and procure solutions to meets its requirements with respect to information technology

• The clinical and professional leadership community has not always understood and championed the part that information technology can play in improving care and transforming business processes

• Where information technology has underpinned innovation the lessons learnt have not been captured nor best practice adopted at scale and pace elsewhere

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Areas for discussion

Have we identified the key challenges/ blockages that currently mean information is not being captured, shared and used?

Have you experience of good integrated care? Why was it good? What role did information and technology play?

Where should the focus of our efforts be to address these challenges? Any quick but sustainable solutions?

Do you agree with our vision?

Questions for discussion

Group discussion

Summary and thanks