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William DyerHealth & Social Care Reform Programme: An Update
23rd January 2015
@williamdyer linkedIn.com/wjdyer
Health & Social Care Reform
Introduction
@williamdyer
The Care and Support Reform Programme A guidance note on social care information and
technology sets out initial guidance and a high level specification for the information and technology changes required for successful implementation of the Care Bill.
Health & Social Care Reform
Introduction
@williamdyer
Socitm was invited to establish a programme of activity to help spread the learned practice from the Health and Social Care Pioneers and from elsewhere (Scotland, Wales, etc.)
across the country.
The primary focus was on the information and technology implications for different localities as they seek to implement:• Reporting requirements (April 2015); and• Integration of health and social care (April 2016).
Pioneer Programme
• Barnsley - Stronger Barnsley Together• Cheshire - Connecting Care across Cheshire• Cornwall and Isles of Scilly - Living Well• Greenwich • Islington• Leeds• Kent• North West London• North Staffordshire• South Devon and Torbay• Southend• South Tyneside• Waltham Forest and East London and City• Worcestershire• West Norfolk
Health & Social Care Reform @williamdyer
Barnsley – Stronger Barnsley Together
Health & Social Care Reform @williamdyer
Barnsley is looking at a whole system transformation across their health and wellbeing partnership. They're looking at a transformation programme built on 3 blocks:• Strength in partnership and governance• Innovation in Practice• Whole systems transformation - inverting the triangle (asking what
the user needs)
Unique to Barnsley• Working collaboratively to deliver telehealthcare• Collaboration with NHS, Yorkshire Ambulance Service and the local
authority with telehealth care at the centre • Developing a UK Centre of Excellence in collaboration with Bosch
for the provision of Telecare Services
Leeds
Health & Social Care Reform @williamdyer
Leeds has set up a programme to integrate health visiting and children’s centres into a new Early Start Service across 25 local teams in the city. Children and families now experience one service, supporting their health, social care and early educational needs, championing the importance of early intervention.
Since the service has been in operation, the increase in face-to-face antenatal contacts has risen from 46% to 94% and the number of looked after children has dropped from 443 to 414.
Patients will also benefit from an innovative approach which will enable people to access their information online.
Kent
Health & Social Care Reform @williamdyer
Summits(Leeds and London)
Workshops(7 Across England)
outputs
Draft ‘Local perspectives paper’
outputs
outputs
…informs National Information Board (NIB) strategy and process
…from stakeholders representing the local perspective – including: • Health and Social Care
Integration Pioneers• ADASS IMG• LGA• LCIO Council and SOCITM
DoH supporting
DoH supporting
September
October December
January
October
November
…can expect further implementation actions and other supporting activities ongoing through 2015…
outputs
Better informed discussion and collaborative action locally
We are here
Summits(Leeds and London)
Workshops(7 Across England)
outputs
Draft ‘Local perspectives paper’
outputs
outputs
…informs National Information Board (NIB) strategy and process
…from stakeholders representing the local perspective – including: • Health and Social Care
Integration Pioneers• ADASS IMG• LGA• LCIO Council and SOCITM
DoH supporting
DoH supporting
September
October December
January
October
November
…can expect further implementation actions and other supporting activities ongoing through 2015…
outputs
Better informed discussion and collaborative action locally
Health & Social Care Reform
National Summits
@williamdyer
• Sharing Information and technology implications• What has been learnt from the Pioneers• Key problems and potential solutions• Online communities• Next steps.
Health & Social Care Reform
Regional Workshops
@williamdyer
Health & Social Care Reform
Summit/Workshop Agenda
@williamdyer
Session 1: The ‘Future State’Andrew Fenton, Informatics Strategy, Department of Health
Session 2: InfrastructureJulie Oxley, Head of Information Management & Technology, Leeds City Council
Session 3: InteroperabilityAndrew Fenton, Informatics Strategy, Department of Health
Session 4: Understanding PlacesEmma Rowse, Independent Consultant at Sea Change CornwallAbraham George, Assistant Director/Consultant, Public Health Dept, Kent County Council
Session 5: IG ToolkitRalph McNally, Head of Local Public Service ICT Integration, Leeds City Council
Session 6: Engaging citizens - The service user perspectiveMartin Greenwood, Socitm Insight Programme ManagerTim Straughan, Director of Health & Innovation, Leeds and Partners
Health & Social Care Reform
The ‘Future State’
@williamdyer
Has anyone asked the
citizen what they really want
to see?
Informal and transparent...and a working document,
rather than a snapshot...
Build a model that is focused i.e. based on
user experience of and journey through the
system and what good looks like / priorities for
change
Health & Social Care Reform
Infrastructure
@williamdyer
Understanding about what data we wish to
share: structured data for commissioning or
unstructured data to improve care of the
patient. Lack of understanding is a barrier
Lack of funding, people being scared
of information governance
compliance when sharing data, engaging with stakeholders
Cross county CCGs are problematic; 3 CCG's in
one county having 3 different business
cases/workstreams for Better Care Fund. Surely
a higher position of agreement should be
mandated?
Health & Social Care Reform
Interoperability
@williamdyer
Big challenge of smaller delivery
organisations that don't use IT
Engage suppliers to
actually release what is available
now
Legislation. If you want to supply
public sector you must provide
Open APIs
Health & Social Care Reform
Understanding Places
@williamdyer
Poor approaches to Data Quality, Data Sharing and Data
Ownership. A common lack of recognition of
the problem at a strategic level in local
organisations
Risk in having two different people:
one responsible for locking it all down
and another looking at opening up and
sharing
Overcoming information
sharing agreements at a
local level to allow access to the data
Health & Social Care Reform
IG Toolkit
@williamdyer
How do the 3rd sector (nursing homes etc.)
gain access to relevant info without incurring
costs which are disproportional to
them as an organisation?
Is it the same as the PSN? Are we
doubling up?, Are we making it more
difficult for providers?, GPs
need convincing of the benefits
Guidance is needed around how citizen-
facing applications can update data within the secure council PSN/N3
connected network
Health & Social Care Reform
Engaging Citizens
@williamdyer
Need to embed user testing in all design. Start with people's
actual need
To what degree are locally provided services
not to some degree, essentially similar/ the
same., Is there a case for adopting a common approach to content
structure, syntax and to navigation?
Need to be aware of
service user IT literacy
Health & Social Care Reform: An Update @williamdyer
[+12] Use region to stimulate engagement and involvement with health partners regionally - we cannot do it in a silo!, [+9] Need to ensure that the right information is available for the citizen to allow them to get the help that they need at the right time., [+7] We need to support the third sector to enable them to engage with the citizen by having access to relevant information and data, [+9] We need to address the IG issue nationally through legislation and locally through agreements, [+8] Form local engagement groups / hubs around service user needs not service delivery organisations, [+8] Use Regional Forum to facilitate key communications with providers in the region about what development is needed (health and social care records systems development),
Health & Social Care Reform: An Update @williamdyer
[+5] Clearer lead nationally - do things once that can be implemented locally (don't reinvent the wheel)[+4] procure IT systems jointly[+4] Collaborate regionally or sub-regionally,
[+5] Greater synergy between N3 and PSN requirements to lead to simpler collaboration[+4] set up a regional group (of those here today plus others) to continue the discussion / learn from each other - could be virtual or meet face 2 face,[+3] ICT need including in discussions feeding back to LGA readiness assessments,
Health & Social Care Reform: An Update @williamdyer
[+5]Get all stakeholders involved in the discussions and not just at a strategic level. [+5]If not in place already, Establish a locality- based public service governance group to agree a and oversee delivery of a blueprint for integrated services and Informatics - probably led by Health & Wellbeing Board?[+3]There needs to be an honesty in the approach - no protecting investments at this stage. There has to be a willingness to go back to the needs at the centre of this agenda, and to almost disassemble the current systems in place and examine their appropriateness and maturity in digital terms.
[+2]Share the practices of other councils[+1]Citizen engagement and early communication with voluntary groups[+1]Design from the outside in?
Health & Social Care Reform: An Update @williamdyer
[+8] We need a common framework for the implementation of Information Governance across health, social care and other sectors [+4] Health & Wellbeing Board to take on ownership and overview of the programme with Director leadership[+4] Ensure informatics is on the agenda of key decision making bodies
[+7] Collaborate with regional IT leads, Care Act leads, LGYH & ADASS branch to organise a regional event to focus on the practical steps to support Care Act implementation in localities across the region - and who knows what that may lead to in terms of future collaboration.[+5] Don't work in silos, share resources and ideas across sectors[+4] Network more and share good practice ( and bad)
Health & Social Care Reform: An Update @williamdyer
[+6] Sharing best practice from pioneers around improving the experience should be a high priority so timing is everything.[+5] Don't focus solely on the health care act focus on transformation and what needs to be done - support engagement [+5] Need a more transparent overarching governance body to support co-ordinated change.
[+2] Clarity of roles - ADASS-IN Socitm HSCIC DoH etc[+2] Develop a meaningful maturity model with relevant support resources, guidance, reference and specification 1[+1] Find a better way to share across boundaries
Health & Social Care Reform: An Update @williamdyer
[+6] Make sure this work sits within wider transformation of care and so puts in place the foundations[+5] Make sure our tactical solutions remain focussed, but also don't lose the strategic vision. Do what we need to do to comply, but with an eye on the longer term[+5] Think iteratively, take small steps keep thinking open
[+4] Be very clear about WHAT needs to be done instead of jumping straight to HOW we will do it.[+4] Identify what business processes will need to change and therefore what the data implications are and how that affects the systems that they interact with[+4] There will need to be a standards infrastructure for the essential data in social care, and some guidance as to what will happen in the interim.
Health & Social Care Reform: An Update @williamdyer
[+4] Dedicated resource to help regionally, perhaps via HSCIC[+3] Open standards for interoperability, pressure/regulation for suppliers to adhere to standard.[+3]Implement identity management and assurance for all citizens
[+4] Communicate across the region to share progress, priorities and intel[+3] More communications with other authorities, particularly neighbouring ones[+2] Establish a meaningful and effective governance model that can oversee, communicate, prioritise etc
Health & Social Care Reform: An Update
What Next?
@williamdyer
• Continuing the process of going through all the comments and points made during the workshop
• Meeting set between DoH, HSCIC, ADASS and Socitm to determine specific follow up events.
Health & Social Care Reform
● Programme of events now completed● Full output of National and Regional Workshops now available
online○ Includes video, slide decks and all comments made using
online discussion tool
http://bit.ly/socitmHSC
Health & Social Care Reform: An Update @williamdyer