The eCare project had attempted to develop a national solution to allow sharing of care plans, assessments and child protection messaging, as well as other data. However local partnerships viewed the solution as complex and expensive. Take-up was limited with some areas developing their own local solution, while others were left unclear about the best way forward. In this context, the DSTB undertook an investigation of the national product set, its current and prospective usage, and decided to decommission the eCare service. DSTB is now engaged with stakeholders on developing a different strategic approach.
Sopra Steria was asked to undertake an information architecture study to help establish a clear picture across Scotland of what information is being shared, and in what way. The aim was to gain an understanding of how best to encourage and support the development and implementation of information solutions by coordinating action at local and national levels, moving away from a one size fits all approach.
Care professionals need accurate, up-to-date and complete information to make the best decisions for the citizens they care for. Multiple agencies deliver care following a variety of approaches and are supported by a variety of IT systems. While delivering an effective data sharing solution is very important for improved outcomes, it has proven difficult to achieve and there is significant variation in the capability to use technology to enable data sharing and collaboration.
"IT enabled information sharing is vital to the success of all efforts to achieve more joined up health and social care services for children and adults. This study provides invaluable insight to the current state. It is also the foundation for a strategic approach that addresses the urgent need for practical, affordable and sustainable solutions within local partnerships."
Murdoch Carberry, Chair of DSTB
With an initial high-level brief, Sopra Steria worked with DSTB to document what was required in a Terms of Reference/Scope Description document. Following agreement of the Terms of Reference, Sopra Steria undertook a detailed study covering sixteen local partnerships, evaluating:
- What data they were sharing or planned to share, and with who, e.g. between primary and secondary healthcare, social work agencies, education, police and the third sector.
- How they shared it.
- Any issues that had arisen.
- The expected business benefits.
Information was gathered via a series of short face-to-face interviews, followed by validation by the interviewee of detailed notes.
The notes and further conversations with key players were then used to complete a paper that detailed:
- A national picture of the degree to which different types of data were being shared. This helped identify similarities across the different organisations and where consistent approaches could be implemented.
- A summary of the various approaches taken to enable data sharing, including a review of the different technical architectures. This highlighted both the similarities and differences between the local solutions.
- A summary of the benefits expected by service users, practitioners and partner organisations.
- Suggested short-term actions to improve national information sharing in the interim while a longer term solution is being progressed.
- Options for progressing health and social care data sharing in the longer term within a national framework, providing the client with the essential tools to help identify the most appropriate solution.
- A maturity model to facilitate future benchmarking of regional solutions, including assessing technical reusability and determining capability, allowing the client to assess local solutions in a standard fashion.
- A detailed catalogue of the current and planned data sharing solutions in the areas surveyed, enabling the client to make easy comparisons between the various solutions.
As data sharing across Health and Social Care is so complex and fragmented, a key challenge was understanding the diverse requirements, varied solutions and complex stakeholder situations and then presenting these back in a clear way to DSTB, within a limited budget.
Benefits of the study
The study has delivered a number of benefits to DSTB including:
- Provided a detailed view of the implemented and planned local initiatives to share health and social care data, allowing comparisons to be made between them.
- Highlighted the significant diversity of the local requirements and solutions that have been put in place or are planned.
- Improved efficiency by supporting better information sharing and exposing the opportunity for more reuse of software and encouraging more co-ordinated, collaborative and standardised solutions. This included consideration of ways to achieve important national aims such as national sharing of Child Protection Alerts.
- Enabled improved coordination with key software vendors – an important aspect of the local solutions has been, and will be the development of interfaces to key vendor packages across the different areas – health, social work and education, and in the future the police and third sector.
What can be achieved?
The study highlights the benefits organisations can derive from data sharing. Technology solutions will vary but there is much to gain from implementing data sharing, Some examples are listed below.
- Provides a more seamless service for the patient
- Less complexity in care pathways
- Assessments provide accurate and up to date information to support early intervention and rapid identification on the patient at risk
- Alerts/ messages provide a reduced risk to patient
- Chronologies enable practitioners to see an emerging pattern of events, leading to earlier identification of risk, appropriate intervention and prevention of harm
- More capacity to deliver a tailored service
- Better protection and safeguarding of children and vulnerable adults.
- Improved quality and efficiency of assessments
- Immediate information sharing 24/7
- Assessments save practitioners time and effort and streamline the process for Lead Practitioners.
- GIRFEC requires an increased level of joint working – use IT to supplement current data sharing activities to improve the business process
- Reducing duplication and increasing efficiency of processes
- Reduces the possibility of crucial information not being shared.
- Improved information security
- Assessments provide consistent feedback from NHS to Social Work
- Sharing of alerts/ concerns reduces personal risk for practitioners
- More consistent and improved recording practices
- Improved data integrity
- Easier statistical reporting.
These benefits in turn contribute to achieving the wider health and social care national outcomes specifically:
- Healthier Living
- Independent Living
- Positive Experiences and outcomes
- Carers are supported
- Services are safe
- Engaged workforce
- Effective resource use.
Therefore, contributing to achieving the overarching Scottish Government vision of 'Everyone living longer, healthier lives at home or in a homely setting by 2020.'
In parallel with the latter half of this study we also worked with Renfrewshire Council and NHS Greater Glasgow & Clyde to produce a detailed proposal for the next phase of their pilot of a data sharing portal, including estimated costs, benefits, scope, development strategy and proposed governance.