With a new government white paper published in February, more integrated care systems coming on stream in April, and a target for ICSs to have shared care records in place by September, a new momentum for integrated care is building in England.
This is one of the reasons that 120-year-old Institute of Healthcare Management changed its identity just a few weeks ago to become the Institute of Health and Social Care Management.
Jane Brightman, who recently joined the IHSCM as its first ever general manager for social care, is clear that data and technology have a big role in making integrated care happen. And her message to ICSs, policy makers, tech providers, and people making decisions in the sector is simple: “Please don’t let social care get left behind.”
Brightman recently helped to organise the IHSCM’s first Integrated Care Conference. Matthew Gould, the chief executive of NHSX, which is reportedly soon to be merged into a new transformation directorate at NHS England and NHS Improvement, told the conference that the digital transformation of social care is just as much his remit as digital transformation in the NHS.
Brightman says the coronavirus emergency has shown this to be true: “I’ve seen many examples where NHSX is supporting social care, including at fast pace during the pandemic, for example with the roll out of free iPads to care homes to support communication with relatives,” she says.
In fact, Brightman believes significant digital progress has been made in social care since the onset of the pandemic. Examples include the introduction of “virtual ward rounds and even verification of expected death.” She says there are “great examples of providers using social media to create activities, communicate and network.”
“All of this is beginning to embed itself as the norm and I hope that the sector can build on this as just the beginning,” she adds.
The introduction of NHSmail has also made a big impact. “At the beginning of the pandemic, NHSmail and proxy access was opened up to all care providers – not just those who had completed and published the Data Security and Protection Toolkit,” Brightman explains.
“This had a bigger impact than anyone could imagine. I’ve had care managers tell me that they have formed much better relationships with GPs, health practitioners and pharmacists simply because they now have an NHS email address.”
Brightman is, however, concerned that technology and security flexibility permitted during the pandemic is likely to have a limited window. “I don’t want to see all that great progress reverse,” she says, urging all social care providers to now take urgent action to complete and publish their Data Security and Protection Toolkit.
“First and foremost, we need social care providers to be as up to speed on data security and protection as health is,” she says.
“DSPT is an annual self-assessment for all health and care organisations. It focuses on what providers need to do to keep people’s information safe, and to protect their businesses from the risk of a data breach or a cyber-attack. Once completed it helps providers to demonstrate that they handle information safely.”
For Brightman, this is the “building block to everything else including NHSmail, proxy access to GP records and repeat prescriptions and even shared care records.”
With that September 2021 deadline to get a ‘basic’ or ‘minimum viable solution’ shared care record in place, Brightman sees further positive developments in the near future.
“Having shared care records in place would be a game changer for service providers across health and social care and the people they support,” she says. “So many frustrations and barriers are caused when information doesn’t flow seamlessly.”
But Gould has emphasised that September will only be chapter one for this initiative. And for most parts of the country, Brightman believes that social care won’t be included in this iteration. “We really need social care to be included in further interoperability,” she says.
“There is a big variation in progress made to date and all integrated care systems are different,” she adds. “I think we’ll see a mixed bag come the autumn. Some areas have made great progress and there are those who have developed open source solutions and very willing to share; such as North Yorkshire.”
It’s not only shared care records that face variation challenges. Brightman explains that digital maturity within social care organisations is very mixed, with large providers often more digitally mature than the many small to medium sized enterprises that deliver care in the sector.
“Often it boils down simply to the digital confidence of the leader or manager as to how much they will engage,” she adds. She explains that in some instances staff are more digitally competent than managers recognise, partly due to some managers’ own limited experience with digital technologies.
Training and development is high on her list of priorities “for all of the social care workforce but probably most crucially leaders and managers” because “without that development providers, can’t confidently commission services as basic as broadband through to electronic care planning.”
Brightman also has a message to technology suppliers, including those that have traditionally focussed on supporting health.
With social care often described as a fragmented market, Brightman is keen to point out that ICSs, which so many health tech vendors are engaging, will now have an interest in social care. And she volunteers services like Digital Social Care and professional bodies like the IHSCM as routes through with vendors can open conversations.
“There are still many issues to be solved and ways of working that could benefit from digital solutions,” she says. “I’d urge the tech community to take an interest in social care if they haven’t already.”
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