william dyer health & social care reform programme: an update 23 rd january 2015...

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.


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


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


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


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


National Summits

@williamdyer

• Sharing Information and technology implications• What has been learnt from the Pioneers• Key problems and potential solutions• Online communities• Next steps.


Regional Workshops

@williamdyer


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


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


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?


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


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


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


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),


[+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,


[+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?


[+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)


[+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


[+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.


[+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.


● 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


http://bit.ly/socitmHSC

william dyer health & social care reform programme: an update 23 rd january 2015...

Documents

social care information

kent health social care

social care pioneers

telehealth care

care bill

integration of health

williamdyer slide

williamdyer barnsley