What’s happening to make big data use a reality in health and social care?

Posted on May 21, 2015 by stevenmcginty

By Steven McGinty

At the beginning of the year, NHS Director Tim Kelsey described the adoption of new technologies in the NHS as a ‘moral obligation’. He argued that the gaps in knowledge are so wide and so dangerous that they were putting lives at stake. It’s therefore no surprise that the UK Government, the NHS, and local governments have all been looking at ways to better understand the health and social care environment.

The effective use of ‘big data’ techniques is said to be key to this understanding. Big data has many definitions but industry analysts Gartner define it as:

“high-volume, high-velocity and high-variety information assets that demand cost-effective, innovative forms of information processing for enhanced insight and decision making”

However, if health and social care is to make better use of its data, it’s important that an effective infrastructure is in place. As a result, changes have been made to legislation and a number of initiatives introduced.

Why is it important to know about big data in health and social care?

The effective use of data in health and social care is a key policy aim of the current government (and will most likely continue under future governments). The changes that have been made so far have had a significant impact on the policies and practices of health and social care organisations. The vast majority focus on information sharing, in particular how organisations share data and who they share data with.

What changes have been made to support big data?

Care.data

This was the most ambitious programme introduced by NHS England. It was developed by the Social Care Information Centre (HSCIC) and set out to link the medical records of GP practices with hospitals at a national level. It was expected that datasets from GPs’ records and hospital records would be linked using an identifier such as an NHS number or a person’s date of birth. However, due to concerns raised by the public, particularly in regards to privacy, the programme was delayed. The programme has now resumed but new safeguards have been introduced, such as the commissioning of an advisory board and the ‘opt out’ provision, where patients can opt out from having their data used for anything other than their direct care.

The Health and Social Care Act 2012 and the Care Act 2014

The Acts have both introduced provisions that impact on data. For instance, the Health and Social Care Act enshrines in law the ability of the Health and Social Care Information Centre (HSCIC) to collect and process confidential personal data. In addition, the Care Act clarifies the position of the Health and Social Care Act by ensuring that the HSCIC doesn’t distribute data unless it’s part of the provision of health and social care or the promotion of health.

Centre of Excellence for Information Sharing

This initiative came from the ‘Improving Information Sharing and Management (IISaM) project’, a joint initiative between Bradford Metropolitan District Council, Leicestershire County Council and the 10 local authorities in Greater Manchester. The centre has been set up to help understand the barriers to information sharing and influence national policy. They hope to achieve these goals through the use of case studies, blogs, the development of toolkits, and any other forms of shared learning. The centre has already published some interesting case studies including the Hampshire Health Record (HHR) and Leicestershire County Council’s Children and Young People’s Service (CYPS) approach to communicating how they deal with data.

These are just some of the steps that have been taken to make sure 2015 is the year of big data. However, if real progress is to be made it’s going to require more than top down leadership and headline grabbing statements. It’s going to require all health and social care organisations to take responsibility and work through their barriers to information sharing.

Further reading

Big Data and Public Health (Parliamentary Office of Science and Technology, 2014)

Read our other recent blogs on health and social care:

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What’s preventing health and social care from going digital?

Posted on February 26, 2015 by stevenmcginty

Image by Innovate 360. Licensed for reuse under Creative Commons.

By Steven McGinty

In the first of two articles focusing on technology in health and social care, I will be looking at some of the barriers organisations face in adopting digital technologies. Financial pressures such as the reduction in public spending, as well as an ageing society, mean that health and social care will be expected to meet greater levels of demand with fewer resources.

The UK Government believes that the implementation of technology is the solution to helping the health and social care system become more efficient and more effective at delivering patient care. However, before health and social care can reap the benefits of technology, a number of barriers have to be broken down.

Information sharing challenges

Integration has been a main focus of health and social care in England, as well as the devolved administrations. If integration is to work successfully, different organisations must be able to share data securely. At the moment, data is recorded in a variety of ways across a number of different IT systems. We also have a situation where the main method for sharing data securely in local authorities, the Public Services Network (PSN), is not fully integrated with either the NHS in Scotland or England. Eddie Copeland, of the Policy Exchange, suggests that full integration of the NHS with the PSN should be seen as a priority.

Financial costs

The financial costs of rolling out new technology within an organisation can be significant. These costs can include the procurement of hardware and software, internet connections, and the training of staff. For organisations which are undergoing major budgets cuts, it may seem very difficult to justify the investment in technologies, even if there is the potential for savings in the future.

Management issues

The importance of technology in organisations can be underestimated by decision-makers. For example, according to Martin Ferguson, Director of the Society of IT Management (Socitm), the ICT challenges involved in introducing the new Care Act in England are not being given enough priority. He highlights that if organisations are unable to share information safely by April 2015, they risk failing to comply with new reporting regulations.

Local authorities can also have policies that restrict the use of technology. A recent Skills for Care report into the digital capabilities of social care found that local authorities are still wary of certain technologies, including cloud based systems, which can offer low-cost solutions, and social media, which can lead to savings for local authorities if used correctly.

The health and social care workforce

The Skills for Care report highlights that over 95% of staff feel they are confident in basic online skills. However less than a quarter of managers believe that they have staff with enough skills to make use of digital technology. This mismatch means that managers may be hesitant to introduce new technologies over fears that staff may have difficulties in using the technology, as well as the costs associated with staff training.

There is also a suggestion that social care staff may be resistant to the introduction of new technologies, due to concerns that introducing technology may over-complicate things and move the focus away from the patient. As we noted in a recent article on digital services within government, a key part of introducing any new technology is changing the mindset of staff and having effective leadership in place to champion it.

These are just some of the challenges associated with introducing digital technologies into health and social care. In a future article, we will look more at how technologies can be used within health and social care and the benefits they can bring to organisations. We also look at a case study of an innovative technology partnership between Calderdale Council and Idox, which is addressing the shared services agenda in social care.

Further reading:

What is stopping a digital revolution in health and social care? (Guardian 2014)
Spending cuts have left the NHS and social care in crisis (Guardian, 2014)
Later Life in the United Kingdom (Age UK, 2015)
Personalised Health and Care 2020: Using Data and Technology to Transform Outcomes for Patients and Citizens – A Framework for Action (HM Government, 2014)
Small Pieces Loosely Joined: How smarter use of technology and data can deliver real reform of local government (Policy Exchange, 2015)
ICT challenge of health and social care integration “not given priority” (UK Authority, 2014)
Digital capabilities in social care (Skills for Care, 2014)
Councils seeing financial benefit of social media finds report (Localgov, 2014)
3 common barriers to the uptake of technology (and ideas for solving them) (iCareHealth, 2014)

Can the Care Act really provide the transformation in adult social care needed for modern society?

Posted on October 7, 2014 by heathercameron25

By Heather Cameron

The legislative framework for adult social care in England has been described as out-dated by the Department of Health (DH) as it is focused on crisis intervention rather than prevention and early intervention, and on the provision of services, rather than enabling the system to be centred around the health and wellbeing of people and carers. The DH has therefore highlighted the need for government intervention to reform the legal framework so it better fits the purpose of modern care and support.

The government’s objectives for adult social care are to improve people’s quality of life, delay and reduce the need for care, ensure positive care experiences and safeguard adults from harm. The Care Act 2014 was passed into law on 14^th May 2014 with the aim of transforming adult social care in England to meet these objectives. Although the Act is generally concerned with care and support matters in England, some provisions extend to the devolved nations. The main focus of the Act is on promoting individual wellbeing and preventing the need for care and support. In particular, it makes provision:

to reform the law relating to care and support for adults and the law relating to support for carers;
about safeguarding adults from abuse or neglect;
about care standards;
about Health Education England;
about the Health Research Authority;
about integrating care and support with health services; and
for connected purposes.

According to Care and Support Minister, Norman Lamb: “the Care Act represents the most significant reform of care and support in more than 60 years, putting people and their carers in control of their care and support. For the first time, the Act will put a limit on the amount anyone will have to pay towards the costs of their care.”

Due to come into force in April 2015, with its provisions related to funding reform to be implemented a year later, the success, or otherwise, of the Care Act’s implementation is as yet unknown.

Nevertheless, there has been much discussion over the potential issues and challenges with regard to implementation. The College of Social Work (TCSW) argues that the implementation of the legislative reforms “will be challenging and demand significant cultural and attitudinal changes, both strategically and in professional practice”.

The Act presents significant changes for local authorities which will be challenging to implement in the proposed timescale. Concerns have been raised by both local authorities and charities over the funding of the Act’s provisions and the sustainability of adult social care services. A recent article published in Community Care highlights such concerns among councils, noting that nine out of 10 councils believe key parts of the Act will be jeopardised if the government fails to provide local authorities with adequate funding for implementing the reforms.

According to London Councils, London is facing double the shortfall in funding to prepare for the Care Act than previously thought with proposed new funding arrangements unveiled by the government to leave the capital with a £36 million gap.

Moreover, a subsequent article in Community Care suggests that local authorities need to consider the training challenge now in order to negotiate the issues raised by the new funding reforms.

The main costs of the Act relate to improved legal rights for carers (rising to £175 million per annum). However, there may be additional costs, for example where local authorities face increased demand for services due to improved information. Greater clarification on the support available to carers could potentially increase the workload for social care professionals as the number of carers’ assessments could also increase.

The additional requirements of providing support to self-funders as well as carers could also take its toll on councils. Caroline May, business partner in finance at Havering LBC noted at a recent roundtable that:

“There are a lot of unknowns out there that will present us with financial challenges. I think culture shift is going to be huge across the board.”

The Association of Directors of Adult Social Care (ADASS), which represents local authorities, is unconvinced that local authorities can implement the changes required in the proposed timescale. In a joint report with the Local Government Association, they highlight the financial challenges local authorities face, particularly at a time of budget cuts and increasing demand for services. A recent inquiry into adult social care in England has highlighted that there was an 8% real terms cut in spending between 2010/11 and 2012/13; and demand for care provided by adults is projected to rise by over 50% between 2007 and 2032, while the supply of this care is projected to rise by only 20%, according to Carers UK.

Despite these funding issues, however, cost savings have also been identified in relation to public expenditure savings of improved support for carers, according to the DH’s recent impact assessment, which also states that these cost savings outweigh other new costs overall. The potential benefits of the Act for people with care and support needs which could also lead to savings were identified as: “improved wellbeing, better prevention of care and support need, greater clarity, consistency and equality of access to care and support and reduction of unmet need.”

It will undoubtedly be challenging to implement the provisions of the Care Act and it remains to be seen whether the funding provided will be adequate.

Only time will tell whether the proposed reforms will truly transform the currently outdated adult social care system.

Further reading

The Idox Information Service has a wealth of research reports, articles and case studies on a range of adult social care issues. Items we’ve recently summarised for our database include:

The Care Act and the care market: conference summary

Adult social care in England: sixth report of session 2014-15 (HC 518)

Using technology to deliver social care, IN Local Government Chronicle, No 7598 17 Jul 2014

Carers’ quality of life and experiences of adult social care support in England, IN Health and Social Care in the Community, Vol 22 No 4 Jul 2014

Transforming adult social care (improving efficiency in council social care services), IN Local Government Chronicle, 5 Jun 2014

Care Act 2014

Understanding personalisation: implications for social work, IN Journal of Social Work, Vol 14 No 3 May 2014

State of caring 2014

Care home top-up fees: research with local authorities

Making our health and care systems fit for an ageing population

N.B. Abstracts and full text access to subscription journal articles are only available to members of the Idox Information Service.