The Department of Health and Social Care (DHSC) has published a new set of government proposals for health and social care integration, including dedicated sections on digital and data.
Entitled, ‘Health and social care integration: joining up care for people, places and populations‘, the white paper sets out wide ranging ambitions and commitments to make integrated care a ‘universal reality for everyone across England regardless of their condition and of where they live’.
The goal is to join up services for the benefit of patients, staff and organisations, with work to continue across the next few years to help national and local partners to ‘deliver the best outcomes on joined-up health and care’, alongside ‘concerted action at a place level’ to ‘improve integration between the health and social care workforce’ for improved outcomes and ‘better person-centred care’.
The summary states that, ‘Successful integration is the planning, commissioning and delivery of co-ordinated, joined up and seamless services to support people to live healthy, independent and dignified lives and which improves outcomes for the population as a whole. Everyone should receive the right care, in the right place, at the right time.’
As part of the publication, DHSC sets out its plans for making progress on ‘key enablers of integration’, which include not only the workforce and financials but an extensive focus on how digital and data can be utilised to link up the population.
A section on ‘maximising transparency and personal choice’ stresses that having a ‘core level of digital capability everywhere’ will be critical to the delivery of integrated health and care. It outlines that, ‘When several organisations are involved in meeting the needs of one person, the data and information required to support them should be available in one place’ to allow for safer and more proactive decision-making.
Commitments and ideas include: digital tools will ’empower people to look after their health and take greater control of their own care’, as well as offering ‘flexibility and support’ – through the NHS App and NHS.uk, remote monitoring and digital health apps; a goal to have shared care records for all citizens by 2024; support for digital transformation by ‘formally recognising the Digital Data and Technology profession within the NHS Agenda for Change’; including ‘basic digital, data and technology skills in the training of all health and care staff’; for Integrated Care Systems (ICSs) to develop ‘digital investment plans’ that will bring all organisations to the ‘same level’ of digital maturity; and potentially introducing mandatory reporting of outcomes for local places.
A dedicated chapter on digital and data then follows, delving deeper into overall aims, as well as plans for digitising care records, information governance, transformation, intentions for ICSs, and rapid adoption.
The section summary explains that providers within any ICS must ‘reach a minimum level of digital maturity’, and be connected to a shared care record, to ensure each ICS has a ‘functional and single health and adult social care record for each citizen by 2024’. A suite of co-designed standards for adult social care will further allow NHS providers to share information, beginning with the ‘consolidation of existing terminology standards by December 2022’.
It’s also planned that each ICS will ‘implement a population health platform with care coordination functionality that uses joined up data’ to ‘support planning, proactive population health management and precision public health’ by 2025.
DHSC estimates that more than 60 per cent of NHS trusts have ‘made good progress into digitisation’, with 21 per cent now digitally mature ‘as set out in the What Good Looks Like Framework’, and only 10 per cent continuing to ‘rely heavily on paper’. However, it adds that the ‘picture is often much more challenging in social care’ with only 40 per cent of social care providers having electronic care records, and the rest largely paper based.
To tackle this, the white paper points to funding of at least £150 million for adult social care to deliver digital transformation over the next three years. It also adds that the What Good Looks Like Framework will be extended to cover community health services and social care, with a ‘tailored framework’ developed for nurses.
Other commitments around social care include the aim to scale technology to prevent falls, with over 20 per cent of care homes to have ‘acoustic monitoring solutions or equivalent care tech in place’ by March 2024.
Further points of note include a focus on what the report calls ‘forthcoming proposals in the Health and Care Bill,’ which if passed will support integration by introducing a ‘power to mandate standards for how information is collected and stored, so that information flows through the system in a usable way’. This is intended, it says, to make sure that when data is accessed or provided it is in a standard form that’s ‘readable by and consistently meaningful to the user or recipient’.
In terms of the workforce, meanwhile, the document returns to the ambition of addressing what it calls a ‘specialist tech skills gap’ by professionalising the digital profession. This will involve bringing in graduates, increasing the number of apprenticeships offered and utilising both the Clinical Entrepreneur scheme and new fellowships.
The policy paper also turns to ICSs specifically, highlighting the importance of Population Health Management and for ICS Boards to agree plans to embed and support these capabilities with data and digital infrastructure.
It’s also hoped that real-time insights from ‘joined-up, aggregated data’ will support ‘multi-disciplinary working, clinical decision support, waiting list management and make the best use of new diagnostic centres in the community’, with ‘digital transformation of screening’ enabling the identification of at-risk groups ‘more accurately’.
As part of an ‘ICS first’ approach, organisations will be encouraged to use the same digital systems, with DHSC intervention and support provided by ‘setting conditions of funding, producing guidance…encouraging disruption and leveraging other allies’. Every ICS will also need to ‘ensure that all constituent organisations have a base level of digital capabilities and are connected to a shared care record by 2024’ and work with partners to drive 80 per cent adoption of ‘digital social care records among CQC-registered social care providers by March 2024’.
And, finally, plans for rapid adoption encompass finalising digital investment plans by June 2022, including the ‘steps being taken locally to support digital inclusion’, increasing frontline confidence, offering a personalised experience for users of the NHS App, and developing new pathways for musculoskeletal, dermatology, ophthalmology, perioperative and cardiovascular.
‘We have a real opportunity to build on this progress and to truly integrate health and care services. To do this, we need to bring everyone on this journey, one which will ultimately transform how care is delivered, improving both safety and experience,’ states the report.
Read or access the white paper in full, here.
