The Government have recently set out a cautious return to normality, following the success of our third national lockdown and the vaccine rollout. Although the end appears in sight, we must consider the risks posed and the potential for a third wave.
The COVID-19 response has been underpinned by the urgent need to have access to the right data, at the right time, and to respond in the right way. Many lessons have been learnt during the pandemic and we must ensure that we continue to progress without simply falling back into previous habits. Social care in particular, has significantly rethought how it provides services to the public. But we must continue to progress. We must grasp the fact that the social care system’s understanding of the dynamic care and support needs of residents was, and still is, far from where we need it to be. So how can we learn from the experiences of the pandemic in adult social care to optimise and improve service provision through data in the future?
This piece shares my thoughts on the use of data in social care, looking at the perspectives of Now, Next and Beyond, exploring how data is vital to the COVID-19 response itself, the recovery over the coming years, and how data usage can be embedded in reimagining service delivery of the future.
Adding emphasis to the need to use data might seem a lot to ask, given an already over-stretched care system. However, internally local authorities are already working in new ways to respond to pandemic demands, whilst keeping their organisations running in a world where we now more commonly work from home. But data usage should not be seen as an ‘add-on’ or additional burden to current care provision. Instead, data is a tool to support professionals, create capacity, streamline and target our services more effectively, facilitate improved collaboration between partners and increase efficiency. So how do we improve data usage in social care to enable practitioners, commissioners and providers to have the information they need to make more informed, evidence-based decisions for service delivery? And what are the challenges?
Now: using data to respond to the COVID-19 pandemic
In responding to this increased demand, one key challenge for care commissioners is the differing nature of social care across local authorities. Its disjointed nature is evident from all perspectives – from policy to practice – this results in challenges to evidence-based decision-making. Social care data is also used and valued differently across local councils, with access to accurate and high-quality data being variable across local authorities. As a result of this fragmentation, care commissioners face three main challenges: siloed data (within authorities, nationally and locally within the NHS); limited data sharing; and access to timely and accurate information.
Internally, this siloed nature of data within council departments and partner organisations is compounded by the collaborative and multi-agency provision of both health and social care. Effective care provision for an individual, however, requires an understanding of their needs and circumstances, such as the support they are already receiving. A holistic view of data is essential for this, but is dependent on adequate data sharing between health, social care and other providers. On top of this, the data shared must be current, accurate and timely to enable adequate planning and delivery of care provision.
Demand pressures for councils across the UK has risen dramatically throughout 2020 due to unprecedented levels of change. Councils face the combined challenges of the COVID-19 pandemic and restricted budgets – all of which compound the rising care and support needs of individuals across society. Data can play an invaluable role in piecing together the circumstances and a picture of what people are experiencing right across the council. It can help by improving awareness and understanding of the live challenges being faced, to help councils respond in the right way.
The COVID-19 pandemic has given rise to additional challenges, which data can play a significant role in solving. Restrictions such as shielding and social distancing, along with a rise in illness, have led to shortages in the workforce, reducing the accessibility, capacity and resilience of care provision. Increased costs due to new requirements (for Personal Protective Equipment (PPE) or digital provisions, for example) simply add another challenge.
An immediate requisite action to streamline social care during the pandemic is for local authorities and care providers to use data to enhance their understanding of local need, thereby establishing a foundation on which to base policy decisions. By piecing together key data sets across the social care system both locally and nationally, care providers and authorities will be able to holistically understand local demand and needs, both on an individual and collective level. Achieving this requires local authorities and care providers to recognise the importance of accurate and wide-ranging data collection. Although this responsibility lies at the local scale, national government must create data-focussed policy to ensure this happens.
Next: enabling faster recovery from COVID-19 through data
In the ‘new-normal’ of a world with COVID-19, care providers must ensure the safety of both service users and staff. In fact, this ‘new-normal’ is what we already have been striving for before the pandemic, but the pandemic brought an urgency to the modernising of services.
Managing outbreak demand will be essential, and this requires a proactive, rather than reactive, model of service delivery. The use of appropriate data sharing across care providers would transform traditional models of care by making better use of community resources through sharing and technology. However, care must be taken from an ethics perspective to ensure that the systems we put in place enable only appropriate data sharing to reduce harm to individuals, and that this data is held securely and safely.
Some councils are already starting to use data analytics to identify those people with the greatest level of need due to the direct and indirect consequences of COVID-19. Focussing individual data across a specific council in this way enables an understanding of the vulnerabilities by specific geography, demographic and risk factor. Importantly, this allows for pre-emptive support of those most vulnerable, protecting individuals and reducing the demand on the NHS and wider council services at later stages of care. Other councils should follow in this manner.
Access to data, giving a holistic view of both the individual’s needs and the overall resource capacity, would enable care providers and local authorities to provide timely, high-quality, safe care and support to residents in need of care and support. This would be important, for example, in vaccinating those in care homes. Data sharing would enable local authorities to know which staff and residents at care homes have been vaccinated and which individuals who may later need to move into a care home have been vaccinated, therefore enabling local authorities to safely introduce new people to the care home. Equally for care workers – knowing who has been vaccinated would increase the safety of individual care provision, both for the care worker and for the individual requiring care.
A data-driven approach to recovery will enable decisions to be made on a strategic, operational and individual level based on a clear understanding of demand, outcomes, need and risk. The inclusion of financial information and market insight data would enable local authorities to accurately evaluate the local capacity of their provision. Social care provision must flex as the UK Government’s response to the COVID-19 pandemic evolves.
Beyond: reimagining services with data embedded at the heart of care
The effective use of data across social care provision is beneficial for many reasons. The pandemic has led to increased social care demand due to increasing care and support needed. Local authorities can use data to proactively respond to this surge in demand by anticipating both demand and resource capacity. Similarly, data allows for an understanding of broader risk factors, giving a holistic view of an individual and allowing local authorities to make informed decisions to provide people with the support they really need.
As we have seen through some of our work we can go even further, being innovative in our use of data in social care. Local authorities also need to understand care demand in terms of care and support as the pandemic has given rise to a new and growing cohort of people who might access care and support. Using data to assess individual needs would allow forecasting of unplanned hospital and care home admissions – again, enabling effective demand management and resource allocation. Going further, using data to forecast needs on an individual level would allow for proactive early intervention support, thereby reducing the demand on later services such as hospitals and care homes.
Looking longer term, social care should have set guidelines to ensure safe, sustainable service delivery in the ‘new normal’. A holistic view of national social care, enabled using data, would allow government to identify where major risks to safe and resilient social care provision are, and allow for targeted funding. Data protection and governance guidelines are also essential.
Is it possible?
Although the COVID-19 pandemic has provided the impetus to change and improve social care provision through data and technology, there is still a long way to go before we can achieve a holistic view of the end-to-end care pathway from a national level right down to an individual perspective. A view such as this would enable finite resources and funding to be targeted where needed, while also providing an optimised, personalised service to individuals with varied and wide-ranging needs.
This may sound too good to be true, but there can be no controversy over the fact that the use of data is essential to achieving optimal social care provision.
Helen Sunderland, Director, EY
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