The recently launched NHSX heralds a new era for Digital Technology that has implications for both health and social care. Two highly significant blogs have recently been published.
Significant because together they signpost a new direction of travel and approach for the development of digital capability which could potentially transform health and social services for the individual as well as the whole system. For the first time, the emphasis is on the people who use digital technology as much as the workforce.
Having just completed a major review, in double quick time, of NHS tech spend alone, Matt Gould, the new NHSX CEO, concluded that the number one priority is the need for interoperability. Interoperability has been left for far too long in the ‘too difficult to do’ drawer. It’s not actually that difficult – it simply means getting the many existing systems to talk to each other. At the moment for various not very good reasons, too many systems can’t do this, both in the NHS and with social care. Matt Gould talks about the risks of a mental health crisis team who may have no idea the patient also has a heart condition. He could equally well have said a Primary Care team which has no idea that the older person has a social care package which could have avoided hospital admission.
The NHSX top five delivery missions include reducing the burden on staff, giving people (note not ‘patients’) the tools to access information and services directly, ensuring safe access to clinical information, aiding improvement of patient safety and improving productivity with digital technology. It’s this last one that’s well worth dwelling on. Linking productivity with digital technology can and will deliver real sustainable change and much needed greater productivity locally. When greater accessibility to joined up data in real time can be achieved, services will be able to measure savings made in one service across the system for another. Take for example the savings for social care through reduced Care Home admissions as a result of reduced numbers of stranded patients, 42% reduced length of stay for patients seen by the Frimley Health Frailty Team.
There’s a strong message from Matt Gould that the NHS and social care both need to become more digitally capable. He mentions social workers in his blog, adding that the capability is not just on the medical side but “our efforts in this space will focus as well on the social care system, where digital capability is mixed.”
Ten top major transformation pieces of work are outlined including a separate mention for ‘social care’. There are certainly a number of other work areas on the list which will hopefully include social care – for example NHS App and Citizen ID and local capability? In addition, there is the scope for including programmes that support interoperability and joining up data across population and place. This seems an ideal time to ensure that the emerging electronic Local Health and Care Records include social care data. Is this too much of a leap? Only by doing this, will we create a truly integrated system across health and social care which is fit for the future. Then the holy grail of pulling together place based data for localities and whole population health will be achieved at last.
Meanwhile, NHSD, along with the LGA, is in the process of evaluating the third wave of projects supporting councils and their health and care partners to explore how better to use local data and how to share citizen/patient information, amongst other initiatives. Wave 3 will support a number of existing initiatives to explore how they can be grown and "industrialised".
Rob Tinlin, former CE Southend Borough Council and member of the NHSD Board commented,
“There is now an opportunity for NHSX is to encourage the mining of the health data with the care data held by LG and the care sector to identify better care pathways, and ways to keep people independent for longer, rather than just mine the exiting health data on its own.”
Finally, a few words on inter-related blog The NHSX User Research: Putting people at the heart of technology. This will ring many bells for social care, mainly because it’s about personalisation and putting people first. It takes the debate about people and patient empowered services one step further. This is crucial if we are to move away from tech being about gadgets and pretty new shiny things. Digital technology is a must have for older people and people with a disability in many as yet unfathomed ways.
Julia Ross was joint Director Social Services and CE PCT in Barking and Dagenham before joining a start-up tech company where she developed integrated data analytics and care pathways across health and social care. She now serves on the RSM Digital Health Council and the Techuk Health and Social Care Council.