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Integrated Care and Social Care

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The way NHS care is delivered is changing. It has to. Frontline services can no longer cope over the long-term with the changes in the population’s demographic; namely more people accessing services, and an ageing population living for longer. In a bid to provide a more efficient and improved service to serve the UK population, social care and NHS organisations are now working together to produce a more cohesive service to patients. It links closely with my first article on Patient Engagement – it’s all steps in the right direction towards improving the patient experience from each end of the medical care spectrum.

As part of my ongoing focus on the 10 NHS digital transformation domains, this blog post will focus on ‘Integrated Care and Social Care’; described as the ability to “inform clinical decisions across all health and care settings and improve the experience of service users by enabling and enhancing the flow of patient information”.

Addressing serious issues

We have recently seen worrying news reporting on cancer operations that are being cancelled due to a lack of available beds. The NHS is trying to address this issue through its Integrated Care and Social Care transformation project by reducing the delayed discharge rates and getting patients out of hospital sooner. For non-NHS savvy readers, delayed transfers of care are when a hospital inpatient is deemed ready to go home but is unable to leave hospital due to a lack of adequate care at home or a lack of engagement with the necessary social care organisations to arrange follow-on care – commonly known as ‘bed blocking’. Because information is still not shared effectively between different organisations across the NHS and social care functions, it can take a long time to organise follow-on care and negotiate arrangements with different parties for patients who are leaving hospital. In November 2016 alone there were 193,680 ‘delayed days’ across England where patients were held up in some of the UK’s most expensive hotels: NHS hospitals.

This is a growing problem as the number of delayed days in November 2016 was up from 153,155 in November 2015, and on the last day of November 2016, the NHS experienced the highest number ever of delayed patients since monthly records were first collected in August 2010.

Communication between NHS departments, hospitals, GPs and the wider social care organisations is constrained due to the lack of adequate systems and technology to enable collaboration – resulting in far more delayed days as information is transferred slowly between organisations.

Sharing data; sharing insights

This is clearly an issue that needs to be fixed in order to free up beds for those who desperately need it, and to enable more effective communication and collaboration between all health and social care bodies for more streamlined operations. The recent news item mentioned previously about the cancelling of critical cancer operations is a clear indicator that drastic change is needed in order to maintain high levels of care.

This needs to start with the improvement of collaboration and communication between NHS organisations and primary and social care bodies – so that clinicians can start a process that brings the relevant care givers into the conversation earlier when a patient is deemed fit enough to leave hospital.

Sharing information is critical to this transformation – but information needs to be shared in a way that makes it easy for all organisations to engage with; and has to ensure patient confidentiality is maintained. Sending letters that take days to arrive, days to respond to, or that could even get lost in the post is not an effective way to manage the care of an elderly patient.

Imagine if there were comprehensive digital workflows in place that could track where patients’ aftercare negotiations were being held up and would be able to report on what needs urgently responding to. Currently we can track the number of delayed days and patients waiting, but do we know exactly where the bottleneck lies for each individual patient?

Having a digital solution in place means that organisations can start to engage more with data analytics to make better choices and decisions about what happens across their organisations.

How technology can help

The upgrade from the N3 network to the new Health and Social Care Network (HSCN) will bring the wider care community onto the NHS’ secure network for easier collaboration and sharing of information; enabling all parties to securely access information across a common network.

As NHS Digital puts it, the new HSCN will “provide the underlying network arrangements to support the integration and transformation of health and social care services by enabling health and social care organisations to access and share information more reliably, flexibly and efficiently.”

The HSCN will enable the delivery of applications that share information between all areas of the NHS and its partner organisations, to speed up the transfer of data and vital info – ultimately helping to reduce the inefficiencies that exist in the space between these organisations and reduce the number of delayed days currently crippling the NHS.

Additionally, organisations need to look at their use of communications tools. The ability nowadays to engage with outside organisations and remote workers using online videoconferencing technology, recording software and screen sharing, as well as enhanced file management and distribution services means that it’s easier than ever for multiple teams to engage and make decisions by using unified communications technology. The ability to record these services means that there is also a more effective audit trail in place to track outcomes and activities – all the better for obtaining useful data to analyse and report against.

Our view

The number one recommendation I would advocate is to avoid embarking on any IT transformation work in silos when delivering a project across multiple departments or even organisations. As budgets for IT projects are often split across multiple departments, it can be difficult to agree upon a common approach that satisfies all stakeholders. This is particularly true of some of the Digital Roadmap programs which can overlap with the activities of the Sustainability and Transformation Plans.

Secondly it’s important to take a standardised approach to any new processes or systems that are put in place – so that it’s easy to integrate with future services and other organisations when changes or new strategy directives are released. We don’t want today’s technology to hinder tomorrow’s strategy - interoperability must be built into all levels of new systems and services.

It’s critical, therefore, to find a provider who can unite all these different services and applications, and work in partnership with other third party providers. For example, you should be looking for a managed service provider who can engage with your patient records system vendor to deliver a joined-up solution. It’s about taking a holistic approach to every part of the process and seeing each application, operating system and underlying infrastructure element as one small piece of the entire strategy so that common standards are adhered to throughout the solution.

At the core, it’s about finding a provider who can translate government strategy, the 10 transformational domains and the Sustainability and Transformation Plans, into technology requirements and outcomes.

We, as providers, also need to collaborate in order to deliver better collaboration and increased interoperability back into the NHS. The NHS of the future may continue to integrate more private sector organisations into its fold, and will need a structure built on open standards to allow for the possibility of increased collaboration in years to come.

As an approved supplier of the new Health and Social Care Network, and also highly experienced in delivering managed service solutions to the NHS, Redcentric and HPE can work with you to move these complex strategies and plans into tangible outcomes and results.

Redcentric and HPE
Redcentric is a leading managed services provider delivering innovative technology to organisations to improve productivity and efficiency. Using HPE datacentre technology to power our managed cloud services, we deliver enterprise cloud and managed service solutions to the Public Sector.

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