The issue at the heart of this session was simply “If we can’t be confident we are talking about the same person or family then we can’t join up our services”.
Presentation slides from Andrew Cooling, Paul Tomlinson and Phil Swan are available at https://knowledgehub.local.gov.uk/group/inetworkformerlynwegg/library (please note login required and membership of the iNetwork Knowledge Hub, which is open to iNetwork members).
This roundtable was held on 6 May 2015 was framed to share ideas and knowledge that would support better integration of health and care services. In particular we wanted to look at the perennial issue of identity – namely using consistent identifiers for people and places across different organisations.
Why this is such as big issue has been the subject of considerable discussion in programmes such as Troubled Families (https://www.gov.uk/government/news/study-shows-scale-of-troubled-families-problems)
During the opening, colleagues shared a number of wider frustrations including:
- Difficulties presented by different information governance regimes.
- Having visibility of others successes and lessons learnt
- Integrating the “front door” to services
- Understanding the wider story of health and social care integration
- Where decision sit as to where to share or not.
- Demonstrating the evidence of sharing, but not having the systems in place that enable the benefits to be realised.
- Getting the IT enablers in place where the requirements keep changing.
- Struggling sharing large database sets, particularly as most don’t have standards for integrated care.
- Accessing each others’ systems.
The discussion returned to these throughout the morning. @shelleyheckman was tweeting though the session too
Need to understand what you need to share data for. Do you need to share DOB data when all you need is to determine if someone is over 60?
— Shelley Heckman (@shelleyheckman) May 6, 2015
Andrew Cooling, Ordinance Survey
Andrew talked through the services available from Ordinance Survey, with emphasis on the single national address gazetteer now available that combines LLPG, OS, PAF data etc and which has full GB coverage called Geoplace.
Geoplace creates address based products e.g. AddressBase, that are free at point of use to any organisation providing government services, including companies and spin out organisations.
95% of local authorities are using the Address Base Premium service i.e. the Unique Property Reference Number (UPRN). All the NHS and LA bodies have access to this information and OS is working hard to get people to use it.
Andrew talked through a good example of integrating information based on location in Wales for emergency response – Multi-Agency Incident Transfer (MAIT) http://mait.org.uk/ which has reduced the average referral time for an incident by 7 minutes to about 30 seconds resulting in savings of 18,000 hours a year.
Andrew then discussed a number of proposals underway including a standard template whereby organisations extract information to a standard template relating to risk and discussions with HSCIC about appending UPRN to the Exeter dataset to enable risk stratification based on property for fire services. This model could be extended to care and “better life chances” type services potentially.
There was a discussion about UPRN and value to NHS. It was agreed that it is important in the context of joint working.
There was a discussion about UPRN and whether it would extend to street furniture. OS is thinking about extending further information in that area. UPRN is now a freely available to use.
It would be useful to have UPRN on health data – further discussion with HSCIC needed and consideration of data protection. GM should consider its requirements as part of DevoManc.
It was proposed that the OS provide a publically available API where you can enter a UPRN and get the full address details. Andrew replied that OS would consider this.
Steve Skelton, Stockport Council
Historically, GM’s focus has been economic development and on back on Manchester Independent Economic Review (MIER) GM leadership recognised that addressing long term unemployment was critical. Growth and reform plan emerged from this, with ability to influence social reform a key component of this.
Two deals have been made: The first in Dec 2014 put in place a Mayoral model. This included a number of arrangements around housing and others areas.
The second deal included the “devohealth” arrangements. There followed an update on current activity – see www.agma.gov.uk for more information.
Colleagues gave some examples of cross boundary issues – for example living in Bolton but having a GP in Wigan.
There was general agreement that from an information perspective, it is easy to buy a system but hard to get interoperability right. There was a discussion about minimum standards that are required.
For reference Steve did not use slides.
Paul Tomlinson, IEG4 (www.ieg4.com)
First, one council needed a way of building assessments across 14 organisations for people / families. They co located people but had siloed delivery with conflicts of interest. So IEG4 built a system with smart assessments and allocation of support needs to providers with correct capabilities. The complexity of delivery is huge though, especially who can see what. This also has potential to enable a payment by result model.
Second, is a national system supporting deferred payment agreements relating to social care charges as part of the Care Act implementation. This model takes data from central government with local configuration to create a central engine that works nationally with local delivery and demonstrates a platform type capability. Paul challenged the audience to consider whether GM could think more “local government as a platform” and, if so, what the key elements would be.
There was then a discussion about big data vs the thin layer of data that we need to share to enable us to work more effectively. The concept of thin data generated considerable interest.
Paul then discussed problems relating to diagnosis of autism and the need to get multiple agreements from different people and organisations without a common standard approach. He asked if we could consider think about people being able to manage their own information as a key enabler.
There followed a considerable discussion including:
Q&A: How do we engage with and enable carers to make it easier for them?
Q&A: How do you connect with backoffice systems?
Q&A: How do you connect with statutory social care requirements – step up, step down – and getting people to step up quickly enough?
Paul summarised with these key messages:
- We need to crack connecting data between the services and data siloes
- We need to have a local solutions
- We need to think about what the thin layer of data is
- We need to agree how we work in areas like autism and enable people to self refer
- We need to understand “What do we actually need to share”
Phil Swan, iNetwork
The key points he made were:
- The NHS Number is not a perfect identifier and there is room for its use and adoption to be improved.
- A new Act was passed in March which create a requirement for a unique identifier to be specified for health and social care and for better sharing between services.
Regards the latter, the HSCIC is keen to work with colleagues to explore how this could be achieved.
It was agreed that a more detailed sessions with HSCIC would be useful.
Paul Davidson, LEGSB
In summing up the day Paul rapidly talked through the concept model and framework developed for better use and sharing of information by www.legsb.gov.uk.
In particular he talked through the work in Rochdale using this framework to build a data warehouse that could combine data from multiple data sources using a common vocabulary. This would enable them to connect data in education, social care and other systems to get a view of a person, as opposed to a pupil, service user, benefit claimant etc.
There was considerable interest in this.
The LeGSB white paper on data sharing is available here: http://legsb.i-network.org.uk/white-papers/a-strategic-approach-to-data-sharing/
The LeGSB white paper on Troubled Families is available here: http://legsb.i-network.org.uk/white-papers/opportunities-for-applying-standards-to-troubled-families/. Please note that a further white paper incorporating the work in Rochdale will follow this
There were requests for:
- Specific discussion with HSCIC.
- Specific session on the benefits of integrated delivery.
- Questions about leadership of this agenda.
- Sharing of contact names between organisations.
- More information on the work in Rochdale
Recognition and appreciation
Thank you to everyone who came to this session. In addition to the speakers, colleagues attended from Stockport Council, Sheffield City Council, Trafford Council, Wigan Council, Blackpool Council, Manchester City Council, Salford City Council, St Helen Council and Tameside Council.
Particular thanks go to the speakers:
- Steve Skelton, Head of Policy, Performance & Reform, Stockport Council
- Andrew Cooling, Public Service Lead, Ordinance Survey (http://www.ordnancesurvey.co.uk/)
- Paul Tomlinson, IEG4 (ieg4.com)
- Paul Davidson, Local eGovernment Standards Body (legsb.gov.uk)
Phil Swan and Shelley Heckman facilitated and supported from iNetwork.