#SCOTHIF Title
HEALTH & SOCIAL CARE INTEGRATION FORUM RT O P E R Y R A W SUMM GLASGO 6 01 2 Y R A U R B E F ries: e s 9TH e in th 6
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We’d like to thank all our industry partners who supported the #SCOTHIF over the course of 2015 and into 2016, your input is vital to support the goals of health and social care providers across the country...
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PANEL SPEAKERS Panel 1 - Integration of Health & Social Care, ensuring that those who use services get the right care and support throughout their care journey in the right setting. Alex Stobart - Director - Mydex CIC Panel Speakers: Nigel Henderson - CEO - Penumbra Matt Smith - Principal FSM - Citrix Louise Wilson - Director of Public Health - NHS Orkney Richard Norris - Director - Scottish Health Council Cllr Iain McMillan - Chair - Renfrewshire Council IJB
Panel 2 - Collecting, use and sharing of patient data, moving towards a model of predictive care for citizens. Alex Stobart - Director - Mydex CIC Panel Speakers: Dr Kerry Mathewson - Scottish Government GP Advisor NHS Forth Valley Philip Couser - Director Public Health and Information Services National Services Scotland Fiona Conti - Business Development Manager, Health Total Mobile Eunice Muir - eHealth Clinical Lead - Scottish Government Hugh Anderson - Commercial and Finance Director Digital Health & Care Institute In Partnership with:
FORUM OVERVIEW Integration of services was clearly agreed as the best approach to not only deliver improved care to patients, but as a means to saving money that enables general services to be delivered whilst budgets continue to be cut. During the sessions, three themes stood out as key areas to be addressed and developed over the coming year. 1. Communication of the benefits of person centred services integration: - To both patients and health and social care providers. - Explain to individuals why they should be open to sharing their data and how they do it. - Educate health and social care providers as to how they explain to individuals how and why they should embrace integration of services. - Visibility of change, the public needs to understand what is happening. 2. Analysis and sharing of existing data as opposed to a focus of collection of new patient data: - GPs are swamped with data already, there needs to be a better way to access this data quickly whilst treating patients to make more informed clinical decisions. - Analysis of existing data sets to make preventative plans for individuals, which would result in a reduction of hospital visits. - Issues surrounding opt in vs opt out, combined with a fear and lack of understanding of why personal data should be shared is creating a barrier that is difficult to overcome. It would be better for health and social care providers to be able to display how they can improve care delivery by using existing data, building the trust of citizen. 3. Delegates heard of the wide range of customer/citizen/patient services that require the input of data from multiple organisations and providers. - The way customer/personal data is currently organised and managed – by separate organisations each in its own silo – works against providing truly ‘joined up’ services. - This problem can be solved via a person-centric approach. Each individual holds their own data and a personal data ecosystem enables the data to be managed and shared by the individual. At the next #SCOTHIF on the 4th October, the agenda will focus in on these areas, allowing delegates to provide an update to one and other on the progression with regards to an improved understanding of how to communicate the benefits of integration and also how they have seen health and social care providers using existing data on the frontline to improve patient care whilst achieving cost saving efficiencies.
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PANEL 1 SUMMARY Integration of Health & Social Care, ensuring that those who use services get the right care and support throughout their care journey in the right setting. Key notes and comments: Integration of services clearly makes sense, in practice, how can current workforces change the culture to overcome a legacy of silo’d working practice? The ageing population means the incremental cost of care will keep growing. Therefore a dramatic change is required to change culture and to provide integrated services which will save money and reduce costs. What’s energising people to make this integration of services work? The answer is basic provision of services, with funds reducing, to deliver services you have to look at things differently and save money that can be used to provide these services. Communications: Highlight what is going to replace the existing service and explain why it is better. Be sure to state the fact the new service will be a lot better than the old one! Barrier to integration: Two parent bodies responsible for their personal overspend. Both bodies will want to track spend and defend their own budget. Moving to a shared budget is very difficult but vital to allow true integration. Social care is charged for, healthcare isn’t. Integration of services will see patients withdraw from their care pathway due to the cost of treatment/care, this is something that needs to be addressed before it becomes an issue. So much data collected at GP surgeries everyday; there is a feeling that there is too much data to be shared effectively. Is this why NHS24 doesn’t have the same data as GPs? Who owns the data, professionals or the citizen? If this can be established and agreed upon, it makes sharing of data a lot easier. The NHS is very risk adverse, particularly when it comes to sharing data and patient information, almost to the detriment of patient services. As a result, an all over, change of culture required. Councilors admit that integration of services is so new that they are not clear on how to convey the benefits to the public. Quite clearly there needs to be an improvement with regards to communicating the benefits to all stakeholders who engage on this matter.
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PANEL 1 SUMMARY Benefits of data sharing are never in the media, education of the nation is required to explain the instant benefits. Individuals need to be educated to understand how they can ask for their data to be shared, and how they can have access to records. Health and Social Care providers need to understand what data sharing is all about before being able to promote to the citizen. Greater Manchester are branding and communicating the integration of services to the public brilliantly. Can this approach be replicated? Social media is capturing more individual data (sometimes by accident) than GPs, what is the best way for this data to be analysed and made useful to those that can use it? It this a viable method for citizens to submit data to clinicians? There are differing levels of concerns with regards to data, people are happy to share wellbeing data such as information from activity trackers. At what point do people start being concerned and how can we reassure patients that data will be kept securely and only seen by the appropriate clinicians? Social media users are very aware of how to give “permission�, this approach should be simple to replicate. In rural communities, patients are concerned about who sees their data as they are part of the community. Also concerned about losing touch with their local GP. Public at the moment don’t trust services. They will be skeptical about not seeing how these new services will be delivered until they receive them themselves. Upstream vs downstream. Perspective in terms of care. Promote care in the community and a predictive approach to avoid ill health.
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PANEL 2 SUMMARY Collecting, use and sharing of individuals data, moving towards a model of predictive care for citizens. Key notes and comments: To achieve the cost savings required by health and social care providers there is a need to remove elements from the existing care process by integrating services and using more effective data analysis. Reducing costs, using new approaches so individuals feel they receive a higher standard of care is critical to the success of this transition. Don’t underestimate 3rd sector involvement in communities. This should be tied into overall wellbeing services as a preventative measure. 3rd sector data collection, hearing huge amounts of information which isn’t being collected/used. How can they capture this data whilst out with patients? Community care interfaces and tools that can be used to implement clinical pathways. Collecting data, considerations when asking community nurses to use technology whilst in individuals homes/care homes: - - - -
Cheap technology, easy to replace Data kept in cloud securely Device can be tracked and locked if needed Ability to work offline
How do we promote personalisation of care to the public? How do you change mindsets of how communities use services? How can you make communities consider their personal wellbeing with a view to not becoming ill in the first place? The NHS is reactive, always has been. How do we use other community services to be predictive and reduce strain on GPs and Hospitals? Effective analysis of data would allow groups of patients to be proactively treated by community health and social care teams. Data sharing is key to patients receiving a whole care pathway; education is vital to allow them to engage in the first place. Opt out vs opt in. Should people who are dead against sharing be responsible for opting out rather than people not realising they can opt in? A high number of citizens could be provided better care if they had opted in to start with. Permissions. Let the citizens choose, young people do it all the time on social media. The message needs to be, if you don’t share, your service wont be as good.
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PANEL 2 SUMMARY Lots of data isn’t being captured as we wait for individuals to come and share it with us. We need to engage with the public, go to them rather than hope they come to us and explain to them why they should share information and demonstrate the improvement in care they can expect. How do we get General Practice to talk to out of hours/unscheduled care and share appropriate data that improves care delivery? There needs to be a clarification of the difference between personal health records and electronic records. Converging personal and electronic, we need to agree what these records are called and the standards that go with them. Agree a common language that clinicians adhere to so patients can understand what is being written and have a better idea of their care pathway. If the citizen does eventually have ownership, care providers will have to communicate in a way that the individual can understand. Clinicians will need to provide trusted information, open and honest. Training for staff in development needs to reflect what is happening in current settings. Their access to the systems whilst in training is limited. By the time they are registered professionals, they won’t have the required experience on the systems. Service delivery can be transformed by educating future staff/users. Need digital champions, passing success onto colleagues and enabling people to see the benefits for the NHS and the citizen. In some areas we’re information rich, don’t hear much about being intelligence rich. The NHS needs to become more predictive and have a strategy to reduce the number of individuals who suffer repeated illnesses. There are other uses outside of direct patient care where analysis of data should be used. For example, continuity of care for those being treated in the community, by analysing data we can ensure the correct provision of staff, at the right time and who have the correct skill set. How do you get the data out of the electronic records? Once you do have it, we should do something with it. Access allows you to challenge opinion, why are professionals doing what they are doing? Workforces are under such pressure to constantly deliver care to individuals, it’s very hard to introduce new technology whilst performing existing roles. This needs to be considered when trying to educate health and social care providers towards the benefits of integration and data sharing. If they don’t engage from the start, it will be hard to change existing practice. How can we use existing technology to achieve efficiencies that allow purchase of additional tools which can save more money and improve services further? In Partnership with:
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