Health and social care integration

Secure information systems are the foundation for co-ordinating health and social care

By 2022, 20% of the English population will be aged over 65 and by 2027 the number of people aged over 85 will have increased by 60%. As well as putting more demands on our healthcare system, this increases pressure on social care organisations as they face growing numbers of patients with complex conditions such as dementia and chronic illnesses associated with old age.

Bed blocking — or delayed transfer of care — is a prime example of a healthcare problem associated with an aging population. When patients cannot be discharged from hospital because there is inadequate social care available for them at home, there is sometimes no alternative but for them to stay in hospital.

Bed blocking is a complex issue affected by many factors. There is evidence that some of the delays are due to social services needing to assess or place patients, as well as a need to take into account personal choice and decisions made by patients and carers. Better and earlier sharing of information between health and social care organisations and the patient will help to reduce delays in situations such as these.

Department of Health strategy

The Department of Health (DH) has outlined its plans in its White Paper, Our health, our care, our say, and generated a £520 million social care reform grant. It aims to develop adult social care infrastructure to facilitate effective information sharing and better co-ordinated care.

The DH’s Putting People First whitepaper is a continuation of Our health, our care, our say. It states that we need system-wide transformation that focuses on self-directed support, individually tailored support packages and personal budgets for everyone that requires help with social care.

System-wide transformation

When implemented, the concepts presented in the DH white papers will bring about radical change. To gain a better understanding of the issues surrounding such proposals, our parent company, OLM Group, has been involved in two major projects that sought to explore information sharing between healthcare institutions and social care organisations.

The first project was a consultation for creating a Common Assessment Framework (CAF) for adults. Intended to be a national application that is connected to the NHS Spine, the CAF is based on the concept of personalisation and will enable information sharing and therefore better co-ordinated social care.

Personalisation and self-directed support

Personalisation aims to put people back at the heart of public sector organisations, give them more choice and provide them with access to the right information and services at the right time. Director General of Social Care David Behan has stated that personalisation presents the opportunity for community-based groups and organisations to emerge, enabling information sharing to provide individuals with genuinely local and tailored services.

Although moving to this personalised system will take time and require great change, the overall outcome aims to deliver value for money. The idea is to empower individuals, their families or carers to take control over their own social care, and leave healthcare professionals to offer advice, support and (where necessary) treatment.

Putting patients in control

The second project considered how to give patients ownership and control over their medical records by giving them an individual budget and the power to determine what care is required to meet their needs

Even though funding will come from different Government departments, including the Department of Health, Department for Work and Pensions and the Office of the Deputy Prime Minister, all relevant information will be recorded in one place. This means that the patient does not need to keep repeating the same information to different health and social care providers.

The role of technology

Technology must take a central role in enabling information sharing if the ideas outlined above are to be implemented. To be effective, information has to be up to date and easily accessible despite being dynamic, coming from a variety of different sources and in different formats.

Due to the sensitivity of the information that healthcare and social care organisations share, it is vital that any solution they adopt is built on secure foundations. Understandably, some patients are nervous about having their medical and social care records accessible over an electronic network. But as long as the right processes and security measures are followed, the benefits far outweigh the risks, as demonstrated by some of the technologies in use today.

N3

The NHS N3 network is infrastructure technology that enables agencies to co-ordinate care by supporting applications that share social care and medical information. Many local authorities are "N3-ready", having already prepared for other initiatives such as GCSx, part of the Government Secure Intranet. It is important that any authority connecting to N3 meets the security standards expected by NHS Connecting for Health, ensuring appropriate firewalls are in place, data is encrypted and staff follow best practice procedures to protect the information.

Electronic care records

Electronic care record systems, such as RiO, give health and social care organisations a single source of information about their patients. The benefits of using electronic records are improved access to patient data, proactive planning of services, overall improved quality of care, and more effective communication between organisations, leading to better planning and co-ordination of care,. Furthermore, using authentication ensures that only those with appropriate rights to access patient data can do so.

COINs

Community of Interest Networks (COINs) enable health and social care organisations that serve the same population to access and share information in real time. Patients are already experiencing faster treatment and reduced waiting times because clinical records and test results are available to those who need them as soon as they become available.

Role-based authentication

One of the concerns that patients have is that all of their medical information will be available to anyone with access to their patient records. By controlling access rights, healthcare organisations can share relevant information to help provide a patient with appropriate levels of care without providing full details. For example, social services may need to know that a patient has problems with his or her memory but they do not need to know what the condition is, or necessarily what treatment they are receiving for it.

Access to medical information by social care professionals can be part of the role-based authentication scheme where individuals can only see information that is relevant to their position.

Summary

Technology solutions will enable health and social care organisations to share information, leading to care that is co-ordinated better for patients, and more efficient delivery of services for the NHS and local authorities.

It is vital that systems are built on a secure foundation, addressing both hardware and software, as well as people and processes, if patients and healthcare professionals are to be reassured that there is no threat from security and privacy issues.

Alan Hunt is Director of Information Security at Hytec, and works with PCTs and GPs to build secure IT networks.

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