Now we're in September, many of us probably don't want to dwell on the fact that winter will be here before we know it. Where has another year gone? However, NHS trusts and Local Authorities don't have that luxury of waiting for winter to arrive. Planning across the country is already taking place for the almost inevitable annual surge in hospital admissions and then the need to discharge patients, often to adult social care services, as quickly as possible to free up valuable capacity.
Despite all this planning, NHS Trusts and Local Authorities will face the same, if not greater, challenges this year as last. The reasons for this are many and varied across the country. They include staffing shortages to lack of appropriate bed and specialist accommodation capacity across much of the health and social care system. These are long term challenges to solve that will ultimately require long term investment in the many billions of pounds per annum.
However, there's one recurring challenge that should not take years to solve. Nor billions of pounds of investment. It will make the working lives of many health and social care professionals easier. It will improve outcomes for patients, service users and their families. And the cost of doing so will be repaid many times over. A win, win, win. And its simple in construct: fully integrate some health and social care data.
To plan anything effectively that's cost effective, we need all the appropriate information at our fingertips to do so. Often, in our day-to-day lives, we take this for granted. Booking a holiday? Go on 2 or 3 comparison websites and we will have all the flight, hotel, upgrade options we need to make a decision that fits our own budget in less than an hour. Yet, when it comes to our health and wellbeing, the most important thing, the same does not apply for the skilled professionals tasked to help us.
Health and social care are inextricably inter-linked. The whole purpose behind integrated care systems recognises this elemental truth. What happens in social care impacts health and vice versa. They both require integrated datasets to show overall demand (by needs), capacity (beds / accommodation and staffing) and the resulting gaps to plan for the future. However, currently much of that information is siloed across multiple systems, inaccessible to professionals who require it, the information often contains material errors and a lot of it's irrelevant anyway. How can these skilled professionals therefore make the best long-term planning decisions every time, on a cost effective basis, to the benefit of us all if they don’t have the full picture?
The current answer is they cannot. So why is this the case? Again, many reasons are given: data privacy; it’s too hard to do so; other more immediate pressures to deal with; multiple stakeholders with different priorities, etc.. But these aren't actually reasons not to do it, they're actually the perceived barriers to doing it right now. Lets’ take each one:
- Data privacy: no one is proposing a free for all with the most sensitive information. Only that those who absolutely require certain information to better plan our collective care in the future have access to it with all the right protocols and protections in place. Which is an overriding principle behind data privacy anyway.
- Too hard to do so: Integrating health and social care data can be complicated. You need to fully understand both sides of the spectrum to do so effectively. And certain technical skills are required. But isn't rocket science and there are individuals and firms that have the requisite skills to do so.
- More immediate pressures: There will always be big immediate pressures in both health and social care. There will never be some lull when it becomes the perfect time to do so. But this would, in time, help alleviate some of the pressures. If not now, when?
- Multiple stakeholders with different priorities: In any health and care system, there are multiple different agencies all with their own distinct priorities and pressures. Finding time, in busy schedules, to support something that is of wider system benefit but where those benefits may not be immediately apparent or realisable to that particular agency at a point in time may not feel like an immediate priority. But ultimately, integrated data benefits us all in the longer term.
Right now, there are thousands (if not tens of thousands) of manual spreadsheets floating around the health and social care system between professionals trying to keep track of current and forecast demand and capacity across different parts of the system. A constant reactive attempt to bypass the challenges noted above. But it's no long-term, sustainable solution. These spreadsheets are often not up-to-date, it requires a huge manual effort to maintain them in some shape (so a recurring waste of valuable resources), don’t contain all the relevant information and are often ignored as professionals don’t trust their accuracy or fullness anyway. Its no way to support effective health and social care planning in the 21st century.
The answer is in the name integrated care systems. You can’t be integrated unless certain data is integrated across the system. And I repeat. If not now, when?
