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Transforming care through collaboration

Liquidlogic : 13 March, 2013  (Technical Article)
David Grigsby Director of Liquidlogic and McKesson's Social Care and Community Health Business, outlines how social care departments can apply the power of innovative technologies to transform care in the UK.

The technologies are already there, but exploiting them requires a collaborative approach.


The UK's government White Paper 'Caring for our future' claims the care system in England is not fit for the 21st century and fails to empower the people it aims to support. This is a harsh appraisal, and one that ignores the impressive work that social care has done to keep driving up standards and increasing value in the wake of shrinking budgets and increasing demand. Social care departments continue to achieve remarkable results in an ever-challenging environment. But a changing demographic, driven by an ageing population and burgeoning demand on the system - and underpinned by widespread financial constraints - means that the existing approach is no longer sustainable. To progress, and to make those incremental steps towards the much-vaunted concept of integrated care, stakeholders from across the care spectrum must collaborate to identify and implement new models of delivery, and technology will play a vital role.


Self-service: empowerment through technology

In truth, social care has developed a much more sophisticated use of technology than perhaps many within it realise. Social care is generally ahead of healthcare in terms of its adoption of innovative technologies. Tools that enable social services customers to interact with social services departments and manage their cases online are gradually being introduced. This self-service approach is enabling customers to use online tools to find the care they need, conduct their own online assessments and manage their personal budget online in partnership with their social worker. Beyond that, clients can then perform an online review of the outcomes their chosen care plan is delivering, and determine whether their personal budget is being used effectively.


Although this self-service model is not yet completely engrained, as more proactive local authorities begin to recognise the long-term benefits, its adoption in adults' social care is increasing. Likewise, in children's services, stakeholders are increasingly recognising the role technology can play in giving them greater control and visibility of how they are safeguarding children - and ensuring that those in need do not fall through the cracks. These are major steps forward.


Integrating care

But the greatest gains for health and social care provision in the UK will only come by truly integrating care. Undoubtedly, securing a fully joined-up system will have major benefits for the provision of better, safer and more sustainable care in the UK. Armed with a holistic view of what is going on, health and social care professionals can intervene earlier and save money in the long-term. But at present, both services often deal with people at the point of crisis, with patchy collaboration - and this is incredibly expensive.


The existing model is of social care and healthcare as separate entities working in partnership. This doesn't always operate as it should and social services can find themselves treating clients in relative isolation from what is going on in health.  This is not financially sustainable. Local authorities are exploring models that support early intervention and prevent costs from spiralling later. Not to do so would risk missing out on the savings and improved outcomes that early intervention and personal empowerment can deliver.


And, of course, the same argument applies in healthcare. Every pound invested in health and social care has got to work as hard as it possibly can. In austere times, there is little long-term value in throwing money at demand - because, with an ageing demographic, demand is only likely to increase. The wider risk is that care becomes unaffordable.


Steps to success

The challenge is for social services to work more closely with health colleagues, to intervene earlier and to enable self-service. The identification of people at greatest risk, followed by earlier intervention to provide them with the support they need to manage their care themselves, could delay their need to go into more expensive and intensive care such as residential. This is widely recognised as a much more cost-effective approach.


Currently, attempts to provide robust linkages between health and social care organisations are mixed. But signs of progress are there. In Islington, for example, NHS London is implementing a new system to exchange assessment and care plans between hospitals, community health and social care organisations. This innovative approach, which has been built to transmit and receive documents using a shared language and format, uses a scalable model that could be easily extended to other parts of the country. Crucially, its implementation is the result of collaboration and buy-in from partners in health, social care and IT providers.


A culture of collaboration

Collaboration is perhaps the most critical component of change. Health and social care organisations are being challenged to develop new models of integrated care - but they do not have to do it on their own. There is a strong appetite amongst the IT supplier community to work with partners across health and social care to develop integrated solutions. This can seem like a big leap but in reality, the leap is not as big as many imagine: the technology and the capability to deliver is already there.


For social care, the continued introduction of self-service models that place the customer at the centre and empower them to manage their own care will be pivotal. The tools for empowerment are already out there. The most proactive organisations are those that have recognised the valuable part technology can play in supporting their needs, and are optimising IT to facilitate change. Social care already supports a client’s online interaction with their personal budget. Meanwhile Health is beginning to pilot personal health budgets. People will not want two personal budgets and two personal portals - demand for an integrated health and social care personal budget seems inevitable in time.


If health and social care providers are to deliver the promise of integrated care, they must not only embrace technology - as well as each other - they must also regard it as an opportunity rather than a cost. Failing to act will be far more expensive in the long-term.


The innovations to provide integrated care pathways are within reach. Many social care departments have already made great progress - though they may not always perceive this to be the case. Social care can be proud of its proactive use of innovative technologies. But as demand increases and pressure on the service intensifies, the need for new models is clear.

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