Local authorities should lead on IT support for allocation of health and social care resources under GP commissioning says Socitm response to Liberating the NHS: An information Revoution

• systems to support personal health and care choices should be delivered by the market and not be centrally prescribed by NHS IT

• learning should be adopted from adult social care, where personalisation and citizen control is further advanced.

• Liberating the NHS is strong on service user engagement and empowerment and on proposals for standards within health

• it is weak on joining-up health and social care information for service users and professionals at points of decision and delivery

Local authorities should lead on IT support for allocation of health and social care resources under GP commissioning, while systems to support personal health and care choices should be delivered by the market and not be centrally prescribed by NHS IT.

These are key recommendations in Socitm's response to the consultation document: Liberating the NHS: An Information Revolution - Making it happen.

The consultation, which closed on 14 January, is part of the Government's agenda to give people more information and control and greater choice about their health and social care.  The intention is to transform the way information is accessed, collected, analysed and used, to give patients in England more access to data, and more control over their records, including allowing online access and sharing with others.

In Socitm's view, the consultation document is strong on service user engagement and empowerment and on proposals for standards within health, but weaker on social care information, and even weaker on joining-up health and social care information for service users and professionals at the point of decision and delivery.

Socitm believes that effective use of information and modern technology will create efficiencies that will free up resources to meet the new challenges being faced by health and social care. However, top-down, large-scale, supply and technology-led approaches to information management and systems that have prevailed in the NHS in the past have failed to deliver effective outcomes for a variety of reasons. The main reason has been failure to involve patients, service users, clinicians, care professionals and the public in their development and implementation.

Instead, smaller scale, regional or sub-regional groups of local authorities should lead on provision of information systems to support allocation of health and social care resources.

With regard to systems needed to facilitate personalised health and social care choices, these are already being delivered by the market and this should be further encouraged

The information systems will need to bring together a range of elements including:

• Citizen and staff ID and authentication.
• Person-based health and social care records, at least at summary level. (Currently many health records are manual and based on treatment episodes).
• Self-directed support, including direct payment facilities.
• Local authority details, where assessments or care plans are agreed with the local authority, including a self-assessment tool.
• Private care assessment services, where assessments or care plans are developed with a private provider, or relatives/friends.
• Personal care plans as shared with carers.
• Specialist sources of information, such as Age UK, CancerHelp UK, Mencap, etc.
• Health services information.

These information systems would be provided to patients and service users through a range of delivery channels, including (but not exclusively) online portals accessible via commonly used browsers.

Development of national standards for interoperability, information sharing and consent will be essential to enable information and services to be joined-up efficiently to meet the personalised choices of patients and service users.

 'Liberating the NHS is based on principles of personalisation and putting patients and service users in control and attempts to set out the implications for information systems spanning health and adult social care' says Martin Ferguson, Socitm Head of Policy, who has prepared Socitm's response. 'Unfortunately, the document is based largely on health care experience, which is less well-developed in respect of personalisation and citizen control than is social care. Further, unlike health care, most adult social care is commissioned and funded privately, often by patients and service users themselves. Our response identifies some different approaches based on this experience.'

Socitm President Jos Creese adds: 'Local authorities can play a vital part in these changes. Not only can democratically elected local politicians reflect local priorities, but local government infrastructure can be made available to assist in the join up and sharing of information which will be essential to help GPs to fulfil their new role

Socitm's response to Liberating the NHS: An Information Revolution - Making it happen can be found at http://www.socitm.net/downloads/download/376/ Key recommendations are:

• Groups of local authorities, rather than NHS IT services, should lead on provision of information systems to support outcome-focussed allocation of health and social care resources as GP commissioning is introduced
• Information systems needed to facilitate personalised health and social care choices are already being delivered by the market and this should be further encouraged
• There should be greater information transparency around care needs, assessments, diagnosis, research, guidance, treatments and availability as well as the cost of health, and social care services
• This greater transparency will generate conditions for innovation by patients, service users and providers of care and therapies.
• Development of national standards for interoperability, information sharing and consent.
• Mandation or regulation to ensure compliance with standards for interoperability, information sharing and disclosure should be considered.
• Information should be shared with patients and service users, including online. This information should cover all significant sources of health and social care diagnosis, assessment, prevention, treatment and care.
• Where needed support (technical and interpretive) should be available for patients and service users, so that they can access and use their own information online
• Joining-up information across systems and organisations for complex cases should be done with the involvement of users. This will avoid unnecessary complexity and retain focus on outcomes
• All staff in public services need further training around the benefits and responsibilities associated with handling and sharing of data and information.
• The Race Online 2012 campaign should take on responsibility for access issues associated with the proposed information revolution in health and social care.
• There needs to be leadership, vision, governance and funding to ensure development and implementation of standards, and joined-up information systems and outcomes.

Further information

Martin Ferguson, Head of Policy
Tel: 07931 456 238 email: martin.ferguson@socitm.gov.uk

Vicky Sargent, Socitm Press Office
Tel: 07726 601 139 email: vicky.sargent@socitm.net