A train of thought

Stuart Bolton,
Engagement Manager,
Centre of Excellence for Information Sharing

One of the unexpected things in my role travelling around England meeting with different local places to capture and share their experiences and learning around information sharing,  is that on the many trains I have been on I have been regularly bumping into people I have worked with during my 20 years in the public and voluntary sector. While this is unexpected and often a good chance to catch-up, what I’ve found really surprising is that I often hear the same message from these old colleagues as I hear at events and the local places I was visiting that day.

A few weeks ago I was returning from London when I looked up and realised I was sat opposite an old colleague from public health.  They had been working for the NHS when public health transferred to the local authorities.  As we got talking they told me that after a few years with the local authority they had now moved back to the NHS.   One of the things that really stuck with me is how they described the stark difference in culture between the NHS and local authority.

They described how they hadn’t realised quite just how much autonomy there was working in health until they had moved over to working for the local authority.  In the local authority a host of factors come into play that influence and shape a different organisational culture, most significantly the factor of local party politics. This means the approach to cultural factors such as partnership working, risk, making decisions and implementing change is very different.

The following day I travelled up to Leeds as the Centre is inputting to the Better Care Support Team’s regional workshops (in association with NECS – North of England Commissioning Support Unit).  I was looking forward to attending this current round of workshops as the previous ones had focussed on information sharing to support direct care and this time the focus was on information sharing to support in-direct care and commissioning.  I particularly wanted to hear from local places to find out how the information sharing culture and challenges for direct and in-direct care varied or were similar.

The day involved a wealth of discussion as it considered the challenges and enablers for the different purposes of information sharing for in-direct care including risk stratification, tracking outcomes on a care pathway, informing payment models and capitated budgeting, and understanding current and future needs of populations.

We will be writing a report on this soon so do come back to check this out but one of the common issues that came up around information sharing for both direct and in-direct care is the demand from local places for Government to provide them with clearer direction on information sharing.  Places were asking for things like a clear national vision for information sharing, reduced and simpler guidance on how information sharing should work and a ‘standard’ Information Sharing Agreement.

However, as one individual from a local place recounted at the workshop ‘even after working for 18 months to develop and put in place an Information Sharing Agreement,  sharing still doesn’t happen’. They summed up their learning from this when they said that ‘information sharing is not about the governance and technology but about the culture’.

So on the flip side of a stronger central steer, local places need the autonomy to develop and tailor their information sharing approaches to take account of and recognise the nuances of local need and local cultures.  This means that that information sharing will actually be able to happen on the ground.

Although quite simple to explain, participants at the workshop have made it clear that it is a significant challenge we have given ourselves to bring together what at times can seem like the very different worlds of health and social care and be able to share information between them.

But what is clear is that to be able to share information successfully the key is to take the time and opportunity whenever it arises, such as at events like the Better Care workshops, local meetings about Information Sharing Agreements or even on the train, to have the conversations with colleagues that mean we are better able to understand and so be able to work across our different cultures.

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