Using and sharing information to support the health needs of local communities is something that local hospitals, GPs and health professionals are familiar with. However, when it comes to sharing information with a wider group of health care providers, there can sometimes be hesitation, even when it means better outcomes for those people. The Centre of Excellence for Information Sharing is working with health care professionals in South Devon and Torbay to find out how they have approached information sharing to improve outcomes for local people.
Professionals and service providers are taking a direct approach to tackle the information sharing problems that are specific to their local health community. The vision is for a Devon-wide, whole systems approach to information sharing, while clearly recognising that the key is to start small. South Devon and Torbay have developed a series of practical tools to give staff a robust framework for sharing information but more importantly, helping to provide consistency across the board so staff feel supported to make important decisions – to share, or not to share?
Vikki Cochran, Data Protection and Freedom of Information Lead at South Devon Healthcare NHS Foundation Trust, has been instrumental in tackling the practical challenges locally, and we invited her to give you an insight on how they did this:
Do you remember the TV show with Sir Andrew Lloyd Webber, ‘How to Solve a problem like Maria’? Well here in Devon, we have had our version, entitled ‘How to solve the problem of information sharing’! I know, I know, you can see it being a big ratings hit! Seriously, for most outside the NHS or the public sector, they probably have no idea of the pain that we can endure trying to protect information and then to share appropriately when it is needed.
Protecting patient care is paramount. Every day there are stories in the papers and if you are very unlucky, on the Information Commissioners Office (ICO) website, explaining how organisations lost, misplaced, dumped and discarded patient information, your information, somewhere where they shouldn’t. I won’t go in to the detail, as we all have a favourite, however suffice to say we are suitably paranoid enough to be extra, extra careful.
Some people may not see a problem with this, however we can become too protective and lose sight of what it is we are trying to achieve, which is to provide patient care. And sometimes, to do that effectively we need to share information; across internal boundaries, across organisations and sometimes across counties. Yes, we must do it securely and ensuring that our patients understand who we share with and why, but share we must.
There are so many, many reasons to do this, but the one that sticks in my mind is ‘what if I was the patient?’ If my health could be improved, if my life depended upon someone knowing something, then I would want that to happen, and quickly. So the questions is, how do we balance the need to protect with the need to share, which brings us back to how do we solve a problem like information sharing.
Well, we approached it collaboratively, but not death by committee. We had agreement and commitment from each of the Clinical Commissioning Groups (CCGs), acute providers, community providers, independent sector organisations and our local hospice that something needed to be done. We created a sub group, made up of information governance (IG) experts, each bringing to the group their own policies and documents, so that we could use the existing process to create something robust and consistent. We used national guidance, NHS England and Health Social Care Informatics Centre (HSCIC) had some good resources and we sat in a darkened room until we came up with our South Devon & Torbay Information Sharing toolkit – a group of documents that we brought together that fit our needs.
Now, you and I know, there are lots of toolkits out there which have been created and which lay untouched, gathering dust. The reason; because they are too hard to use and don’t think about who is going to use them. So that was our other driving force, not only did we want best practice we wanted best practice that you could actually use. Everything we did was reviewed to make sure that it was easy to understand and that it could be completed without the need for a PhD in Information Governance.
So we had some documents, our toolkit, we had the commitment of our community; all we needed was to test it. We had a few projects which were getting under way, which involved sharing information, either in a new way or across organisations that had shared before and it seemed like a good way to test it. We used a number of the new documents, in a variety of different settings and asked the users to rate them and feedback how they found the process.
The results were good; they had some comments, which we incorporated into the final documentation. We felt it was important to listen to their views and not produce documentation that didn’t take into account actual processes in our organisations.
In February of this year, we took the completed documents, together with what we had learnt from the pilot projects, to our Information Sharing Group. The group ratified the documents and each lead was tasked with going back to their organisations to ensure that the toolkit was agreed by their IG Steering Group (or equivalent).
So have we solved the information sharing problem? I don’t want to speak to soon, but the outlook is looking really good. What we achieved was not impossible, but it took a lot of hard work, collaboration and a desire to do something positive. Having gone through this, my advice to other places embarking on this challenge would be to seek best practice from far and wide and use it to shape your local approach. There is lots of useful information on the Centre of Excellence’s website and we are keen to share the work that we have done with any organisation that would find it useful.