Information sharing and the double-edged sword of health and care integration

Gurpreet Sarai Gurpreet Sarai, Engagement Manager
Centre of Excellence for Information Sharing

This week marked the expansion of the Integrated Care Pioneers Programme as 11 additional localities joined the existing collaboration to test new and innovative ways of joining up people’s care around their needs.

On Tuesday, the host city Leeds welcomed national partners and the new and existing Pioneers at the One Year On event where Care and Support Minister, Norman Lamb recognised and commended the Pioneers’ achievements over the past year.

It was an interesting opportunity to hear from the 14 original Pioneers about their successes and challenges over the last year. Although it is still early days for most, it was clear to see that integration of health and care is starting to make a real difference for local communities. A range of examples included reductions in hospital admissions because people had been empowered to manage their own health; faster and efficient care through seven-day services and multi-disciplinary working; and increased seamless pathways into the system through a single point of access.

Among those recognised by Norman Lamb were Cornwall, and South Devon & Torbay Pioneers which we have been working with to help break down their barriers to effective information sharing.

Cornwall was praised for its innovative approach to partnership working with Age UK through the Living Well programme. The programme has developed a community line which is manned by volunteers and provides a trusted link between local multi-disciplinary teams, key workers and local resources. An Age UK worker is seconded into the multi-disciplinary assessment team to work alongside a GP, district nurse and social workers.

South Devon & Torbay have continued to use their Mrs Smith narrative to develop a single point of access with a unified call centre. This means that when Mrs Smith or her daughter makes a single call for any health or care service, she will be supported by her care coordinator to not only get personalised support for her condition but also for her mental health and general wellbeing needs too. Information sharing across all parts of the system means that whenever Mrs Smith receives care for one condition, it automatically and electronically triggers others that are needed for support or prevention too.

However successful these approaches have been, our initial work with local areas indicates that information sharing can sometimes become the double-edged sword of health and care integration.

On the one hand, it is recognised as a critical enabler to integrated care but on the other, it can also be perceived as a barrier to effective and secure information sharing. The problem is complex and involves technology, information governance and culture. With disparities between the principles and the application of information sharing between organisations, for it to be truly successful it requires recognition of the parallels, real commitment from leaders – both executives and those on the front line – and most importantly, like the Mrs Smith narrative, a systematic change that embeds the principles of person-centred care.

South Devon & Torbay recognise this lack of consistency across the system in terms of the information, assurances and checks needed to share information effectively. To address these and to ensure that cultural and organisational boundaries are not a barrier to providing safe and effective care, they are working in partnership with local health, care and other provider organisations to implement a new information sharing strategy and toolkit.

The strategy aims to provide a consistent approach to information sharing, facilitating appropriate and relevant information flows across organisational boundaries. It also aims to support the needs of both direct and indirect care, as well as enabling tools to be continually reviewed, ensuring that guidance and documentation remain current and effective. Over the coming months, the approach will be piloted on four local services to test its effectiveness.

To find out more about the pilot, keep an eye out for more news and views from the Centre over the coming months.

You can also read more about the pioneering achievements of Cornwall, South Devon & Torbay and the other national areas in the Integrated Care Pioneer Programme Annual Report 2014.