In a recent blog post, my colleague Kathryn Ward raised some questions about how the fire service, health and social care providers and other services are developing their information sharing approaches to support collaboration. Questions raised covered the approach to information sharing risks; identifying priority cohorts who would benefit from integrated services; what arrangements are needed for sharing across agencies including how feedback will be managed; and finally how an integrated approach to training would be built in to multi-agency collaboration.
All of these questions and many more were in our minds, when we went to Greater Manchester Fire and Rescue Service (GMFRS) to meet their Chief Fire Officer, Peter O’Reilly, to find out more about the approach to information sharing which is underpinning the collaboration work they are developing with a range of partners. During the meeting, Peter gave us some powerful examples of the people and organisational issues that have influenced how information sharing has developed. He talked about how relationships have changed and grown, the need for improved and on-going communication and that improved outcomes for vulnerable people should be at the forefront of integrating services and sharing information.
From much of our work, many places, partners and providers feel that by writing and signing up to an Information Sharing Agreement (ISA) this will resolve the problems around information sharing for their project or program of work. Unfortunately this is not borne out by experience and it was refreshing to hear that Peter, whilst recognising the role of ISA’s, highlighted that they are only part of the solution to enabling information sharing and often may not be as significant or as valuable as others believe. What Peter and the GMFRS have been doing is thinking about the role of culture to support information sharing, the need for relationships, communication and leadership. Peter has developed ISAs between GMFRS and the various local mental health NHS trusts but he also spoke about more significant cultural enablers for information sharing including co-location, relationships, trust, the approach to delivering change, taking risks, working with the willing and organisational agility.
Peter re-counted an example of how by using the commissioning relationship partners were able to unlock information sharing that achieved both significant cost-efficiencies and improved outcomes for vulnerable people. Manchester Council wanted to commission a new provider for the installation of fall prevention equipment in the homes of vulnerable people, already identified across Manchester. The Council were on the verge of going out to tender for a new contract for this service. Because of developing partner relationships and on-going conversations Peter spoke to Manchester Council and put the offer that GMFRS would do this service for free!
‘Why would you do that for free?’ asked the Council.
As Peter told us “well it isn’t for free, the names and addresses are some of the most vulnerable people in Manchester and that is my services target group. These are the same names that previously could not be shared with the fire service because of information governance (IG) concerns”.
This now means that GMFRS has the access to the details of people who Peter points out are ‘possibly also lacking in confidence when it comes to crime, possibly vulnerable to fire and who also may be vulnerable around other health and welfare issues’.
This conversation, a move away from information governance issues as a barrier and subsequent relationship building has meant that the CRIT have supported over 700 vulnerable people to receive a Safe and Well assessment by GMFRS in their own homes.
Peter also highlighted the importance of communication and described his approach to internal communication that has ensured that the whole organisation knows about, understands and is on board with the operational changes that they are delivering with partners, like the new Community Risk Intervention Team (CRIT). A considered and careful approach to communication means understanding around both operational change and the information sharing that supports it effectively zippers down the whole of GMFRS from executive to front line. The result is that staff understand and are confident in their approach to sharing information.
Peter described the regular sessions where he speaks directly with front-line staff and how he has built this in to his daily work so that every time he attends a meeting away from GMFRS HQ he ensures he visits a nearby fire station or other site to meet with his staff. One key impact of this is that all levels of the organisation are getting a clear and consistent message from its leader.
As Peter described it;
“by hearing it from the horse’s mouth and giving the opportunity for people to ask me questions there and then or later by email, misunderstanding or ambiguity can’t creep in.’
This means that the opportunity and risk of changes becoming derailed are reduced and that the shift in the mind-set of staff that enables information sharing to happen is realised. With everyone at all levels in the organisation receiving the same message and knowing what the vision for change is then staff are free to get on with the task in hand, implement changes and undertake the sharing of information.
Finally Peter talked about the value of high level organisational governance in enabling operational front-line service information sharing. Peter described how GMFRS took a deliberate decision a few years ago to drop the approach of organisational vision and mission statements and instead to work with a clear and simple single statement of purpose. This is to 'protect and improve the quality of life of the people in Greater Manchester' and as Peter pointed out this statement doesn't mention fire!
This has effectively freed up the GMFRS and given them the flexibility to progress the collaboration and changes they are pursuing. This is seeing them lead on integration approaches between various services including health, social care, young people, education, environmental health and licencing. As Peter pointed out for GMFRS to fully realise their purpose, information sharing is essential and front-line staff can clearly understand that they have a responsibility and duty to share.
So with all that positive progress what frustrates Peter now? Well considering all that has already been achieved around information sharing Peter is clearly set on tackling those barriers which are stopping the sharing of information about vulnerable people, like the identified survivors of accidental fires who are recovering in hospital or vulnerable individuals who are regularly presenting at A&E with burns and other fire related injuries. So there is still plenty of work to do to make head way on information sharing, but the learning so far will help in informing and maintaining the resolve to tackle this challenge, whilst still fighting fires.
On the 9th November, we will be delivering an information sharing session at the ‘How do you talk to people if they don’t exist’ seminar, hosted by CFOA as part of the ESRC festival of social science.