A coalition of the willing

Jovian Smalley
Engagement Manager,
Centre of Excellence for Information Sharing

When I think about Bristol North Somerset and South Gloucestershire (BNSSG)’s information sharing journey, what resonated with me most is the importance of a coalition of the willing to create a compelling narrative for change in the way information about people’s health is shared. The Connecting Care programme’s common vision is “that, by sharing information securely and effectively, we will make a lasting contribution to the health, well-being and opportunity of our population.”

This is indeed a clear picture of where BNSSG want to be in the next five years and beyond, but it is striking that this vision was actually only developed through consultation with the programme’s 60 or so user groups this summer, a good four years after the conversations about Connecting Care began.

So instead of trying to project manage health and social care integration down to the last detail, what happened at the outset was a far more organic and iterative process, directed by a small group of Information Governance (IG) leads with their own ideas of how patient information could be shared better. Andy Kinnear, the South West CSU’s CIO, called this mentality ‘being an organisational terrorist’ when I met him.

This doesn’t mean that they are actively working against the stated goals of any organisation in the partnership; more that for Andy and his colleagues, there was no organisation in the system just as there is no ‘I’ in ‘team’. It was simply one big collective, trying in their own way to make a difference for their health population by joining up the services they need.

Andy gave me another good example from Grimsby. An extraordinary meeting had been called by a health agency involving the mishandling of a patient’s data. They had expected the director, or perhaps his or her subordinate from the other agency involved to turn up and explain their role in the process breakdown. Instead they were amazed to find the Chief Executives of all the core partner organisations lined up in their reception, ready to take the flak together. It was a potent symbol, Andy concluded, of how seriously the Grimsby partnership took information sharing.

Back to BNSSG, and how they managed to build a coherent case for change. The IG leads realised that they were willing to start small but think big – so they broke the project down into manageable stages – a pilot phase involving only 500 users, a significant amount of system testing and huge effort put into understanding and explaining the benefits an Integrated Digital Care Record would bring not only to the people needing health services but the system users themselves. Slowly but surely the anecdotes rolled in – of communication breakdowns between in and out-of-hours services, of poor information in emergency wards preventing doctors assessing risks to patients, and of wasted time chasing up key medical data such as allergy statuses.

And after that, it wasn’t too hard to start persuading partners that by opting into using Connecting Care, not as passive users but an equal partnership of professionals, they could start to turn that picture around. Andy and his team admit they still have a lot of work to scale up to the envisaged 10,000 users by 2020, but the seeds have been sown and the results are telling:

• time saved on unnecessary appointments
• safer prescriptions
• reduced risks
• less unnecessary hospital admissions
• better care planning
• increased public confidence
• Potential efficiency savings of over £220, 000 per year.

Not bad for a few IG leads who simply asked themselves one day if there was a better way to share information.