No stone left unturned

Kathryn Ward

Kathryn Ward,
Engagement Manager,
Centre of Excellence for Information Sharing

Warrington has always had a special place in my musical memories, as my last visit to the local authority in 2012, coincided with The Stone Roses playing their first gig in sixteen years at the Pyramid and Parr Hall venue. By the time I had got out of my meeting, all of the tickets had sold-out and I didn’t have any band memorabilia with me that was needed to get hold of one of the famous golden tickets. I did however, happily stand outside, listening to the band through an open door!

So in late September, when I was invited to a workshop at Warrington Town Hall, to hear about the planning and preparation stage of the Warrington Better Information Sharing Programme, I made sure I had a Stone Roses gig ticket stub and a CD in my handbag; as you never know if lightening might strike twice in the same place and being prepared for any eventuality will always bring reward!

Warrington Borough Council have recently commenced work on health and social care integration and recognised that a barrier to this proposed integration was how sharing of personal data among various agencies was highly variable and potentially compromised the quality of care and ultimately the delivery of the integrated care agenda.

Across Warrington, there had, previously, been a number of data and information sharing initiatives and improvements which have successfully addressed some individual data and information sharing problems. However, there had not been a wider, more holistic, cross-community analysis of the overall information sharing problem facing services across Warrington. Neither had there been overall sufficient senior management engagement or clinical and patient input to address this barrier to successful service integration.

So to address this, in the autumn of 2014, the Warrington joint Health and Well-being Board (HWB) and Local Service Provider Board decided to rectify this situation and chose to commence work on service integration with a rapid, root and branch assessment of the current provision and barriers. They wanted to make the work high profile, inclusive and transparent with no stone left unturned, whilst also recognising that the sharing of personal confidential data and information was a highly sensitive issue affecting many people. Following this it was agreed that a different method was needed to tackle the problem and chose a Select Committee Inquiry (SCI) approach to identifying issues and solutions. (A SCI is a small group of Members of Parliament who have been given a remit to investigate and information is gathered by members through the questioning of witnesses and reported on.)

Stage one of the programme commenced with the establishment of the committee. The Select Committee comprised of members who represented services who deliver, receive or support the delivery of patient care. This resulted in a committee of influential senior managers, clinicians and patients questioning a range of care professionals, patients and carers and other expert witnesses at three public hearings. To supplement this oral evidence and to ensure everyone had an opportunity to become involved, a request was made for submission of written evidence and a public survey was undertaken.

There was considerable communication from the outset using a variety of channels – websites, professional journals, local press and social media. An inquiry website was set up containing all the inquiry documentation including agendas, minutes, Terms of Reference and survey results. This process resulted in a vast amount of evidence which the Inquiry Manager organised into groups of findings. These findings became the foundation for the initial recommendations to the HWB.

One of the initial recommendations from the Select Committee inquiry was that the collective set of actions should form an on-going programme of work to be undertaken within the governance of the Transformation Board, thereby ensuring alignment with the IT and IG programmes happening across services. It was also recommended that the Inquiry be followed by a scoping, planning and preparation stage which would form the foundation of the implementation of the recommendations, leading onto stage two; Planning and Preparation.

Warrington has recognised that it is important to ensure that the right people are working together and this was clear at the event. The Senior Responsible Owner for the Programme is also the Clinical Commissioning Group Clinical Chief Officer and also a practicing GP. His energy and vision undoubtedly helped to bolster attendance with representatives including an Accident & Emergency (A&E) consultant, a Psychiatric Consultant and GP’s from across practices in Warrington. With the additional drive and commitment from the programme lead, there were also delegates from the Council and NHS Information Governance, along with patient representatives; this was a group that had exactly the right people in a room to make change happen.

The purpose of the workshop was to get the views of care professionals, working across services in Warrington, on a range of potential solutions, to the information sharing issues identified by the local authority select committee at the commencement of the programme. The select committee had identified six recommendations, which will form six ‘mini-projects’, along with two over-arching work streams: communication and engagement and change and benefit.

The six ‘mini-projects’ are:

  • Privacy and Consent – The consent process, together with associated data protection safeguards will be reviewed to ensure it is easy, quick and practical to use by all care professionals.
  • Communication and Relationships – Information provided to patients/service users will be reviewed to ensure ease of understanding for everyone.
  • Culture, Confidence and Willingness – A campaign of trust and confidence building will be undertaken.
  • Information Governance – The current processes, rules and guidance around information governance will be reviewed to ensure clarity, consistency and ease of application.
  • Information Capture and Sharing – An analysis of the definition of “clinically relevant data” will be undertaken.
  • IT Systems, Interoperability and Security – Patient information need to be able to flow seamlessly between clinicians, care providers and patients.

For each of the recommendations, the attendees were asked to comment on potential solutions, using the following headings:

  • Relevance – do the suggested solutions fully support each recommendation? Are they clear enough? If not, what changes are required?
  • Completeness – are there alternative solutions?
  • Risks – are the solutions practical and useable in day to day practice? Will they be acceptable to all care professionals and other staff? What other risks may hinder implementation?
  • Recommendations – do the Select Committee’s recommendations need changing in any way?

One of the aims of the Centre is to promote to other local places with similar information sharing issues, the benefit of joint partnership and multi-agency working. But can that really happen with clashing diaries, protected budgets and conflicting priorities? Well, just like the Stone Roses at Parr Hall, I believe the focus, energy and commitment to deliver something special was also being heard in Warrington Town Hall.  Whilst I wait for the possibility of another opportunity to see the band, The Better Information Sharing Programme is here to stay, partners across Warrington, are changing the landscape of health and social care for forthcoming generations across Warrington.

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