ASSIST Meeting 08/10/09. H&SC Integration. Experience and Emerging Benefits. Wigan Council

Transcription

1 ASSIST Meeting 08/10/09 H&SC Integration Experience and Emerging Benefits Wigan Council Steve Corns H&SC IM&T Programme Manager Dept of Adult Services Wigan Council

2 Introduction..

3 Wigan Council Department of Adult Services (DAS) Children Young People Schools (CYPS) (LEA / Education / Schools / Children Social Care) Dept of Environmental Services (DES) Planning / Engineers / Cleansing / Highways / EH etc Chief Executive Democratic / Legal / Policy / Strategy etc Business Support Services (HR / Fin / IT)

4 Social Care Once upon a time there was Social Services.. Now - Social Care: CYPS Driven by DCSF Children In Need / Child Protection / Looked After Children Laming Report (VC / Soham / Baby P / etc). Contact Point DASS Driven by Department of Health Transformation of Adult Social Care (TASC) Personalisation / Self Directed Support H&SC > focus on Adults

5 DASS - Responsibilities Director of Adult Social Services (DASS) responsible for: Health and Wellbeing of the Citizen. DH statutory guidance instructs local authorities about arrangements for establishing a director of adult social services (DASS) post..

6 DASS - Responsibilities Council with Social Services Responsibilities (CSSR) Statutory Reporting > DH / DCSF / CQC Annual Inspections > CQC Provider Payments e.g. 28M pa Client Billing e.g. 12M pa

7 Drivers (Adults) Demographic time bomb - Aging population!!! Over 70% of social care clients - over 65!!! NHS pressures. Managing LTC in Community TASC (Personalisation / Choice / Independence) Joint Working / Information Sharing CfH National IT Programme H&SC integration Funding Crisis - Public sector!!!!

8 Wigan Adult Social Services Teams 1. Central Duty Team (CDT) 2. Hospital At Home Team 3. Intermediate Care Team 4. Older Persons Hospital Team 5. <65 Hospital Discharge Team 6. Continuing Care Team (End of Life / Palliative) 7. Reablement Team (promote independence / recovery) 8. Occupation Therapy Team 9. Physical Disabilities Team 10. Learning Disabilities Team 11. Drugs & Alcohol Team 12. Sensory Team Deafness and Hearing Impairment Blindness and Visual Impairment 13. Adult Placement Team 14. Carers Services Team 15. Deprivation of Liberty Safeguarding (DOLS ) Team 16. Protection of Vulnerable Adults (POVA) Team 17. Direct Payments Team 18. Community Care and Commissioning Team 19. Finance and Administration Team

9 Diagram - Adult Social Services high level organisational information flows (In / Out)

10 IT Systems (Wigan Social Care) Northgate Integrated Systems: Swift Social Care Information System (v24) CYPS - ICS v9 (Ebase Eforms) DAS - AIS v3.3 (Ebase Eforms) DAS - Supporting People (SPLS) ESCR Information@Work (EDMS)(DAS & CYPS)

11 ICS (CYPS) AIS (DAS) Swift DataBase Repository ESCR EDMS)

12 Nightmare - Pre Swift (2003) K e y A p p lic s in c. in p a c k a g e A p p lic s n o t in c in p a c k a g e IU R E G D H O M E (In s p. o f R e g 'd 3 4 H o m e s ) IU C U S T C A R E (C o m p lim e n ts & C o m p la in ts ) 3 5 C S D P (P h o n e R e n ta ls ) R N IB (F o s te r c a r e r s o /s B o r.p a y.s y s ) P A Y E (P a y a s y o u e a t) 1 1 M O W (M e a ls O n W h e e ls ) 3 3 * W A H (C o m m / H o m e C a r e ) * L A H (C o m m / H o m e C a r e ) 3 8 * R e fe r r a ls fr o m H o s p ita ls S o c ia l S e r v ic e s A p p lic a t io n s 3 7 M H R C (S ix M H c e n tr e s ) C D T (C e n tr a l D u tie s ) A C I C o m m C a r e Y O T (Y o u n g O ffe n d e r 's 3 9 T e a m ) A L C D R U G S (D r u g s a n d A lc o h o l) 4 0 C A F (C h ild r e n a n d F a m ilie s ) 2 6 G A L (G u a r d ia n A d L ite m te a m ) 4 5 F O S T E R IN G 2 8 A D O P T IO N 2 7 A F T E R C A R (A fte r C a r e ) 3 0 T R A N S P O R T (T r a n s p o r t S e r v ic e s ) 4 1 L A C C S (L o o k in g a f te r c h ild. in c a r e ) 2 1 C D R (C h ild D is a b ility R e g is te r ) 4 4 R A P (R e fs,a s s e s s, P c k a g e s ) 4 8 P R E S C H O O L 3 6 R E S ID (R e s id e n tia l) 7 H o m e C a r e 1 8 L e a v e /S ic k ( H C ) S E N S O R Y 2 5 * O T (O c c u p a tio n a l T h e r a p is ts ) 2 4 J E Q S T O R E (J o in t e q u ip. s to r e ) 3 2 M a in fr a m e M a in fr a m e A C C O U N T S 4 /5 S A S (S u p p.a c c o m. S e r v ic e s ) 8 F IN S Y S (M a n a g e m e n t B u d g e ts ) 6 \\H Q S Q L 1 \D E V E L O P 2 \A D M IN \P K G C H A R T.A F 3 D A Y C A R E 2 3 D a y C a r e V o lu n te e r s ( S /T /G ) 1 9 C A R B A D G E (C e n tr a l C a r B a d g e s ) 2 2 S T A F F D E V (H u m a n R e s o u r c e s ) 1 3 P O L C L E A R (P o lic e C le a r a n c e ) 1 4 S IC K L E A V E (L e a v e & S ic k - n e s s (X 2 0 )) 2 0 T R A IN IN G 1 5 N V Q IN F O M E T (R e s o u r c e D ir e c to r y ) 4 3 C U S T C A R E ( C o m p lim e n t s & C o m p la in t s ) 4 2 W IA C (W e lfa r e R ig h ts ) P T C K IT A P P D IR Y ( P a y m e n ts to H D E S K (C o m p E q u ip. (D ir e c to r y o f (F o s te r ) C a r e r s ) (H e lp d e s k ) (lo c a tio n? )) A p p 'n s ) /

13 Wigan Council Key H&SC Successes!!! 2002 NHSnet Code of Connection 2004 NSTS access (NHS Number) 2006 NHSnet upgrade to N NHS number upload into Swift» via online electronic batch / weekly traces 2007 NSTS > CSA / PDS migration» Spine access via NHS smartcards 2009 Spine traces - GP Practice 2009 NHS Number Programme exemplar site - to promote use within social care.

14 Partner Workstation Access - via N3 Social Care access to: BPT MH system (Otter) 2009 WWL EPR 2009 ALWPCT ipm 2010? LRC??? NHS access to SC Information System (Swift): 5BPT A&E PCT

15 CfH Wigan CfH Spine Spine LHE Systems: NSTS NSTS // DBS DBS // PDS PDS // PSIS PSIS // SCR SCR // Lorenzo etc etc Services: NHS NHS Number // DPN DPN // GP GP details details // CAFA CAFA etc etc NHS N3 Network Council Swift PCT ipm Acute EPR MH Otter

16 Key Strategic Objectives (IM&T) 1. Support National Programme: Transformation of Adult Social Care (TASC) CfH CAFA H&SC integration 2. Support Local Health Economy (LHE): Joint Working Exploit current IT infrastructure / systems / investment. Drive change... Prepared to take some risks...

17 Information Governance (IG). Information Governance: Data Protection Act Caldicott Freedom of Information Civil Liberties / Human Rights ISA Supports / Improves: Information sharing Decision making Safeguarding e.g. POVA / Laming Reports / VC / Baby P / MH coroners reports / Efficiencies.

18 IG Issues.. Sharing.. Consent. PID. Boundaries - Professional / Organisational / Cultural / Silos Misinterpretation of information risk to client / patient

19 Limited Case law!!! IG Issues.. Professional Dilemma: Information Commissioner warning!!! Disciplinary / Dismissal!!! Risk to patient / client e.g. injury / death!!! Risk to frontline lone workers e.g. OOH / Community!!!! National Guidance please. Maybe ADASS policy to share or not to share Whose data is it anyway patients / clients???

20 Other Issues Information Governance / Information Sharing Agreements (ISA) Secure Information Sharing e.g. PID H&SC Integration security / technical barriers / resources / capacity / systems suppliers Benefits Realisation - Identify, quantify, communicate, promote Promote knowledge management / decision making based on information ion Information Silos Organisational / Professional Boundaries Still pockets of apathy / resistance to IM&T Resources.. Challenge status quo Strong leadership to drive Change / transformation

21 Resources H&SC Service Desk NSTS / PDS / NHS number / DPN / GP traces Swift User Support NHS LIS funding NHS Number administrator IT trainer H&SC IM&T Programme Manager H&SC IM&T Programme Support Officer N3 rental

22 Emerging Benefits (LHE) Supports / improves: Bed management Hospital Discharges Managing LTC in community. Unscheduled Care / Intermediate Care / H@H MDT working, information sharing Safeguarding

23 Emerging Benefits and Outcomes Supports: TASC H&SC Transformation / Personalisation CfH / CAFA / SAP. Patient Care Pathways and experience

24 Emerging Benefits and Outcomes Supports: Information / Knowledge Management Operational / management Performance / KPI & statutory returns Finance & Commissioning Reduced fraud e.g. Blue Badge scheme.. Decision making

25 Janet Swift Service Desk Manager Administration: NHS number / DPN / GP traces / VWN 99% clients within Swift now have a valid NHS number New routine to trace clients GP and update Swift currently 3000 clients with no known GP NHS number a great tool for managing duplicates

26 Mary - H&SC Information Officer DH returns e.g. NI125 Achieving Independence Access to Swift / MH Otter / ipm / EPR... Uses NHS number to trace and validate clients on NHS & Social Care systems.. Loves the NHS number - god send in finding clients... would really struggle without it

27 Phil CDT Manager NHS number now used to trace / validate clients on NHS & social care systems e.g. Swift / Otter (MH) GP trace and details in Swift very useful especially for OOH social workers when dealing with elderly or confused clients Previously could take days to identify clients GP

28 Paul - Home Manager (mobile working team) NHS number used all time for identifying clients within Swift and NHS systems e.g. EPR. Cuts down system search hits - improves performance, especially via mobile device.

29 Paul / Paul / Paul - H@H / IC / Hospital Discharge Teams EPR access ( via N3): Enables patients ward / bed location previously could be a big problem as duty nurses may not know, as patients frequently moved. Provides demographic info not yet on Swift Access to discharge information e.g. next outpatients appointments > re-arrange home care / care package to support client Access to blood tests to alert / pass on to consultant as part of referral e.g. Toxic Confusional State / UTI Speeds up referral / care package for clients Co-ordinated / efficient / just in time service delivery Ultimately reduces stress for clients, carers, families

30 George Customer Relations Manager Since Deceased Patient Notifications (DPN) updates in Swift......complaints from relatives have reduced as we no longer send letters or bills for services to deceased clients...

31 Childrens Service (CYPS) Supports LAC services especially when dealing with LAC nurses. Helps track children across council boundaries e.g. travellers. Supports statutory returns Supports child protection / safeguarding In Wigan Swift still the single integrated system for Adults and Children social care...

32 NHS NWPC Swift Access A&E Used by NHS A&E nurses and consultants Provides key discharge information e.g. Key social worker... Improves and speeds up Hospital Discharge procedures. Supports bed management Supports safeguarding & safe discharges NHS number used as unique ID N3 connection as secure link

33 NHS NWPC Swift Access - LD Used by NHS Learning Disabilities (LD) admin staff Significantly improves communication of updated information to key social care staff following NHS consultant outpatients / reviews for LD clients Recent success feedback wonderful / marvellous / lots of benefits NHS number used as unique ID N3 connection as secure link

34 Elsie Older Person Service User Less need to repeat information (SAP Vision ) Faster care delivery / Higher quality support Improved quality of life with less stress Benefits for carers, families, third sector etc Safer hosp discharging... Improved safeguarding

35 DH CAFA2 Bid - Adastra / Swift Adastra GP / OOH System used in over 70% of PCTs Interoperability Project: Electronically Message contact assessments from Adastra > Swift Alert OOH duty Social Worker to check Swift Replicable to other Local Health Economies (LHE) Supports: OOH service Walk-in Centre Falls Service Wigan OOH Social Care calls ( via Adastra): April 449 calls = 229 new clients March 377 calls = 181 new clients

36 OOH OOHContact (400 (400 pm): pm): Public Public // Police Police // Homes Homes NHS NHS // GP GP // Nurses GP Call Centre Voice Call Alert New Contact check Swift OOH SW Current Process: 1 OOH SW works with voice info. 2 Later faxed / ed Contact details re-inputted into Swift by OOH SW or Admin (dual entry / delay / inefficiency). Electronic Message Dataset: Full Contact Assessment Swift Adastra System Project - Adastra / Swift

37 Future (Swift) Daily / Nightly NHS number updates for new clients - to meet request from admin / practitioners GP online trace and Swift update.. DOB updates - following request from our performance people

38 Future (SCA) Single Commissioning Agency (SCA) Joint PCT and Adults Services agency PCT to host and develop new SCA IT system Swift key feeder system (finance / commissioning) Support World Class Commissioning / Personalisation N3 secure link (integration / file transfer) NHS number unique client ID to sync / validate client data

39 Future CfH Programme: Social Care Integration access to Lorenzo Support and promote programme Identify benefits / issues Resolve IG issues CareFX Project. CAFA support Northgate CAFA 1 demonstrators e.g. UAT / QA / early adopters / beta versions / advisors / critical friend CAFA2 proposal (Adastra / Swift).

40 The End Any Questions??? some answers (maybe)!!! Enjoy it.