The country’s push to integrate health and social care onto one IT platform is making progress
A programme to integrate health and social care at national level across the whole of Wales is now on course to include all the relevant organisations – but only by not waiting until all stakeholders were ready.
The news was shared with delegates at last week’s EHI Live NHS IT conference by Andrew Griffiths, director of NHS Wales Informatics Service, talking of the Welsh Community Care Information System (WWCIS).
“We were able to get health and social care bodies to sign up quickly, but for a long time local government held back,” said Griffiths.
He said the vision of bringing the two systems closer together begun to become achievable after a decision to only see services through the user’s point of view, not those of the many component organisations.
“In the end, we decided to go ahead, confident that Welsh local government would come on board when it was ready.”
Early users
The idea seems to have worked: as it stands, WWCIS now has some significant users - two authorities and a Welsh NHS organisation with another, Powys, set to go live this month - and 12 more confirmed contracts in place. Griffiths and his team expect the majority of participants to be live by the end of 2018-19.
“At the start of our conversations, it was a bit like dating,” he joked. “Everyone was a bit nervous, not sure of expectations and secretly wondering who was in control of the process.”
But the fact that a common administration system, delivered by supplier CareWorks and based on Microsoft CRM technology, is now up and running from a contract awarded in March 2015, shows it was the right way to tackle the problem, he said.
“Of the 29 possible participant organisations across health and social care, 28 have now said yes to coming on board,” he pointed out. “As a result, the next two years will see every relevant stakeholder using the same system, with one single record and one single database for the population as a whole.”
Early benefits reported include fewer missed appointments, a decrease in record duplication across health and social care, improved protection of user data, and clear signs that when fully up and running the unified system will support better management of resources and improved care.
Strategic choice
Getting there has not been easy, Griffiths said, but had been helped by a strategic choice to allow participants to join when ready rather than all at once, and by the Social Services and Wellbeing (Wales) Act, which gives more rights to those in receipt of social care help. Also, most Welsh NHS organisations’ IT contracts were coming to an end and their social care peers had by comparison very little technology at all.
“There was really little or no investment in technology for community health system and a lot of the other stakeholders were in positions where they were about to procure new systems anyway,” he added. The promise of cost savings by a sharp reduction in the need for software licences, and the promise of economies of scale, by going to one platform were also significant attractions. It all made public sector teams open to a discussion of pooling resources and moving to a unified IT back end.
Before such a platform could be properly commissioned, a lot of work had to go into clarifying requirements.
Terminology of needs
“What we found was that what at one time seemed like a very demanding set of needs, over 50,000 different requirements, actually came down in the end to more like 1,500 for the final system. That was because a lot of terminology was actually about the same things, functionally.”
In the end about 70% of health and social care organisational requirements were agreed as being essentially the same.
“What’s guided us has been the idea of making this as simple as possible for participants,” Griffiths concluded. “We’ve tried all along to make this the easy choice to do the right thing.”
WWCIS has received significant funding support from the Assembly, including a £6.7 milion grant last year.
Image: W.Rebel under GNU Free Documentation Licence through Wikimedia
