1. Informatics and the Care Act Joint Programme Office Regional Events June - July 2014

2. The Transformation of Care and Support Informatics as an Enabler, not a Barrier to Change
Care Act – delivering the most significant change in the legal framework, funding and provision of adult social care for over 50 years
Integration – Better Care Fund and Pioneers accelerating joint working and new models of care. Technology Fund supporting capacity building across sector, with a focus on interoperability and opportunity for Local Authorities to apply
Personalisation – increasingly putting the citizen at the heart of the system, in control of their care and support
Quality – seeking continuous improvement in the quality and experience of care
Prevention – exploring ways to reconfigure services to manage increasing demand
Against a backdrop of:
Limited Resources – Local government facing challenging settlement, so we need to seek ways to drive innovation to better support staff and reduce burden

3. The Informatics Challenge
Future Position
Current Position
Services designed with the provider/ commissioner in mind, not the end- user
Paper and fax based processes, with professionals having to spend time processing information rather than supporting people
Silo-ed working, with often little information and intelligence shared
Traditional market model, with small number of suppliers
User at the heart of the system, with the same level of customer service/ interaction as in other areas of life
Staff embracing technology as a key part of getting the job done and reducing burden
A fully joined up information system within health and social care in the wider context e.g. independent sector.
Effective prediction and prevention
Dynamic market, open to innovation

4. To deliver, we need to understand interdependencies
Our ultimate objective is to provide higher quality, more joined up care to the citizen, and to support them in taking greater control of their health and care.
Data
(e.g. NHS Number, Standards, open APIs)
Information Governance
(e.g. aligned IG Toolkits)
Network
(e.g. PSN, N3)
Citizen focused health and care
To achieve this, we need to take action across a number of different programmes to agree common approaches. These include:
Being able to share information securely across networks
Streamlining governance toolkits
Agreeing standards – starting with NHS Number and Secure standard
Promoting a more open technology strategy (Open APIs)

5. Summary of Informatics Priorities Nationally
Seek to share data and increase interoperability between health and care systems, including the information standards required in Adult Social Care
Implement the information system changes/upgrades required by the Care Bill
Encourage bids to the Integrated Digital Care Fund to support the development of Integrated care and support
Digital Care records between health and social care
Supporting personalisation and addressing the resulting new data requirements
Improving information and advice to citizens

6. Summary of Informatics Priorities Nationally
Encouraging greater innovation and diversity in the current marketplace
Embracing new technologies to drive greater use of digital services for local populations
Ensuring that there is appropriate sharing of data, in the best interest of citizens, including taking forward the Caldicott2 recommendations
Implementing the Zero Based Review and continuing to develop the adult social care outcomes framework (ASCOF)and the new transparency tool
Developing informatics solutions which support working with all providers especially voluntary and community providers and the independent sector

7. Care Act Cross-Cutting Themes
Scale:
Large number of self‐funders coming into the system
Much higher volume of data and information stored for longer
Case for replacing any manual systems with technology and investment in online assessment systems
Need for reduced admin burden e.g. pre‐population of data
Skills
Separate workstream on workforce development
Personalisation
Online information and assessment
Improved links to advice and care records

8. Care Act Cross-Cutting Themes
National consistency
Eligibility criteria
Deferred payments
Cross Boundary Working
Technology supporting information flows across agencies
Information Governance
Implications for data sharing, consent models, access to data and applications and services across networks
Transparency
Being open and transparent about rules and processes

9. Service Specifications: Essentials
Universal Advice and Information:
Improved content – focus on needs of self‐funders and links with health/housing services
Increased use of nationally available information
Connectivity with sources of independent financial advice
Development of directories of services at local level (drawing on national level directories in time)
Assessments
All LAs will need to consider their assessment systems and ensure that they are able to scale up to increased demand
All LAs will need a system for recording carer’s assessments and plans.
Financial Assessments and Charging
This may require some changes to value fields (parameterised)
LAs will need a financial assessment system compliant with the Bill
All LAs will now need a system for managing DPAs
Interest rate – set nationally. Government still need to specify whether fixed to individual or variable

10. Service Specifications: Essentials
Care and Support Plans
Functionality to calculate PBs and IPBs either through RAS or alternative
Personal budget must include meeting all needs but only the cost of meeting eligible needs will count towards the person's cap on care costs. Systems should therefore be able to capture this information
New functionality to ‘meter’ (algorithm) including potential to ‘stop the meter’ (e.g. if individual moves into NHS funded care).
Ability to set different levels of cap for different demographic groups
Functionality to keep individuals updated on progress towards cap and inform individuals when they reach the cap (ahead of time)
The Act requires authorities to give people written confirmation of certain parts of the process, such as a copy of their assessment written confirmation of the determination on their eligibility, and a copy of their care and support plan
Reviews
All systems will need to have appropriate functionality to prompt reviews of care plans and to send out relevant information to individuals on progress towards the cap.

11. The Engagement Proposals
The Care Bill
Engagement with Local Authorities on confirming specifications for Care Act
Engagement with current suppliers on meeting the specifications
Engagement with potential suppliers on the market opportunities of the changes
Online Information and Advice
Personalised on‐line advice to follow on‐line assessment
information and advice to help citizens exercise choice – including information about providers and the continued development of e‐market places
Collection and use of data to support understanding of local needs and local market
Access to care and health records
Tools to support any or all of the above
NHS Number – and wider scoping work on standards
We expect that correspondence between health and social care will use the NHS Number as primary identifier
Expect all new systems and software upgrades to have the NHS number built in as primary identifier – preferably automated via links to PDS/ Spine mini‐services or a batch process.
Expect all LAs who do not currently use the NHS number to have a strategy for implementing this across relevant systems

12. Engagement on Standards
NHS Number is one standard
The new, published, Secure standard is another
These Standards will support
Secure exchange
Portability of information between local authorities so data is transferred efficiently and effectively – continuity of care
Use of API’s
Great potential to innovate the market not just in social care
Probably more of a medium to long term solution

13. Questions
How much engagement would you want around the national work on IT and its applicability to the Care Act?
Are there any specific areas where you would welcome further help and assistance?
Are there any activities you would expect to be happening nationally which have not been covered here?
Are there any activities which could be led by LGA or ADASS to support local authorities better?
Are there any major risks that we should be aware of?