Is fragmented information a barrier to #connectedcare? guest post from @PaulBromford

One of the important issues identified ahead of Connected Care Camp is that people struggle to find information, advice and support about care services both online and offline.

Certainly the web is much more complex than it was a few years ago and the Care “marketplace” is an increasingly crowded space that many find difficult to negotiate.

One of the Breakout sessions at #psicare discussed this problem and attempted to come up with some solutions.

Our initial look at the problem revealed the following:

There’s no a lack of information – Searching “advice for carers” gives about  16,400,000 results search results.  But identifying trusted sources is an issue.

• Many people only look for information once they are at a point of crisis – which confuses the issue further as people frantically search for an immediate solution.
• People have difficulty identifying what a great care service looks like. There’s a need to share lessons from care successes and failures. In England the Care Quality Commission have an important role in sharing information.

So here are five possible solutions we came up with:

Make space for difficult conversations

The group accepted that making social care “sexy” is a challenge.  We live is a society obsessed with denying the effects of ageing. We keep hearing 50 is the new 30, 70 the new 50.

Although we agreed the need for a huge culture shift on attitudes towards ageing – we also accepted we had to be realistic around the outcomes of a 60-minute workshop!

Suggested Solution: A campaign of awareness for public and professionals to start having proactive conversations around longer-term care needs. The starting point to be establishing much better communication between health, housing and care. Housing in particular was thought to have a key role.

If every professional was equipped with the right skills, technology  and space to have a conversation – imagine how we could help people seeking care at the point of crisis?

Establish a principle of “The 5 Things I need to know”

In a free market the emergence of a “Tripadvisor” of Care might be wishful thinking.

But how about we establish the Top 5 things everyone should know to look for when they are looking at options? Available across care and related sectors including health and housing – this would also better support multi disciplinary specialists to give advice.

If it’s difficult to know what “good” really looks like let’s give people 5 things they should look for before anything else.

Map and connect locally available resources

The group felt that vital community hubs are underutilised as a way of enabling access to care information. There are scores of interest groups, informal community networks and clubs available in most localities that often exist under the radar of local authorities. Often run by volunteers they are the hidden networks where people seek informal advice and support from trusted advisors.

How can it be in 2013 that nobody can articulate how many of these actually exist? Surely technology – especially location based apps – can help us unlock this resource to help in the sharing of information and even to identify informal and potential carers.

Enable people in residential care to access digital tools

It remains a problem that many residential homes still do not have access to the most basic technology. Additionally most hospitals do not have publicly available WiFi – this is another barrier to stop people seeking out advice and support.

How can we expect and encourage people in residential care to suggest how their care can be improved when they are all too often excluded from the internet?

In a world where funding can go to all sorts of projects which struggle to articulate meaningful outcomes making digital technology available to the most socially excluded must be a priority.

Establish a more consistently understood and coherent way of care users engaging with services before, during and whilst receiving care services.

The group thought we were missing valuable insights from care givers and those receiving care about how they thought access to information and support could be improved.

It was felt there is no consistency for users in understanding when care services should be reviewed or appraised for instance

Linking to the “5 things you need to know about care” the group pondered how digital technology could help people comment on the service they receive and raise awareness of resources such as Patient Opinion, Care Opinion, NHS Choices and Your Care Home.  Perhaps a personalised digital care plan – complete with alerts for family and friends could be used to connect services in one place and sharing updates to innovations like Mindings

Quick Poll: Which organisation would you recommend to an older person seeking advice about care and support options?

One thing was very clear from our discussion:

We don’t need more information. We need better quality connected conversations.

 

 

 

 

Reflections on Connected Care Camp #psicare

First of all an introduction to the Connected Care Mindmap developed by @clarkmike. We have been identifying relevant resources over the past few months to share and give people a context for the problems identified through many online discussions and the Priorities for Care survey.

So much energy, thoughts and learning in one day and a lot of sharing resources through Twitter, videos & blog posts. A great post from @whatsthepont highlighting the benefits of collaboration  Open Data Age UK Cheshire, Fire & Rescue Service, Dementia Advisor. Odd one out?

For me many key problems centred around confusion about the role and responsibilities of the different care and health bodies. How does NHS England link with Healthwatch, the Care Quality Commission and the Health and Wellbeing Boards? What will be the impact of the £3.8 billion Better Care Fund and the Integration Pioneers?

Recommended viewing the excellent Alternative Guide to the NHS produced by the Kings Fund.

I would like to encourage @TheKingsFund to produce a similar Alternative Guide to Social Care I think many people would find this very helpful because the sector is so complex and fragmented!

There is a need for cultural change in health and care services which will enable innovations to be adopted and adapted more quickly. “We need to create the environment for difficult and challenging conversations” and with a huge funding gap looming this was seen as a priority. Despite the fact that social care is critical to support people mdischarged from hospital the sector is seen as the junior partner. This is not doubt influenced by the considerable discrepancy between health and care budgets and that health care is free at the point of delivery whilst social care is means tested. Changing the culture of organisations with the added pressures of public expectation about openness and transparency was seen as a major challenge. There are currently perverse incentives in the funding mechanisms and little encouragement to be brave and take risks in the redesign of services.

@shirleyayres @hospicedoctor NHS unlikely to engage at scale until pooled £ & shift from med model to cover health, wellbeing, QoL #psicare

— Mike Clark (@clarkmike) December 8, 2013

There was considerable discussion about how people can access information about existing resources both online and offline. There was a recognition that we need to tailor information channels to suit the different needs of individuals. An innovative proposal was the suggestion of developing guides to “the 5 things I need to know” across the wider care sector.

I was interested to learn that Health and Social Care West Midlands have created a site to to support health, social care and wellbeing leaders in the West Midlands to develop the more integrated services envisioned in the Health & Social Care Act 2012. Could this provide a template for more regional sites which provide access to relevant and timely resources? @hscwm

The importance of enabling people in residential care to access the internet and digital resources was recognised and there was some astonishment that we do not know how many care homes currently provide this for residents.

A consistent theme was the need to share both good practice and to learn lessons from what has not worked. there were many examples shared of how different organisations are supporting and connecting people to feel less isolated and more supported in their communities. It is worth reading the newly published Joseph Rowntree Trust Report on what makes a better life for older people.

Identifying transition points  and making sure that services are built around supporting individuals and their families was an important issue with many comments on the lack of basic information shared between the NHS and social care and poorly designed hospital discharge plans.

Many of the concerns about Integrated Care which were raised at Connected Care Camp are echoed in the recent @iMPOWERCONSULT report “A Question of Behaviours: Why delivering care integration and managing acute demand depends as much on changing behaviour as new systems and structures.”

One of the many sessions on the day discussed data driven social care which has been helpfully summarised by @resiflexUK in his post a round up of #psicare. An impressive summary thanks Conor!

Some big isssues:

On February 14th 2014 152 local authorities have to submit plans which should include how they are going to link health and social care data together by NHS number. The November TelecareLIN eNewsletter supplement on Integrated Care @clarkmike helpfully provides the  Better Care Fund requirements for joined up systems.

Who owns the data held on each of us and how can we free it?

How will local authorities deal with all of the self funders who will be eligible for an assessment under the new Care Bill?

There were very diverse levels of awareness about the potential of digital technology to help develop new ways of working and collaborations which are defined by outcomes rather than outputs. But a cautionary note from @MindingsStu an inspiring technology innovator and entrepreneur!

Are we rushing towards tech rather than people for social solutions? Great question from @mindingsstu #psicare pic.twitter.com/3GooN8kxmU

— Paul Taylor (@PaulBromford) December 7, 2013

My call to action!

https://twitter.com/whatsthepont/status/409350948616933377

 

#psicare Connected Care Camp – what are your priorities?

On Saturday 7th December Connected Care Camp is bringing together professionals, people who use services, carers and volunteers from across the care, health, housing, community services and voluntary sectors to explore how innovative thinking and technology can improve the wellbeing of individuals who need care and support as well as their families and carers. Connected Care Camp is provided as part of the Hub Launchpad and FutureGov Public Sector Innovation programme.

Thanks to everyone who completed our online survey for Connected Care Camp. These problems will form the starting point for our discussions on the day as we consider a whole range of possible solutions guided by the considerable and diverse knowledge and experiences of participants.

We are not live streaming Connected Care Camp because most of the day will be taking place across six different breakout sessions but you can follow and contribute on Twitter using #psicare. We will be taking photos (with thanks to @tomsprints) and hopefully will be capturing highlights through some video interviews.

Snapshot of the responses

The problems identified from the online survey and discussions (NB: this is not an exhaustive list of all the care challenges confronting social care, health and housing sectors   )

Problems to be explored in the Breakout Sessions

1. Social Isolation and Loneliness

How can health and care services support people who are lonely and isolated?

How can we learn and share lessons from successes and failure across the wider care sector?

2. Information, Advice and Support 

People struggle to find information, guidance and advice – how can we improve the systems?

How can we support self-funders and help make their purchase of care services more effective? What are the implications of the Care Bill?

How can we learn and share lessons from successes and failure across the wider care sector?

3. Connected Communities

How can we support more connected communities?

How can we support people with disabilities to live more independent and fulfilling lives?

How can we encourage all hospitals and care homes to provide wi-fi and internet access and ensure that residents in care homes are less isolated?

How can digital technology help to support carers & care networks?

How can we find out who funds innovation in the care and health sectors?

How can we learn and share lessons from successes and failure across the wider care sector?

4. Digital Literacy, Inclusion and Technology Barriers

How can we support staff, people who use care services, carers and volunteers to improve their digital skills and feel more confident using technology?

How can we negotiate the internal barriers which stop the adoption of technology which will support people to live more independently?

How can we share innovations including digital technology and good practice across the wider care sector?

Are commissioners aware of the importance of continuing technical support when establishing technology projects?

How can technology help develop the local care market place?

How can we learn and share lessons from successes and failure across the wider care sector?

5. The challenges of Integrated Care

How can we ensure that integration is focused not on systems but on co-ordinating care and support around individual needs and aspirations?

Are there any alternatives to the 15 minute care visits?

How could doctors, nurses, social workers and support staff better coordinate care planning and visits?

How can we encourage care homes to have video links to GPs and hospital doctors to avoid unnecessary visits and disruption?

How can technology help to reduce unplanned or readmissions to hospitals and ensure effective discharges

There are particular challenges for people living in rural areas to access services & product. How can technology help us to address the rural premium?

How can we learn and share lessons from successes and failure across the wider care sector?

6. User and patient engagement and the personalisation of services

How can digital technologies give people more control of their care and support and make person-centered care a reality?

Are there practical ways in which we can implement effective preventative measures?

Can we make any connections with NHS Change Day?

How can we run an effective campaign in the care sector to challenge perceptions and change the conversations?

How can policymakers (e.g. Health and Wellbeing Boards) use social media to liaise with local people?

How can we learn and share lessons from successes and failure across the wider care sector?

What do you think the wider care sector should stop doing i.e. because it involves duplication or is not cost-effective? 

Endless assessments (that are not acted upon/shared) ‘buck passing’ between services

Evidencing everything – instead find intelligent ways to do this to support care staff – so they are not spending all there time working on paperwork rather than care.

Large scale system developments – these invariably seem to be expensive with dubious improvements in the quality of care and support

Transport and ignoring the wider community offer.

Commissioning separate services for a specific client group

Not sharing information between professionals working with one individual. There is a major cost to duplicating of collection of data, storing and not sharing.

The training of carers is not good enough and needs to be overhauled

Make medication reviews mandatory for older people every 3 months. This to be done by a pharmacist to avoid duplication, conflicts and unnecessary repeats

Using jargon

Spending money on high level conferences and developing top down national initiatives

In local government – let go.

Commissioning in blocks

Find different ways of dealing with falls – current call outs are very costly for Ambulance Trusts.

Practical ideas about where money should be spent

Prevention, Prevention, Prevention

Developing capacity at neighbourhood level and encouraging micro-commissioning via online service portals.

Identify mavens/community champions – the people who know things in the community and ask them how we can support them in what they do. Do not create systems or structures for them to work within – they are already ‘doing it’. It should be about public services supporting what already exists, not building new.

Increasing number of hospital support assistants so that older people can be offered regular fluids to avoid delayed hospital discharge because of urinary tract infection.

Training for those interviewing care staff  to ensure that those being cared for are not vulnerable to abuse.

Use data/info to focus approaches and look at effective discharges. Develop a new role for health and care mentors.

Develop voluntary connected care champions in every neighbourhood.

Carers want to support each other through sharing their experiences, carer to carer training and using technology. Carers are fearful of asking for help from local/public sector but carers and their skills are community assets and they should be given micro finance to support and help identify more carers. Technology and reciprocity schemes are important to carers too.

Joint commissioning and integrated services.

The challenges in the system are significant in terms of technology and the lack of specific transfers between key professionals. Still heavy reliance on faxes for example.

Increasing the digital skills of activities co-ordinators Raising awareness in care organisation about the importance of technology

Providing digital access is a major barrier for connecting care. User demand can only happen when you give people the plaform and the skills.

Encouraging cross sector collaboration. What can business do in terms of working with the providers and Local Authorities around preventative measures?  We need to acknowledge the ability to recruit talent and drive engagement for productivity is affected by factors outside the workplace.

Connected Care Camp survey – what are the priorities?

Connected Care Camp on the 7th December is bringing together front line staff, managers, people who use health and care services as well as carers to explore how we can improve the wider care sector including housing.

Connected Care Camp is part of the Public Service Launchpad a new programme to help passionate people who work either paid or unpaid in all kinds of public services – whether in local government, housing associations, health services, the third sector, social enterprises or elsewhere to develop ideas to solve the problems that they encounter every day. Ideas can involve small changes or radical redesign of services.

Not everyone can attend this one-off event in person but you can join in on Twitter using the hashtag #psicare.

We know what many of the problems are, many are making headlines on a daily basis so we are looking for solutions that work and that can scale. We need a clearer vision of what works and who could benefit so that we can optimise the skills and resources we currently have. This includes decommissioning services that are not effective.

In a fragmented health and care system we need to be clear about who has responsibilities for action, how organisations and communities can be more effective and how health, care and housing can be better co-ordinated around people who could benefit.

To help us organise the day and better engage the wider community via social media we would welcome your responses to our survey.

Click here to take the survey

Find out more about Connected Care Camp and book your place here

Welcome to the Connected Care Camp on 7th December 2013 #psicare

“The role for many public service organisations is to actively mainstream the innovation that is already out there. There are loads of innovators and entrepreneurs who just need a route to market. Some of them may already be employed by you.” Paul Taylor Innovation Coach Bromford speaking on the Disruptive Social Care podcast May 2013

Public Service Launchpad is a new programme to help passionate people who work either paid or unpaid in all kinds of public services – whether in local government, housing associations, health services, the third sector, social enterprises or elsewhere to develop ideas to solve the problems that they encounter every day. Ideas can involve small changes or radical redesign of services.

As part of the scholarship programme and to encourage wider participation across care the Connected Care Camp has been organised on Saturday 7^th December from 10.00 – 4.30 in London.

We want to encourage front line staff, managers and people who use care services to come along and share experiences, wisdom and ideas about how we can improve care services.

Here are some of the problems we know about in the care sector

• How can health and care services support people who are lonely and isolated – there’s a million of them
• People struggle to find information, guidance and advice – how can we improve the systems?
• How can we support more connected communities?
• Are there any alternatives to the 15 minute care visits?
• How could doctors, nurses, social workers and support staff better coordinate care planning and visits?
• How can we support people with disabilities to live more independent and fulfilling lives?
• Why don’t all hospitals and care homes have wi-fi and internet access?
• How can we support staff, people who use care services, carers and volunteers to improve their digital skills and feel more confident using technology?
• Why don’t care homes have video links to GPs and hospital doctors to avoid unnecessary visits and disruption?
• How can digital technologies can give people more control of their care and support and make person centred care a reality?
• How can  technology  help develop the local care market place?
• How can digital technology  help to support carers & care networks?
• How can technology  help to reduce unplanned or readmissions to hospitals and  ensure effective discharges?
• There are particular challenges for people living in rural areas to access services & products . How can technology  help us to address the rural premium?

Do you have any great ideas about how we can fix these and the many challenges confronting the care sector?

Do use #psicare to join in the Twitter discussions before and during the day.

Connected Care Camp Programme 

9.30 – 10.00 Registration

10.00 – 10.15 Welcome

10.15 – 10.45 Introductions

10.45 – 11.15 What could community care and support look like in the 21^st Century? A wish list (small group discussion)

11.15 – 11.30 Break

11.30 – 12.00 Feedback and Discussion

12.00 – 1.00 What do we need to start doing, what do we need to stop doing and  what do we need to carry on doing?

1.00 – 1.45 Lunch

1.45  – 2.45 Choice of themed  sessions exploring opportunities for innovation

• Community Connections
• Health and Wellbeing
• Digital Inclusion
• Residential Care and Housing with Support
• Social Media workshop to develop confidence and share expertise about the use and potential of digital tools

2.45 – 3.45 Themed sessions repeated

3.45 – 4.15 Panel debate “Next Steps”

4.15 – 4.30 Closing Remarks

By the end of the day you will:

• Have made at least 10 new contacts who are involved in the care, health,  housing and voluntary sectors
• Shared emerging and good practice
• Discussed and received feedback on your ideas
• Learned about at least 20 current innovations across the care sector

It should be noted that the care sector is a complex and fragmented market and the adoption of new ideas is not easy and present many challenges.

A roundup of Connected Care Camp posts, resources and videos #psicare

Introducing ‘Shared Walk’ a novel form of visual communication

Being isolated and housebound can have a serious impact on a person’s health, well-being and quality of life. A new internet and smartphone service is helping housebound individuals to explore the outside world with a friend, relative, carer, or volunteer. The aim of Shared Walk is to help people stay in touch through sharing access to photographs and short videos that can be easily and spontaneously transmitted from a customised mobile phone app.

In particular, it allows anyone with a smartphone to capture and send narrated videos to a housebound partner with access to personal space on the Shared Walk website. It is hoped that this service will be particularly valuable for relatively isolated individuals with access to the website. It will enable them to keep in touch with any contact  (or group of contacts) who can use a smartphone app. It is secure, accessible and user friendly to the novice – and it’s free to use.

The mobile member of this partnership typically captures brief video episodes of their daily lives with the  phone app and instantly transmits them to ‘domestic’ partners to view and, if they like. comment upon through a simple webpage. The video might be outward looking views of a “walk” (although it might even be the view from a “journey” rather than a walk – say the view from a bicycle or car). Housebound participants can also subscribe to “stories” in which a mobile individual posts intermittent video clips that capture something of their everyday lives –  this could range from a student,someone in business, a member of the clergy or a teacher.

“We were motivated by the idea that vivid and personal visual material was a powerful resource to animate and sustain relationships, particularly among those increasingly disconnected from an active social world.”  Professor Charles Crook leading the team developing Shared Walk

The research team at the University of Nottingham (with funding from the Nominet Trust) have been looking at how everyday technology can help those who are socially and physically isolated feel more connected with their families, friends and community.

Shared Walk are partnering with charities working with housebound individuals to promote the service and encourage people to sign up. Have a look at the introductory video and do email  Professor Crook charles.crook@nottingham.ac.uk or contact Charles  via Twitter if you would like to be involved in this innovative project.