This presentation was delivered at the QualityWatch seminar: 'Allied health professionals: can we measure quality of care?' on 12 November 2014. Allied health professionals (AHPs) are a group of 12 distinct professions that form a critical part of health care. By 2013 AHPs had made up around 6% of the NHS workforce and accounted for an estimated £2bn of the NHS salary bill. The role that AHPs play in delivering care is likely to increase further into the future as the population ages and people live with more complex needs. Yet despite the size of the workforce and the broad scope of care, there is very little systematic information available to describe the quality of care delivered by AHPs. Find out more in a new report from the Nuffield Trust and the Health Foundation > http://www.qualitywatch.org.uk/AHPs

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12 November 2014
Integration and information
Dr Martin Bardsley
Nuffield Trust

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Why the current interest in integrated care?
•Rising levels of chronic disease and ageing population
•Increasing levels of hospital admissions and readmissions, especially among the elderly and vulnerable, and children
•Economic hard times, and unsustainable health and social care economies
•And too often we still do not get it right in terms of care co- ordination, care planning, communication with families
•Interest in preventive solutions that reduce the need for future care
•Integrated information systems seen as key element of integrated care

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Integration
Sara Shaw, Rebecca Rosen and Benedict Rumbold What is integrated care? An overview of integrated care in the NHS Research report. Nuffield Trust June 2011

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The power of information
“What's measured is what matters”/ (what's measured improves) “In the absence of information people make stuff up” Information helps people do their jobs better. Good information flows from operational need - do not collect data for the sake of it To use information effectively need to look beyond the single encounter to episodes of care and sure information systems can talk to each other - consistency (inter-operability)

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Data are everywhere…
GP
Local Authority
Commissioner
A&E
OP
IP
Pharmacy
Community
Health
Services
Up there
Housing
Council
Tax
Council
Social
Services
Social care
provider
Ambulance
NHS Direct Control
Commissioning data ...

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Tomb raiders?

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Health and social care timeline – an individual’s history

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Use of linked person level data
Audit and Quality Improvement Patient safety (e.g. monitoring drug side effects or surgical mortality rates) Public Health programmes (immunisation; monitoring cancer rates) Evaluate Services (are they effective and cost effective?) Planning services (e.g. ICU bed availability; pandemic flu plans; manage changing patterns of demand) Manage Performance (e.g. readmission targets; health outcomes indicators) Resource allocation Research

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Testing for gaps in care

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Emergency admissions for cases where nursing started 8-14 days before death

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But you know all that
from Making It Happen the Power of Information
Key ambitions
•Information used to drive integrated care across sectors
•Electronic care records increasingly used as the source of information to improve care across sectors
•Information recorded once at first contact and share securely..

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So what is the rate limiting step….
•Access to the technology and having the right hardware/software tools
•Ability to integrate care records across services /provider to achieve value
•Uptake of the technology/ awareness and skills
•Ability to use existing information
•Priority given to developing and using information tools

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Promoting better integrated information from Making It Happen the Power of Information

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12 November 2014
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Martin.Bardsley@nuffieldtrust.org.uk