The NDG reflects on the relationship between the NHS and social care and the importance of using data. She also highlights the value of Caldicott Guardians for organizations dealing with social protection data.
As I write this in the early days of the COVID inquiry, I look forward to the questions it will raise about the relationship between the NHS and social care. I very much hope that it will provide insights into how we can improve social care by making better use of resources, better decisions and better use of data.
Historically at least, health always takes center stage. “We make people better off when they get sick” is an easier and more engaging (more pleasantly dramatic, even) story to tell for those of us who are healthy, than its equivalent of “We help people live well and be active in their communities.”
Reflecting on the challenges of the COVID pandemic should give us all pause to think about how we want health and social services to work together to support individuals. We may be emerging from the public health emergency period of the pandemic, but we know that the relationship between health and social services is essential in “normal” times – and that humanity will again face pandemics.
Listening to discussions at a Health Service Journal forum on data and analytics recently, I was again struck by the long-known but inconvenient truth that if we want more people’s health to improve, we need to invest more in social care and the social determinants of health, such as housing, work, the natural environment, our food environment, and meaningful social connection.
Ensuring adequate funding for social care requires potentially politically controversial decisions. In the absence of substantial additional funding, it may be necessary to question the diversion of funds from organizations labeled ‘health’ to ‘care’ or even beyond.
My hope is that as integrated systems of care (ICS) mature, they will provide the autonomy and infrastructure necessary for these decisions to be made locally by the people living and working within these systems. They are in the best position to determine what matters most in their region to improve people’s lives. Helping ICS make these decisions will require better access to, and use of, data that already exists.
Given this, I was delighted to learn recently that work was underway on the adult social care data roadmap, alongside plans for digitalizing social care, within the Department of Health and Social Care’s National Data Advisory Group (a group convened to review and challenge the continued implementation of the Data Saves Lives strategy).
I felt a real commitment to understanding better what people working in the social protection system need on the ground.
I encourage all who commission or provide social care, and most importantly, service users and carers, to ensure your voice is heard on the data needed to improve services through the government’s Care Data Matters consultation.
The consultation closes on July 31, 2023.
The National Data Guardian’s advice on Caldicott Guardians
From my side, I must acknowledge the ongoing resource challenges that social care organizations and their staff are facing in relation to the implementation of our 2021 Caldicott Guardians guidelines.
This guidance encouraged (although important, did not require) all organizations to have or have access to a Caldicott Guardian. Recently, some welfare organizations, especially smaller welfare organizations, have expressed concerns about the feasibility of implementing the guidelines. The guidelines make it clear that where an organization considers that it is not proportionate or feasible to appoint a member of its own staff to the Caldicott Guardian role, it must arrange for the function to be carried out in some other way.
This may involve sharing a Caldicott Guardian or arranging with their commissioning organization to provide this function. The guidelines also provide for the circumstances in which an organization chooses not to appoint a Caldicott Guardian.
However, I want to stress that the advice we have produced is not about every organization giving someone the Caldicott Guardian title to ‘tick a box’. This role is important as a key part of supporting staff and maintaining a proven reliable health and care system.
I know from personal experience as the Caldicott Guardian that sometimes frontline staff and senior managers need timely support and advice when there is a difficult decision about how people’s confidential information should or should not be used. I believe that those working on the front lines in social care should have the same support as their colleagues who provide health care when faced with these difficult questions.
To be effective, the role of Caldicott Guardian must be held by someone who has knowledge and experience of working in the social care environment and who is accessible and available to frontline staff to provide responsive support in often urgent situations. I hope the guidance will continue to help organizations and their frontline staff think about what the Caldicott Guardian role offers and what it looks like best for them.
Our recently published FAQ helps social protection organizations exercise their own judgment about what is desirable and feasible in their particular social protection context.