Information-sharing in public services: Improving inter-agency coordination and governance

Submitting Institution

Newcastle University

Unit of Assessment

Business and Management Studies

Summary Impact Type

Societal

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services
Commerce, Management, Tourism and Services: Business and Management
Studies In Human Society: Policy and Administration


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Summary of the impact

Research at Newcastle has made a significant contribution to the public services modernisation agenda in the areas of inter-agency working and information-sharing. The research showed that effective information-sharing required not just that different information systems are made compatible with each other, but also that people from different professional cultures are enabled to work together through a common understanding of information governance issues. In active collaboration with a range of service providers, a number of processes and tools were developed for the significant benefit of service users. They have been implemented in a variety of policy settings, including children's services and adult social care, and have informed current programmes funded by the UK government.

Underpinning research

Research context
The Centre for Knowledge, Innovation, Technology and Enterprise (KITE) at Newcastle University is home to a network of leaders in the area of the governance of information and complex relationships within the health and social care sectors. Those whose work is featured here are the Director of KITE, Rob Wilson (1995-), James Cornford (1988-2009), Sue Baines (1993-2007), Ian McLoughlin (1998-2008), Mike Martin (visitor 1994-), Roger Vaughan (1995-2007), Sarah Walsh (1999-2009), Paul Richter (2004-) and Gregory Maniatopoulos (2004-2008).

Understanding the relationship between service providers and information systems
Since 2000, Newcastle researchers have been studying the relationship between service providers and information systems. The platform for this work was the Engineering and Physical Sciences Research Council (EPSRC)-funded Advanced Multi-Agency Service Environments (AMASE) project (Grant 1). The study adopted an action research approach, a key element of which was the active involvement of service managers and practitioners. The research challenged the conventional view that multi-agency working could be achieved simply by integrating technical information systems. Emphasis was placed instead on the relationship between the systems and those responsible for the governance of information.

Building on AMASE, an investigation was undertaken of the implementation of a complex data system, Virtual Electronic Social Care Records (VESCR) (Grant 2) (2). Through a series of focus groups and workshops with service providers, a working prototype of VESCR was produced. The Newcastle research contested the notion that one single information system would be suitable for all service providers, finding in contrast that all inter-agency communication channels required interaction and facilitation between practitioners from different professional backgrounds (1-6).

Developing the Framework for Multi Agency Environments (FAME)
The relationships developed through AMASE also led to the team being invited to become part of the FAME project funded by the Department for Communities and Local Government (DCLG) (Grant 3). In its examination of the governance issues involved in data-sharing, this research confirmed the importance of the relationship between different service providers in situations in which the sensitivity of information makes client confidentiality an issue. In 2007 the research team began to develop FAME to provide local authorities and their partners with the tools to implement partnership-based multi-agency working. The approach guides teams through a series of stages, from mission statement to technical specification (3).

Co-ordinating care: Identity management and service directories
The work on VESCR and FAME led to a range of long-term relationships at national and regional level. Work on the Children's Services Directories project (Grant 6), supplemented by consultancy for collaborating organisations, focused on the challenges of service co-ordination with reference to service directories, information-sharing, recording practice and identity management (4). The research explains the complexity involved in the design of secure, ethical and responsible governance of information systems. Issues to be resolved included the precise information to be stored about an individual, the ownership of that information, and the terms on which it is shared.

Personalisation of care for older people
Based upon their distinctive research in the field, Wilson et al. were invited to become part of consortia examining issues relating to the personalisation of care for older people. Two projects were awarded, the first of which sought to create knowledge to accelerate the implementation of Telecare in England (5) (Grant 4). The second, Older People's E-Services at Home (OLDES) (Grant 5), was a joint European Framework research project in the Municipality of Bologna and the Azienda Unità Sanitaria Locale di Bologna (2007-2010) (6). The OLDES scheme trialled an electronic `digital companion' in the form of a low-cost PC that provided health and entertainment services for older people. The Newcastle team worked to ensure that developments were grounded in the parameters of the social and health care system, the cultures and economies of the specific pilot, as well as other European public service contexts (6). The latest extension of this work was the completion of an evaluation of the Provider Development Innovation Fund for Adult Social Care (2010-12) (Grant 7), which explored the provider market and personalised adult social care.

References to the research

1. McLoughlin, I., Wilson, R. (2013). Digital Government at Work: A Social Informatics Perspective. Oxford: Oxford University Press. REF2 Output: 171617.

 

2. Wilson, R., Walsh, S., Vaughan, R. (2008). `Developing an electronic social care record: A tale from the Tyne'. Informatics in Primary Care, 15(4), 239-244. Available at:
http://www.ingentaconnect.com/content/rmp/ipc/2008/00000015/00000004/art00005.

3. Baines, S., Wilson, R., Walsh, S. (2010). `Seeing the full picture? Technologically enabled multi-agency working in health and social care'. New Technology, Work & Employment, 25(1), 19-33. DOI: http://dx.doi.org/10.1111/j.1468-005X.2009.00236.x. (ABS List 2010 3*). REF2 Output: 154819.

 
 
 
 

4. Wilson R, Martin M, Walsh S, Richter P. (2011). `Re-mixing the digital economies of care in the voluntary and community sector (VCS): Governing identity and information sharing in the mixed economy of care for children and young people'. Social Policy and Society, 10(3), 379-391. DOI: http://dx.doi.org/10.1017/S1474746411000108. REF2 Output: 162730.

 

5. May, C., Finch, T., Cornford, J., Exley, C., Gately, C., Kirk, S., Jenkings, K., Osbourne, J., Robinson, A., Rogers, A., Wilson, R., Mair, F. (2011). `Integrating telecare for chronic disease management in the community: What needs to be done?' BMC Health Services Research, 11(1), 131 (pp1-11). DOI: http://dx.doi.org/10.1186/1472-6963-11-131.

 
 

6. Wilson, R., Maniatopoulos, G., Martin, M., McLoughlin, I. (2012). `Innovating relationships: Taking a co-productive approach to the shaping of telecare services for older people'. Information, Communication and Society, 15(7), 1136-1163.
DOI: http://dx.doi.org/10.1080/1369118X.2012.711845. (ABS List 2010 1*).

 
 
 
 

Table of Relevant Grants/Consultancy projects

Principal Investigator(s) Grant Title Funder Period of Grant Value to Newcastle
1. Ian McLoughlin / James Cornford Advanced multi-agency service environments (AMASE) EPSRC 2000-2003 £950,000
2. Rob Wilson / Ian McLoughlin Virtual electronic social care record (VESCR) Department of Health (DH) / Newcastle City Council 2003-2004 £30,000
3. Rob Wilson / Ian McLoughlin / James Cornford / Sue Baines Framework for multi-agency environments (FAME) DCLG 2003-2007 £800,000
4. Carl May / Rob Wilson / James Cornford Integrating telecare systems for chronic disease management in the community DH / National Institute for Health Research (NIHR) 2006-2010 £316,550
5. Rob Wilson Older people’s e-services at home (OLDES) European Commission 2007-2010 £234,000
6. Rob Wilson / Sue Baines Children’s service directories project DCLG 2008-2009 £25,000
7. Rob Wilson Evaluation of the NE adult social care innovation programme and
e-marketplace support
DCLG 2010-2012 £80,000

Details of the impact

The work undertaken at Newcastle has had impact in linking together the human and the technical aspects of information-sharing. It has been particularly significant in two ways: changing the practice of practitioners who work with each other and with each other's information systems; and developing the governance relationships between practitioners, information systems and service users.

Improved information-sharing and governance
The findings from the AMASE and VESCR projects allowed a wide range of practitioners to address both the human and the technical aspects of information-sharing in the area of electronic social care records. For example, the Director of the Regional Youth Work Unit confirmed that the research has "contributed to stimulating thought across the sector in the North East. It has inspired deeper thought about the issues and implications of information-sharing, not just the delivery of services. It has enabled practitioners to be able to have conversations with those who are having the new ideas. The key contribution of Rob's [Wilson's] work is that the systems and technology are of less importance, it is about the governance of the information, this has to be the starting point of conversations about information-sharing." (IMP1).

The growing reach of the research impact is demonstrated through the Newcastle team's collaboration with Socitm, the national professional association for ICT and related professionals in the public and third sectors. Their Director of Policy and Research commented that "in May 2011, Socitm published Planting the Flag, a strategy document for the reform of public services enabled by information and communication technology. Of the six key issues identified, the first three have drawn on the research of Rob [Wilson] and the team, specifically relating to information governance, information management and transparency, and digital access and inclusion. Additionally, Socitm collaborates with the Cabinet Office and the Data Handling Guidelines produced with the Cabinet Office have been influenced by the research of Rob and the team." (IMP2). The influence of this work has been confirmed by influential policy think-tank DEMOS, in a 2012 report which makes direct reference to the Newcastle work: "Wilson et al. [(4)] outline how reconciling real-world identity with its data representation can strain relationships between a service user...a large VCS organisation and the social care system" (IMP3p59).

Enhanced inter-agency working and information governance
The importance of FAME (IMP4) as a means of facilitating inter-agency working and information governance has been recognised at national policy level. It informed the plans of the Office of the Deputy Prime Minister (ODPM) for co-ordinated services, with a specific endorsement as follows: "We recommend that further work be done by ODPM and local authorities to develop more protocol agreement frameworks for local partnerships along [the lines of] the FAME ... model" (IMP5p61). Although this was published in 2005 and there has since been a change in government, FAME continues to influence the extent and nature of integration across the public services. This can be seen in a current national exemplar programme, Improving Information Sharing and Management (IISaM), established for organisations supporting families with complex needs. The IISaM website states: "Throughout the IISaM project, we have been keen to learn from the experiences of others, whether to understand and share good practice or to develop case studies. Indeed, the `information sharing journey' framework which we have used as a basis for the toolkit came from research undertaken on behalf of DCLG a few years ago. We have picked up learning from the FAME project, which provided a framework for the development of multi-agency collaboration" (IMP6).

At the local authority level, FAME featured in the Newcastle Plan for Children and Young People 2006-2009 (IMP7p51) and the Lead Specialist Children's Health at Newcastle City Council commented in 2013 that "I think the work with the FAME toolkit meant there were individuals committed to the partnership agenda. We have since added the voluntary sector and now have a real culture of partnership working across children's services. Now the Wellbeing for Life Board is gaining from the lessons learned from the Children's Trust about how to make things work" (IMP8).

Commissioning and personalised care
The OLDES project (Grant 5) aimed to improve the efficiency and effectiveness of support services for older people. CUP2000 S.p.A is an industrial company, a market leader in Italy in electronic healthcare and Internet networks. Its General Director wrote to Wilson et al. following the project to recognise the impact of their work: "OLDES was a very important project for CUP2000 and our partners...as it helped us to improve our knowledge of the ICTs and information-sharing needed for the quality of life for frail elders in managing at home. Your team at Newcastle University did fantastic work on the analysis of the situation, and assured that the OLDES developments were close to the workings of people and organisations of the social and health care system in Bologna including helping us with issues of information-sharing and the use of the federation in ICT to help agencies co-ordinate for older people. This meant that we were able to continue and expand the work of OLDES in following developments...funded by the Regional Government and the EU" (IMP9).

On the basis of an action research project (Grant 7) Wilson and Martin made recommendations to the North East Procurement Organisation (NEPO) as part of the national framework for developing e-marketplace platforms for personalised care budgets. NEPO is using the project's findings to make a case to government on the commissioning of services in relation to the current White Paper, Caring for Our Future, which sets a mandate for better information to be provided by local authorities on their social services by 2014/15. NEPO's Senior Regional Category Specialist commented: "[Wilson's] research has changed the thinking of NEPO — from a system approach (basically buying a system that can become an e-marketplace) compared to now a system architecture approach where you have a much broader view of the challenges involved in developing an e-marketplace and now consider what the solution should look like (rather than previously had been focused on buying an off the shelf solution)" (IMP10).

Sources to corroborate the impact

(IMP1) Testimonial from Director, Regional Youth Work Unit.

(IMP2) Testimonial from Director of Policy & Research, Socitm.

(IMP3) DEMOS (2012) The Data Dividend (research by Wilson et al. cited p 59). Available at:
http://www.demos.co.uk/publications/thedatadividend (accessed 06/08/13).

(IMP4) Vaughan, R., Martin, M., Wilson, R., Gannon-Leary, P., Baines, S., Walsh, S., Carr, J., Cornford, J. (2007). FAME Generic Framework Guidance and Readiness Assessment Toolkit. London: Department for Communities and Local Government / Office of the Deputy Prime Minister. Available at: http://www.fame-uk.org/about/tool/ (accessed 06/08/13).

(IMP5) Social Exclusion Unit (2005) Inclusion Through Innovation: Tackling Social Exclusion Through New Technologies, A Social Exclusion Unit Final Report London: Crown Copyright. Available at: http://dera.ioe.ac.uk/5655/ (accessed 06/08/13).

(IMP6) IISaM website post. Available at: http://informationsharing.co.uk/thinking-about-the-iisam-project-in-a-wider-context-mopan-conference-at-newcastle-university/ (accessed 25/10/13).

(IMP7) Newcastle City Council (2006) The Newcastle Plan for Children and Young People April 2006-April 2009. Available at:
http://www.newcastle.gov.uk/wwwfileroot/legacy/socialservices/children/TheNewcastlePlanforChildrenandYoungPeople.pdf (accessed 16/07/13).

(IMP8) Testimonial from Lead Specialist, Children's Health at Newcastle City Council.

(IMP9) Letter from General Director, CUP2000 S.p.A, March 30th 2011.

(IMP10) Testimonial from Senior Regional Category Specialist, NEPO.