People are the most effective integrators

At a discussion about integration the other day, someone talked about the four agencies which came to see her parents to support her Mum who has dementia. Each with their own agenda (continence, aids and adaptations, homecare etc) and each demanding the same set of information from the lady who now struggles to communicate clearly and her husband who is at his wits’ end.  We’d all see that as wrong, but what to do?

If your world view is that of a service provider you may well suggest the solution to this is for the services to share their data. To do this, of course, you need to align everyone’s IT systems. This will cost £10bn and collapse in miserable failure about five years later.

Looking at this problem from the family’s point of view, however, you might decide that the key thing is that, if each agency wants a similar set of information, the information gathered by the first one needs to be given to the individual or their family, on a sheet of paper will do, but you could throw in a USB key as well if you want to get technical, and the family can then show that information to the next agency, who can add their own sheet if they’ve collected anything new. These days you can capture information in an instant via a photo on a smartphone and then translate that info into the agency’s particular format if they need to.

It’s a simple, virtually free solution, but there a couple of quite deep cultural changes implicit in it. The first is that an individual or family can and should take ownership of their own information, and by implication share ownership of their care package. The family might lose it, I can hear some people saying. True, they might, in which case they will need to accept having to repeat themselves.

Another challenge is that this only works if the agencies are after roughly the same info, which suggests perhaps that they are all interested in similar things. This would be more likely to be true if they shared the same goals and priorities. It’s time to set one set of goals for all public services. I suggest the goal of helping people to achieve well-being, which handily has already been set as the goal for social care by the Care Bill. From that shared, holistic goal will come far better results in terms of integration than a hundred restructures.

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