What’s the Issue?
Data refers to facts, figures or details and can be either quantitative (things which can be counted or measured) or qualitative (describing the qualities of something). This network is focusing on quantitative data. Data can support people, such as commissioners, policy makers, managers and people who use care and support, to make better decisions. Decisions can then be grounded in fact, and this helps to ensure that resources are used efficiently and to achieve the best outcomes for individuals. This is called evidence-based policy and practice.
Networks are meeting across the UK, coordinated by:
What does the evidence say?
Challenges of using data in social care
There is a long tradition of collecting and analysing data in healthcare to implement evidence-based practice but this is more limited in social care. There are a number of challenges to collecting social care data:
Adult social care data is often seen as of poor quality compared to health data. This is partly due to the complexity of social care in that it supports personal needs but also social needs and is therefore more difficult to capture.
Adult social care is very complex, with a wide range of services from residential and nursing homes, day care, and homecare, to support for unpaid carers. There is no agreed definition of what social care is, making it hard to measure. In addition, services are delivered by a wide range of (mostly private) providers and there is no national system for collecting data
Social care data is sensitive and while there is a push to integrate health and social care data, there are concerns around privacy and security.
The policy context across the four UK nations
Policies in relation to data for the Health and Social Care sectors across the four UK nations have strong similarities, but there are some differences, particularly in relation to social care. In England, Wales and Scotland Adult Social Care is provided by local authorities (LAs) or councils, whereas in Northern Ireland it is the responsibility of regional Health and Social Care Trusts. Across all four nations, Adult Social Care is a “means and needs” tested service, with differences in Scotland where personal care is provided for free. All four nations are implementing a two-fold strategy which includes increased digitalisation and integration of health and social care data.
Strategies to improve data and social care
The national strategies of 1) digitalisation and 2) integration go together, as it is argued that increasing digitalisation will allow for the integration of health and social care data.
The argument for increasing digitalisation was highlighted at the start of the covid-19 pandemic. The assumption is that ‘going digital’ would help the health and social care system to improve through four priorities:
- Prevention,
- Personalisation,
- Performance and
- People.
Many care providers are now using digital care records but there are multiple systems in use and a lack of consistency in the use of identifiers making it difficult to compare data to understand the ‘big picture’. One risk is that some groups become less visible if their data is not recorded.
Care management software is promoted as saving time for staff but some software has been shown to take longer than paper records or to create more tasks for care workers. This means that they might not engage with the data collection effectively. egies to improve data and social care
The integration of health and social care data is a policy priority in all four UK nations. Early findings suggest that in Northern Ireland an integrated approach has resulted in improvements to care services and delivery. Integrating health and social care funds has been suggested as a way to improve care for people with complex needs. However, a review of evidence suggested that the link between better outcomes and costs was weak. This was because more integrated care often uncovers unmet needs which might lead to higher costs, although it may still represent value for money.
Broader evaluation methods are beginning to be used in social care, such as Social Return on Investment (SROI) approaches. These can capture some of the complexity of social care but often different methodologies make it difficult to compare results.
Using Data to Improve Services
At the practice level data can provide an important tool to support frontline professionals’ decisions. Social workers, for example, can use quantitative data from needs assessments to identify services and necessities that a particular population lacks access to, whether defined by age, income, or geographic region. Randomised Controlled Trials (RCTs) are sometimes used to test whether interventions are working. One such example includes a study which used a RCT method to test whether a training programme for social workers was effective at reducing challenging behaviours with Adults with Learning Disabilities in Supported Accommodation. The researchers demonstrated that the intervention was successful in reducing challenging behaviours, as well as improving communication and quality of life. RCTs are a popular method of evaluating interventions but they are sometimes criticised for supporting the creation of standard protocols but not personalised support. They also limit the involvement of people with lived experience.
At the policy level data has been used to formulate public policy. One project has examined how data can develop better policies in deprived areas of England. One of the the main learnings of the project was that evidence does not provide a ready “recipe” for policy but it provides principles and tools to adapt interventions locally. In Social Care, this meant building trust with vulnerable groups, keeping people engaged through small nudges, and ensuring services were delivered at the right intensity and time. The project also found that databases which integrate more information together can support Local Authorities and National Governments to define more focused strategies to support certain populations.
Further examples of data being used to understand the needs of certain populations include:
- the Ageing Better Measures Framework, developed by the Centre for Ageing Better,
- and the Unpaid Carers Dashboard, created by the Centre for Care.