In 2021 the NHS England Transformation Directorate produced What Good Looks Like, which described how integrated care boards (ICBs) should work together to enable care providers to connect and transform services, using technology and data. In 2023 we now have a very similar initiative in adult social care (ASC). What can we learn from DHSC, what are the differences in approach for digital social care and how do we think services will improve because of this renewed impetus to use technology more effectively in local government?
WGLL, as it affectionately became known, came at a time when the care agenda was dominated by the reorganisation of services, to join them up more effectively. This resulted in the creation of ICSs. So, it is no surprise that the strapline behind WGLL was a call to digitise, connect and transform. This reflected the fact that the NHS needed to get off paper and share data better. Only then could it really deliver a step change in making services clinically and operationally better. It wasn’t just the NHS that had issues. Local government has suffered from an historic under-investment in technology and so ICSs had work to do to support local authorities to join in the transformation. WGLL was followed by Who Pays for What (WPFW), which was the question on the lips of many people who bought into the vision of joining up care but were unsure how it would be funded.
We have learned a lot since 2021 and there have been some great achievements in, for example, the way organisations are digitising, connecting and transforming services using data that is following people as they traverse health and social care in shared care records. The Front-Line Digitisation initiative has not yet delivered on its promise to enable improvements in electronic patient records and other important pieces of NHS technology – but it is on its way. This is creating new opportunities to address some of our most difficult issues, as we try and join-up care. WGLL and WPFW were born in the NHS and the adult social care version of WGLL is defining what needs to be done in care so local government can be an equal partner in the transformation journey.
At face value, the documents are very similar – with a green wheel for the government and a blue one for the NHS. However, the ASC version is very much focused on the challenges of joining up care, from an ASC perspective, and it specifically calls out the need to support the workforce so that people feel more empowered. Having the right staff to run services is a global challenge – as is managing demand for services and enabling people to do more to help themselves. Nowhere more so than in social care.
Consider the 7 areas the ASC transformation needs to focus on:
Taking a practical example such as hospital discharge, the most tangible interface between health and care, we can begin to see how the WGLL framework can help the sector innovate and transform.
An ambition to drive cultural change tempered with pragmatism will unlock the power of digital.
Improving underlying technology creates the basis for innovation.
Use technology to prevent people from being lost in the system or stuck in a process.
Simplifying and digitising processes enables staff to be more productive and reduces strain.
People want more control over their lives and digital enables this.
There are areas where analogue processes can be quickly digitised to create impact, at scale, quickly.
Understanding need and managing well-being closer to home is key to reducing demand on services.
In this sense, WGLL for ASC is almost a double-click on 2021’s WGLL as it digs into the challenges faced by a set of services that are important pillars of a joined-up care system. It is an important tool in helping the sector understand the digital transformation and maturity journey it needs to embark upon if we are to realise the significant benefits that digital presents. The key will be to help the sector use the tool in a practical way, to support continued investment in digital to disrupt traditional ways of working and create a more sustainable model of health and care that is fit for the 21st century.
Paul has over 30 years of health and social care experience, gained in the NHS, software providers and consulting organisations. As a Partner at Channel 3 Consulting he is currently delivering a range of projects to improve technology platforms that support community and social care, use virtual wards to enable new care models and digital strategy and roadmaps for ICSs.
Ralph has over 20 years of consulting experience within the public sector, designing and delivering complex transformation programmes across health and social care. Ralph has helped the sector pioneer thinking in the areas of demand management, sustainable change in complex systems, behavioural science and intermediate care.