Integrated Intelligence in Kent

Dr Abraham P George Consultant / Asst Dir in Public Health [email protected]

Context

• Huge NHS and public sector funding gap • Public sector services expected to discharge statutory functions with ever shrinking budgets • Growing need for ‘whole system’ understanding how money and resources are being utilised for population health and wellbeing • Greater insight required to develop higher value models of care that can meet the funding crisis

The answer: Integrated Commissioning enabled through Integrated Intelligence Purpose of capability

1. Meet the Health and Social Care funding and care gaps head on 2. Provide a means of designing and assessing the whole systems impact of strategic programmes such as: • Kent Integration Pioneer Programme • Facing the Challenge • Better Care Fund

Citizen Needs Health Visi ng & School Nursing A Educa on

All Kent health, well being, public and private-voluntary services

Primary Care Children’s Social Care Urgent Care OOH Care Adult Social Care Secondary Care District Council 3 rd Sector District Council Housing Providers MOSAIC, ONS, other demographic data; surveys, social media, blogs Mental Health Comm unity Health Ambulance Fire & Rescue Police Citizen Outcomes B Understanding citizen journeys across health, social care and all services to enable commissioners to:

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Truly understand the impact of all health and public services, their interplay and behaviours upon the outcomes for

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citizens Think cross-agency and cross-agency budget to identify the most effective ways of co-ordinating investment to create more value for money towards short, medium and long term outcomes Understand behaviour of citizens and adapt the behaviour of the system to enable them to participate in their optimal outcomes

Slide 3

Local Profile

• >1.5 million population • Governance of commissioning at multiple levels • 1 County Council, 7 CCGs, 12 districts, 4 acute trusts, 1 community health trust, mental health trust, >200 practices • Public Health Observatory team • Well networked with other intelligence teams – JSNA development – Health & Social Care Maps – Local needs assessments – Other analyses

Public Health involvement till date

• Work started in 2012 – QIPP LTC programme • Whole population profiling using risk stratification – Burden of multiple morbidities – Impact on service utilisation - ‘Crisis curve’ – Modelling how benefits of integrated care could be realised • Delivery of national YOC programme in Kent - implementation at sub Kent / CCG level • Submission of linked datasets (using NHS numbers) to national team for analysis • Contribution to national guidance eg. designing linked datasets by MONITOR, new capitated funding model by NHS IQ • Contribution to Kent Pioneer and BCF plans • Already using linked datasets for other purposes eg. service evaluation • Currently working with local intelligence in developing whole system intelligence dashboards, mapping and linking other non NHS data

Kent whole population dataset report

http://www.nhsiq.nhs.uk/resource-search/publications/population-level-commissioning for-the-future.aspx

Key Challenges

• Information Governance is a key challenge – Current approach to data sharing has been difficult – different expert opinions on how share / link data – National policy on data sharing for ‘indirect care’ is evolving eg. role of ‘DSCROs’, Department Health consultation on ‘Accredited Safe Havens’ • Data quality and accessibility – Good support from provider organisations – Quality / completeness of data variable across different organisations • Commissioner buy-in – Still some way off in application toward CCG plans – Difficult to change mind-set of commissioning capacity towards outcomes.

Next Steps

• Application for ‘accredited safe haven’ status (

it’s complicated….)

• Explore what other public sector routine data is being collected eg. Fire and Rescue, Probation, Police • Networking with other local intelligence teams – harness their skills and expertise • Develop technical solutions for IT architecture, ‘safe haven arrangements’, system modelling tools • Building up Year of Care programme in Kent – our ‘flagship’ of the integrated intelligence work

Key Messages

• Opportunity to capitalise ‘big data’ in public sector • Importance of person level linked datasets using NHS numbers • Using technology to accelerate the linking of data from disparate sources • Understanding the role of intelligence to develop higher value models of care to incentivise prevention and improve population health and wellbeing • Opportunity for business intelligence teams to work together develop whole system intelligence

Thank you