I fought the law, and the law won (until the Law Commission recommended a review)

As many readers will know, earlier this week the Law Commission released their report into Data Sharing between Public Bodies.  Those desperate to know the outcome will already have worked their way through the weighty tome, but I thought I’d highlight a few points for those who might be contemplating it as holiday reading!

Law Commission report front cover imageThere’s no such thing as a perfectly rational actor

The influence of behavioural psychology and insight has spread far and wide (see the Behavioural Insight team, amongst others) and it seems that the Law Commission has taken this on board.  The report acknowledges that the development of legislation doesn’t happen in a vacuum – external factors such as current public preoccupations, high profile individuals and political movements all have an impact.  Likewise, the way that legislation is applied is also affected by a variety of factors.  The Law Commission are clear that those external factors are outside its control – but that they have had on impact on the development of legislation related to information sharing over the years, and should be considered when contemplating future reform, as non-legislative activity might (will!) be needed to support any legal changes, whether that means codes of practice, training or case studies and practical examples.

The picture is complicated (and getting more so)

One striking conclusion of the report is that the legal landscape around information sharing is enormously complicated.  When a scoping project, conducted by a Law Commission team, works on the topic for around nine months and concludes that a list of relevant legal gateways is beyond its resources, you know how complicated it is!  At least now if anyone asks the Centre for a comprehensive list, we can point to the Law Commission’s conclusions on the impracticality of the task.  The proliferation of specific gateways also makes organisations less willing to rely on wider powers (such as the Localism Act).  An increase in commissioning and innovative service delivery means we need to think about sharing with third and private sector organisations.  And alongside the enormous number of gateways, the report makes the point that many gateways duplicate one another or cover very similar territory, making it difficult for organisations to know which gateway they should use in which scenario.  The variety in interpreting gateways is also noted – as the report says, that isn’t strictly a legal problem, but it does highlight that there might be a problem stemming from legislation.  Which leads me to…

There’s a lack of resource and expertise in this area

The report notes that specialist legal expertise around information sharing is in short supply, particularly outside the big government departments and agencies.  In fact, from our point of view, the key is to look at all the factors influencing information sharing, not simply legislation, so while legal eagles and information governance gurus are a key part of the team, they’re not the whole story.  Information sharing isn’t a job in itself – it is the responsibility of all of us involved in developing and delivering public policy, and so it is often poorly acknowledged and under-resourced.  Part of the Centre’s mission is to get information sharing recognised as a key enabler of delivering better public services, so that conversations about information sharing law happen in context.  And the report’s conclusion, that the legislation needs clarifying and simplifying, will hopefully make it easier for bodies to agree information sharing approaches, without getting trapped in legal argument.

There are no easy answers

Information sharing queries are often a search for the absolute.  A straightforward yes or no answer to the question “Can I do this?”.  But, more often than not, there isn’t a simple answer – it comes down to a balance of risks and benefits, being innovative while maintaining safeguards, and being willing to take decisions, supported by evidence.  The report follows that same theme: there is a balance to be struck around the public interest (respecting the privacy of the individual, whilst also making best use of limited public funds for the benefit of all), around the burden we place on the state against the burden on the individual (such as the use of consent), and around the need to be strategic and future-proof legislation, against the need to be specific in order to prevent abuses.  Policy and guidance over the last few years has demonstrated that thinking about information sharing does swing backwards and forwards, and that creates inevitable challenges for those creating and using legislation.  We can’t get away from those challenges, but it shows that an active balance needs to be maintained, rather than letting things slide too far one way or the other.

In conclusion, the Law Commission recommends a full law reform project, which (if accepted) will take two to three years to complete.  The Law Commission also recommends that “soft law” solutions (such as guidance, training and sharing best practice) should be considered within that.  So the work of the Centre is likely to be of great interest to a reform project, and we will certainly be ready to contribute in any way we can.  And in the meantime, we will do our best to help resolve some of these issues on the ground, and move the conversation about information sharing forward.

 

Sharing and caring: a case study on E-Health Insider

A new case study, published on E-Health Insider, looks back over the history of information sharing initiatives in the pursuit of more integrated health and social care, and asks what lessons can be learnt from what has happened so far (hat tip to the ever helpful James Freed at Public Health England for highlighting it).  The case study highlights that more integrated records (to improve patient experiences, and reduce inefficiency) have been a long term goal in the health service, but that changes in priorities and approach have led to a ‘patchwork’ of initiatives across the country.  Some of these initiatives are profiled in the case study, and there are a few key lessons and themes to come out of them all:

  • Pilots are all very well, but you need to reach critical mass

While we’ve seen evidence that starting small minimises the risk in innovative information sharing projects, there comes a time when the service needs to be embedded into normal service in order to be sustainable.  The case study’s authors say

This may be one reason that so many national and local projects have failed over the years; they never managed to cover enough people, include enough information, and get well enough embedded into local workflows to succeed.

For me, the key point is the last one.  So often information sharing becomes an ‘add on’, which could make a difference to the way professionals do their job – if only they would use the new service / approach / system!  We all need to be realistic about the likelihood of people using any approach which needs complicated additional security, logging out of one system and into another, or remembering to check a box that can normally be safely ignored.

  • Information sharing projects need time and commitment

Screenshot of Hampshire Health Record webpageThis is definitely borne out from the experiences we’ve seen – as the authors rightly say, information sharing can help deliver better, more joined-up services – but it isn’t a quick fix.  Anyone who has seen Stephen or I present on the Leicestershire Multi Agency Information Sharing Hub will remember the slide “Give it time” is closely followed by “Give it some more time”.

  • Sorting out information sharing agreements take time

Again, this echoes with what we know.  But here my experiences diverge from those of the authors.  The authors suggest developing

sample business cases, data sharing profiles, and model information sharing and consent agreements

Some of those things already exist here on the website, and more will be shared as we work with more areas on a broader range of topics.  But each area develops agreements or documentation which meets their specific needs – because often it isn’t the agreement that needs working on, but the relationship.  That takes time to develop – not just the paperwork.

  • There is surprisingly little evaluation of what works, and what it delivers

This is definitely something that rings true.  In fact, early ideas for how the Centre of Excellence might develop were modelled on the ‘What Works’ centres, with a focus on sharing evidence of the impact of information sharing.  We rapidly realised that the evidence is thin on the ground, so it is one of the key things we will be working on with local places: how can we demonstrate the impact that information sharing has had for them?  And how did they do it?  We look forward to sharing that evidence as it develops, but in the meantime, if you have evaluated the role of information sharing, why not get in touch, and help develop a case study of your own?

Three – it’s a magic number

I like the number 3. It’s a friendly sort of number. For a start, I can keep 3 things in my head before I need to reach for pen and paper! So it helps that there happen to be 3 main reasons why local places want to share information:

  • To design and commission services that meet people’s needs
  • To deliver services in a joined-up way
  • To evaluate whether services are successful

We worked with 3 local places this week – Swindon, Bath & North East Somerset and Surrey – learning more about their information sharing work and how the Centre could support them. Their information sharing work covers all 3 of the reasons above, and a variety of service transformation areas.

In Swindon, the council and its partners are trying to work out if there is an overlap between the service users who regularly receive a service from across the public sector. In Bath & North East Somerset, they’re looking at how to build the infrastructure which can support them to use data to safeguard children, and improve the health of residents. And in Surrey, they want to know how information can help design and deliver an integrated service to prevent and respond to a mental health crisis.

I was also in Manchester this week, hearing about the importance of gathering evidence about the positive impact of service transformation, with a selection of local places, including Carolyn Downs of the Local Government Association, Helen Edwards of the Department for Communities and Local Government and the Public Service Transformation Network.

The Centre is well placed in terms of its approach to evidence gathering; we have expert evaluation input from our Academic Advisory Panel, and our model of support to local places includes base-lining the situation, and documenting what works as well as the lessons learned along the way.

As much as I like the number 3, I like bigger numbers too. There are 3 of us in the Centre at the moment, but soon there will be more. I am excited at the prospect of a bigger team and the opportunity to support more local places. These are truly exciting times to be involved in creating lasting change. So don’t forget, today is the closing date for submitting applications http://informationsharing.co.uk/jobs/

Charlotte Piper, Assistant Director

This week has been brought to you by the letter T, and the number 2

I hope at least some of you get the Sesame Street reference!

Thanks to the Bank Holiday, this week has only been a short one, but nevertheless I have managed to get out and about in order to see in more detail what is happening in (two!) local places.

In Leicestershire, the Multi Agency Information Sharing Hub (MASH) has been successfully working with the ‘Supporting Leicestershire Families’ programme for a while now. But the MASH service is now going to support a new work and skills programme in one of Leicestershire’s districts – Melton Borough Council’s ‘Me and My Learning’ project.  The project, which aims to help 500 people in its first phase, aims to provide a ‘wraparound’ service to improve employment chances.  Having a consistent picture of which agencies already help support an individual will mean that they can be referred more effectively to the right services at the right time, without asking the individual to repeat their story over and over again.  This is a really exciting development and I will be watching their progress over the coming months with a great deal of interest.

Then in Chester, Cheshire West and Chester council spent the day sharing their experiences around designing and delivering their Integrated Early Support service.  This is a coordinated approach to dealing with children, families and domestic violence, using a single key worker approach, a team around the family, informed by a comprehensive understanding of issues within the family in the form of a 360 degree profile.  Attendees came from all over the UK to hear about developing the partnership and approach, delivering and commissioning more effectively, and measuring the impact for professionals, and for service users.  Cheshire West had been so inundated with requests to learn more about their approach, that (supported by the Public Service Transformation Network and Early Intervention Foundation) they decided to run a day-long event to help as many people as possible in one go. It also had the happy coincidence of bringing together a range of people from all over the country who are interested in all aspects of Cheshire’s model: I chatted to Troubled Family coordinators and social care managers, but also accountants, academics and economic development specialists.  We will be working with Cheshire to develop a case study of the information sharing side of their approach, so look out for that soon.

Count Von Count - "Two! Ha ha ha!"So that’s the Sesame Street number.  But why the letter T?  Well, talking to people from Melton and Cheshire, the thing which has made their work possible is trust.  Having strong partnerships has made it possible for each place to develop a shared vision for what can be achieved: independence, improved wellbeing, better lives.  The vision has driven new ways of working, where services are tailored to meet the needs of individuals and families, and where multi-agency working has become a reality.  Information is being shared, to make that possible, in a way that reduces the burden on service users, protects their privacy, and uses our limited public money more effectively.  But all of this depends on trust: between our organisations’ leaders, between all the professionals who work in this new way, and in the relationships between service users and public agencies.