Social services directors have written to NHS chief executive, Sir Nigel Crisp, pointing out that there is no structure for engaging social care services in the National Programme for IT (NPfIT). The letter said that social care input had been sought only on an ad hoc basis. 

David Johnstone, Director of Social Services for Devon, told a conference on the development of the NHS Care Records Service (NCRS) last week that a response was still awaited. He said the Department of Health had said something was being drafted "and it had a positive overtone"

In a wide ranging presentation on the contribution of social care IM&T to the development of an integrated care records service, Johnstone emphasised that he was very committed to modernisation.  However, he was critical of the NHS’s approach.

"The failure, if it occurs, will be due to this strategy, to the top-down approach.  I think the principles are correct and the aims and objectives are correct, but the process is flawed," he told the conference.

In correspondence with E-Health Insider after the conference Johnstone said that the letter had been sent from Andrew Cousins, the current President of ADSS.

"We have concern over a number of issues in relation to the NHS National Policy for IT in that it would appear to demonstrate little recognition that there is a social care information world and that it is essential for the NPfIT to interface with that world – for the benefit of NPfIT," he said.

Johnstone added: "My personal observation (not one which might be shared by ADSS and not an official position of ADSS) is that there is a dismissive and patronising view of social care information, despite the fact that our systems are already people-centred and capable of delivering a high proportion of the functionality of patient-centred health records as described in the Integrated Care Record Service [the predecessor version of the NCRS]. We have had these systems in place for over a decade in most social service departments.

"My experience of working with NHS on collaborative projects requiring computer-based infrastructure is of stepping back 10 years in time in terms of systems, access to hardware and culture.  The NPfIT and the thrust of NCRS – no longer Integrated Care Record Service – is dangerously inward looking and at odds with the principles of integration, modernisation and most important of all being person-centred.

"I wonder what contact, if any, social care is going to have with the LSPs, or are LSPs going to go blundering up the NPfIT version of the lost world oblivious to the wider world, dropping billions of pounds of taxpayers’ money in their trail?"

Social care is usually at the top of the list of public services with which the NHS needs to share information effectively.  In his conference presentation, Johnstone described examples of joint working in Devon which have reduced hospital stays – a critical issue now that local authorities face fines if hospitals are forced to keep patients for longer than necessary. Child protection is another area in which information sharing is seen as vital.

He listed several successful implementation requirements including:


  • Joint development of NCRS with the electronic social care record – starting now

  • Focus on whole population/whole system

  • Integration of top down national strategy with bottom up health and social  care development

  • Joint health and social care development strategy for IM&T.