How info sharing is improving help for Troubled Families

By Stuart Bolton and Imogen Heywood and Stephen Curtis | 19 March 2018

Information sharing is crucial to public service reform across all policy areas and all public-sector organisations. It is often seen as a side issue, but we know from the work we have been doing at the Centre of Excellence for Information Sharing (the Centre) how central it is to delivering services in a different way.

It’s only by sharing information that we can identify those most in need, target and coordinate our limited resources, design public services with service users’ needs at the heart, and show the real difference new ways of working is having on people’s lives. It is fundamental to everything we do.

A recent example of our work which cuts across several policy areas, and involves numerous services, is the troubled families’ health information sharing project. As with all our work, culture and behaviour have been crucial to breaking through the barriers to sharing information – in this case between the council, health, and wider public-sector partners involved in supporting troubled families.

Whether it’s as part of our troubled families work, or within another area, when we work with places to find and support good practice, what do we see? We see organisations working together, working out how to deliver services differently to achieve a better outcome for the people they are supporting. We see services being redesigned, to enable the right information to be shared with the right people. We see consideration being given to how they communicate with service users to be transparent about how their information is going to be used. And we also see joint discussion about how data can be used to target services and demonstrate change. However, underlying this, and key to sustainable reform, we see people working on their cultures, behaviours and organisational change, with leaders playing a crucial role in making it happen.

From both our troubled families’ health information sharing project, and our wider work, we have identified several challenges to information sharing, these include:

  • an absence of a focus and shared understanding of the problem that we are tackling;
  • a requirement for the right leadership to break through information sharing barriers;
  • understanding what barriers to look for, and not just leaning back on governance or technology.

We all have a role to play in solving these issues, and as leaders we need to keep information and data sharing on the agenda, both in communicating about the importance of information sharing, and in supporting the development of better information and data capabilities across the public sector and beyond. 

As we look to the future, information and data is not going to diminish in importance, it is going to play an ever-increasing role to target services better, and provide more co-ordinated and joined-up support to the most vulnerable.

One of these vulnerable groups is families with multiple complex needs, and I mentioned earlier about the troubled families’ health information sharing project. In this context, information sharing means problems can be tackled more effectively, resulting in better outcomes for families.

With the support of the Ministry of Housing, Communities and Local Government, the Department of Health and Social Care and Public Health England, the troubled families’ health information sharing project was established to provide case studies to help those who are trying to share health information better.

My colleagues Stuart Bolton and Imogen Heywood have worked with key professionals involved in the management and the delivery of both the Staffordshire and Oldham Troubled Families Programmes. Capturing the approaches taken in each place to sharing information with health partners, to share the learning and encourage others by showing what can be done.

Stuart and Imogen will look at the case studies produced in more detail below. I urge you to share these case studies with your service managers, troubled families’ co-ordinators and partner organisations as there will be learning to take away. I also urge you to come forward if you have your own story to share – it may be your own approach, what you’ve learned along the way, or a top tip you’d like to share from your own experience of information sharing.

On a final note, these case studies would not have been possible without the time and support from both the Staffordshire and Oldham troubled families team and their partners, and we would like to thank everyone involved for sharing their views and experiences with us for others to learn from.

Stephen Curtis is director of the Centre of Excellence for Information Sharing

To share your experiences of information sharing, email: info@informationsharing.org.uk


Case study: Staffordshire

The Troubled Families Programme in Staffordshire is known locally as ‘Building Resilient Families and Communities’ (BRFC). Key health, council and other public services work to a shared local vision - enabling families to be ‘safe, healthy, self-reliant, educated, responsible and informed’ by coordinating support across local services. It is delivered through a partnership approach to workforce development, joint commissioning, and improved information sharing.

Phase one of the programme revealed local need around ‘hidden harm’ (domestic abuse, mental health, and substance abuse), which strengthened the case for sharing information between health partners and the BRFC programme.

The Staffordshire case study therefore focuses on the local priority of information sharing with mental health partners and highlights the role commissioning can play as an enabler of information sharing.

Benefits of information sharing

The Staffordshire case study highlights numerous benefits of information sharing, and I’ve selected two to tell you about.

First, BRFC is providing a more integrated service because of information sharing. An example of this is where the BRFC’s Family Intervention Partnership (FIP) workers co-location with the substance misuse team is enabling better information sharing that supports the coordination of support to families. Mental health training has also been given to FIP workers so they can deliver low level mental health interventions, signpost to appropriate mental health services and provide them with a better understanding of mental health information.

The second example is where information sharing means partners are better able to identify vulnerable families with multiple and complex problems. In Staffordshire, the mental health partner has developed an information sharing approach with BRFC which is supported by an Information Sharing Agreement. BRFC provide their mental health partner with the profiling data that identifies individuals with a match against the various troubled families’ eligibility criteria. The partner then cross references this information with their own records to identify if any of the individuals are an active referral across the range of mental health services. Where there is an active referral, a mental health flag is placed against the individual. This information is then passed back to BRFC who input the information into their data solution to identify those families with a mental health criterion. This sharing of information means vulnerable people can be identified at an earlier stage before their problems escalate.

Stuart Bolton is engagement manager at the Centre of Excellence for Information Sharing


Case study: Oldham 

Background

Within Oldham, the Troubled Families Programme sits within a universal age ‘early help’ service. Delivered by council-based teams and through contractual arrangements with third party suppliers, Oldham’s early help service is targeted at residents who experience multiple and often complex issues in their lives. The different strands of the service are designed to identify these residents, and provide short but often intensive services, with the aim of resolving complex issues before the need for escalation to more specialist services such as social care, mental health and drug and alcohol services.

The Oldham case study focuses on looking at two ways of using health information.

First, as part of a pilot with a local GP practice where direct information sharing enables early identification of families with significant levels of need (including health needs) before they reach crisis.

And second, working with public health services and a Clinical Commissioning Group to better understand the level of use and the level of demand on local health services by families with complex needs.

Benefits of information sharing

Like Staffordshire, a range of benefits were recognised from sharing information within Oldham’s early help service and their health partners.

A key benefit has been the ability to identify vulnerable people, previously unknown to local services. A review of the Oldham GP data sharing pilot found that the data sharing mechanism and subsequent risk stratification could find households with unmet need who were at risk of spiralling further, or those who had just managed to stay below thresholds in individual services. The early help service is now supporting a number of these cases where short-term interventions were identified as being able to realise the benefits. Whilst other individuals who were recognised as needing longer-term support are now receiving support from the focused care programme (run by the GP practice).

Another benefit is that the GP and the early help manager found that sharing of information through a case discussion provided a more comprehensive picture of the patient’s need, enabling effective decision making about how these needs would best be supported and by which agency. By sharing information through case discussions, the GP was also better able to understand underlying root causes of complex problems.

Imogen Heywood is engagement manager at the Centre of Excellence for Information Sharing

You can read more about the benefits of information sharing within both Staffordshire and Oldham, or download the summary report which considers both case studies and highlights the overarching findings by following this link.

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Health Adult social care Troubled families Transformation Public health
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