The Local Government Association (LGA) has this month published a brief but detailed report on how councils are using information and technology to transform delivery of social care services for children and adults.
The report, Transforming Social Care Through the Use of Information and Technology - co-produced with Oxford Brookes University and the Institute of Public Care - shows that local authorities are increasingly using hi-tech devices and systems to improve how they meet the care needs of vulnerable children and families, and do so in a more efficient way.
Two clear themes emerge: how social care systems link with other agencies to share information; and how professionals interact with children and families and each other.
Systems solutions
A self-assessment of councils' "digital maturity" carried out for the LGA report shows that using IT to share information is now standard practice in children's services, with 90 per cent saying they are involved in such initiatives. However, work to link social care systems with those used by other agencies and organisations engaging with many of the same children and families is only just starting to gather pace. For example, the LGA survey found that only 15 per cent of councils contribute to the health and care record of local citizens, and just four per cent of children's services have access to them. The finding highlights the long-standing problem of health and social care systems not talking to each other - a factor regularly raised in serious case reviews as failures in safeguarding (see research evidence, p20).
One systems-based initiative that aims to overcome that is NHS Digital's CP-IS project (See practice example, p26). This will link up child protection systems with those used by "unscheduled" healthcare settings, such as hospital emergency departments and walk-in-centres, in 80 per cent of English council areas by 2018. It should mean that social workers are alerted when a vulnerable child presents at a health setting, while information about a child's care status will be flagged to health professionals when they treat children.
The Children's Health Digital Strategy, developed by NHS England covering the period up to 2020, highlights the need for more information sharing between the health service and other organisations responsible for the health and wellbeing of children. It states that health systems are complex and cumbersome and offer "limited access" for social services. The strategy outlines a vision of an integrated system that holds information from health visiting, safeguarding, mental health, school nursing, and primary and secondary care settings.
For its part, the government has pledged to spend £4.2bn over the course of this parliament to help achieve its ambition of a fully integrated health and social care system by 2020. However, some areas are already integrating systems.
Regional devolution has presented Greater Manchester with an opportunity to integrate health and social care services, as part of the reorganisation of services and systems following the transfer of health and social care budgets. Having outsourced day-to-day management of its children's services to an NHS trust, Trafford Council plans to become the first area to fully integrate social care and community health services for children and adults. If successful, the pilot is likely to lead to the other nine councils in Greater Manchester following suit.
Meanwhile, a collaboration of academic and health organisations in the city is developing a project called Manchester DataWell that will enable NHS services and bodies to share patient information more securely, with the aim of improving outcomes for disadvantaged groups.
The South West is another region leading the development of integrated systems. Connecting Care is a partnership across the Bristol, North Somerset and South Gloucestershire area that will link 14 different care record systems across 17 organisations, including three councils, hospital and ambulance trusts, GPs and community health providers. Information drawn from the agencies' systems is collated to produce an "integrated data set" for each person that can be shared securely and updated daily.
Children's services will have access to the system from January 2017, with the potential for education and police to input information in the future to improve how the system protects young people from the risk of abuse and exploitation. Connecting Care say the value of the system to children's services will be that it will provide a more complete picture of a child and a clear timeline of interventions. This will enable practitioners to develop an appropriate response and potentially reduce the need to intervene if a child is already known to agencies.
The LGA report also highlights the potential of using technology to better analyse data collated by agencies and help identify earlier those groups most at risk of poor social outcomes. Some areas, such as Essex council, are already developing such solutions for use in targeting early help (see practice example, p28).
Changing social work practice
The widespread availability of mobile devices and digital technology has enabled children's services to rethink how care is delivered. It is changing how social workers interact with children and families, giving young people a greater say in their care, and helping practitioners manage cases and workloads.
The LGA's digital self-assessment found that 36 per cent of councils now have digital channels of communication with users of social care services - "whether this is through better use of email, online video conferencing or instant messaging". An increasing number of social care practitioners are now using apps to discuss issues with young people - such as female genital mutilation and mental health (see practice example, p28) - and record information about their care needs alongside them by using tablet computers.
Mobile technology is also changing how social workers record information. Slough children's services trust has invested in tablets that enable key social work staff to update care records during or straight after a visit, perhaps while on the way to their next meeting. In East Sussex, the council has kitted out every social worker with mobile technology that enables them to access care records while working remotely, to aid decision making.
Academics say that information generated through better data analysis can also help social workers to engage vulnerable communities earlier and encourage self-help (see Joanne Westwood expert view).
Despite much innovative work going on across the country, a lack of national co-ordination has led to a piecemeal approach in how technology is adopted and used in children's social work. Just a third of respondents to the LGA survey said they had sufficient access to funding to develop systems, suggesting action from government is needed.
Concerns over sharing sensitive information through integrated systems and the impact that technology could have on relationships between workers and children have also held back some areas (see Richard Selwyn expert view).
The LGA report concludes that children's services leaders have an important role to play in promoting the opportunities that technology offers for sharing information and working collaboratively. It states: "Technology approaches are no substitute for face-to-face care but they can support delivery and maintain wellbeing - care professionals have a critical role to play in this area."
How children's services must adapt to meet the changing needs of young people
By Richard Selwyn, local government service commissioner
If we believe a recent Ofcom report, the age when a child understands technology better than a 45-year-old adult is six.
It's not long until they have their own device - catching Pokémon in augmented reality, socialising in massive online worlds, and interacting with virtual assistants like we might with a real person. Facebook is so 2010.
Our services however can be a little behind. Only recently I needed to let parents know about a bus strike, but had to send 700 snail-mail letters.
In some ways, we are lucky to have the most tech-savvy users, keen to embrace digital help or Skype visits. Young people expect Google to market products to them because they mentioned it in a private email, and find it crazy they have to tell their story to children's services so many times because we don't share data.
So children's services is a dichotomy of the modern lived experience of children and families, and the service model designed by adults. Maybe we need the odd child of six in our commissioning teams, or on health and wellbeing boards?
Young people and parents are keen on this emerging technology. For example, peer support apps for emotional wellbeing are enabling them to share how they are feeling and get (moderated) guidance from other young people; getting in touch with school nurses through ChatHealth we've seen high-level needs self-reported that wouldn't have been picked up normally; and parents and professionals accessing online advice and guidance for speech, language and communication needs.
But online services can only sit alongside face-to-face options, not replace them. This is not digital by default. And there is a darker side to the technological march of progress. Bullying and predatory behaviour has moved online - so parents and teachers need to know how to protect children.
So changes in technology can help us but there are dangers and it shouldn't replace traditional children's services. Our users are much more accepting of digital services than professionals or commissioners. And if we look at other industries that have been disrupted by the digital revolution, we might expect something similar for children's services.
Here are three potential technology-based innovations that may affect children's services:
- Online offer Amazon-style websites of public services and community resources, including automated services (for example, linking a new parent with a local childcare group). This moves our ‘shop-front' from children's centres to the web.
- Monitoring Everything from devices that test vital signs and reduce admissions to hospital, to DNA testing that shows your emotional resilience.
- Big data Collection and evaluation of data on every resident which enables us to predict need. This opens up a new range of early help services, and also shows which interventions work best.
Impact of social and digital media on social work
By Joanne Westwood, assistant director social work education, University of Salford
Technology and particularly social and digital media has provided children and young people with new ways to connect and engage with peers, family, friends, agencies, organisations and knowledge. For children, young people and families involved with social care, this can mean improved communication, increased surveillance by workers and/or parents, better informed parents, speedier access to information and new ways of sustaining relationships.
Here are four ways that social and digital media is being used in children's social work.
Using apps to improve engagement
The University of Stirling and Queens University Belfast are working on a pilot project which is an app designed to gather feedback from service users at the point of the intervention. It is hoped that the app - being piloted in Northern Ireland and England with children's and families' teams and in Scotland with a voluntary sector drug and alcohol service - will collate responses from service users which can be used to inform and shape future services. The data generated by service users will not be used to identify individual social workers but draw attention to areas where practice needs to improve across a service.
Improving social worker education
The University of Stirling has been developing an online module - Professionalism Online with Social Media - which is delivered as part of professional programmes in housing, dementia and social work. The module has been designed to provide students with a range of activities to work through as they prepare for practice learning and encourages them to consider why they use a particular social networking platform, and how this might change when they are practising. The activities also require students to set up an online profile using a social media platform of their choice and which their employers can access.
Improving practitioners' skills
Understanding Child Development apps were developed in 2013/14 as learning tools to support student social workers undertaking an Assessed Year in Employment, for recently qualified social workers and social work practitioners in Northern Ireland. The download data surpassed all expectations with the apps being used in 199 countries.
Early intervention and self-help
New digital and social media technologies can provide information for people to access help and support. Smart technology use is commonplace in the UK. As such, focus should be on social work organisations, researchers and practitioners curating and publishing what is available and how best it can be utilised for practice, and by service users. With the wealth of information out there, advice on which platforms to use would be welcome. Service user groups and individuals are actively promoting self-support and help online, and have also been instrumental in campaigning against welfare cuts.
