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From movement sensors and digital patches to open data, Surrey County Council’s ambitious digital transformation programme is all about improving services for local residents.
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The council aims to rethink, restructure and fully update its services, with a big emphasis on digital.
A major focus has been on linking up its different services and partners to ensure the best possible outcome for residents.
“The way we have delivered services has been structured around individual service departments and that is how it has traditionally been delivered,” said the council’s chief digital officer, Lucy Glenday.
“We have to shift and transform. We either jump on the bandwagon or stand back and watch it happen.”
Glenday said there is often a focus on outcomes in council services, but those outcomes are now delivered by multiple agencies.
“Ultimately, the main outcome is about the residents seeing value, so we have got to understand what is happening across the partners,” she added.
For example, the local authority holds several lists of vulnerable people in Surrey, but traditionally, the various services involved did not talk to each other and there was no way of gathering information about vulnerable individuals quickly, should the need arise, said Glenday.
The council has worked hard to establish links between health, emergency services and the authority’s own care services.
“If we don’t have a way of talking to each other when we need to get information about vulnerable people in the community quickly, that becomes problematic,” she said.
To meet this challenge, the council has devised a system whereby responders on the ground can quickly obtain relevant information from health and care systems, matching it to a dashboard or map of vulnerable people.
For example, if there is a risk of flooding in any part of the county, the fire and rescue services could quickly obtain a list of vulnerable people in the area, said Glenday.
The system would pull information such as an individual’s name, address and any relevant information, such as whether they need a sterile environment, are in a wheelchair or have a mental health problem, so the rescue services can bring the right equipment with them.
The system uses people’s NHS number as a primary identifier, but Glenday stressed that the information is completely secure and follows strict information governance protocols. Responders can only see information that is relevant to them, and no detailed medical history.
“It gives them the kind of information they need to be able to respond immediately,” she said.
Sensors and digital patches
Surrey County Council is also pushing technology-enabled care services and has begun trialling movement sensors for older people living in extra care housing – self-contained accommodation designed for greater accessibility.
The sensors monitor residents’ movement, and their usage of water and electricity. Residents also wear digital patches, so the system gives a full picture of how they are doing.
“It means we can understand people’s patterns of activity,” said Glenday. “If you overlay that information with the vital signs information you get from the digital patches, you can start creating patterns quickly. When that pattern is broken, you can act quickly on it.”
If a resident’s pattern of behaviour changes, an alert can be sent to either a carer or a family member, prompting them to contact the resident to make sure they are all right and enabling intervention before care needs escalate.
As many residents would rather an alert goes to a family member than a carer, the system enables their family to get involved in a way that may not have been possible before.
Glenday said that if an ‘extra care’ resident has sat in their chair all day, they may be dehydrated, which makes them more susceptible to suffering a urinary tract infection (UTI).
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UTIs are common in older people, and can cause confusion, especially in those with dementia, she said. This is also one of the major causes of hospital admissions in people over the age of 60.
“Having an alert come up could potentially pre-empt the need to go to hospital,” said Glenday.
The pilot scheme is small so far, but in February 2016 it will be extended to Whiteley Village, a retirement community with 500 residents.
The residents there range from people who are very independent and may resent having any sort of overview of their activity, to those in quite advanced stages of dementia, so it will be a challenge, said Glenday.
“But we have to do it. Without it, we won’t understand future models of care,” she added.
Open the door for data
When Glenday became CDO at the council two years ago, moving from the the Government Digital Service, she intended to change the way the authority thinks about digital services. As well as bringing in a platform approach, she has seen the council commit to opening up data by default.
“It’s a massive commitment and taken a lot of work,” she said, pointing out that people, especially in IT, have traditionally been afraid to share data.
But after a couple of years’ work, the people who used to be scared are now advocates of sharing data, she said.
“We’re pushing five-star linked data,” she said. “We have to be able to link our data sets with NHS data sets and central government data sets. It’s been hard work.
“Now we have got that level of understanding of the complexity that comes with it, but we understand the benefit that comes with that for developers and researchers as well.”
But the council is taking it one step further, and is now working on making those data sets consumable “not just for the geeks”, but for the average resident too, she added.
“We want to make it useful and readable to anyone, such as Jade, a mum of two who wants to know the likelihood of getting her child into her first choice of school,” said Glenday.
So far, the council has published 59 data sets, many of them five-star, and the list is growing. “We’re not going to stop now,” she added.