Learning from practice

Durham has streamlined care services with the introduction of a groundbreaking computer system, says Kath Burke

The elderly and people with physical disabilities across Durham are receiving seamless care from social workers, housing officers and district nurses who share offices, a single manager and electronic records.

A computer system launched by Durham CC means district nurses visiting clients in their homes do not have to ask clients the same questions twice. Social workers can check patients leaving hospital receive the bandages they need and that they get their stitches removed when they should or that those with diabetes are referred to a community podiatrist.

The system was pioneered in June 2004 in the Sedgefield locality when about 20 social workers, housing officers and district nurses came together as an integrated care team.
So far, the system has supported 10 integrated teams across four localities to implement the single assessment process. Single assessment is designed to cut through red tape, saving patients from the irritation of repeated discussions and questioning sessions with a range of agencies.

Social work assistant Jane Hughes, a member of the pioneering Sedgefield team, says the shared computer system has been a godsend because she can ask her district nurse colleagues to keep an eye on any clients she’s concerned about.

“In a close, committed team like we have here it’s excellent because the nurses know most of the people on their rounds. Sometimes people only tell you want they want you to hear but we know the nurses are going in every day or week,” she explains.

IT innovations are continuing; since June 2006, two integrated care teams have been trialling laptop-sized tablets. Staff on home visits jot details straight into the tablet on their knee. When they get back to the office this information can be automatically updated to the main database.

The shared system also helps plan and schedule each team’s workload. Managers of each integrated care team can see how long it typically takes for a staff member to visit a client once a request is logged or to deliver care packages.

Senior NHS managers and housing/social care managers attend regular performance days, during which they analyse the reports against national targets.

Council information and communications manager Keith Forster, who project managed the introduction of the new system, says making the system user friendly, especially for district nurses, was crucial. District nurses were given three days off-site training to build up their computer literacy and competence.

“We were changing the culture of frontline staff to one where IT was seen as intrinsic to quality care. Social workers had used IT for years, but for some of the nurses it was the first time they were exposed to IT. We needed to make sure they were all at a similar level to help the team grow together.”

Users can call a single helpline phone number to get any problems fixed, thanks to behind the scenes collaboration between IT teams at the council and the NHS.
Mr Forster is particularly proud of the work done to ensure that the shared system meets strict NHS connection criteria and that it fits with and can grow with the overall health service IT programme. Good working relations meant that this integration work took less than half the nine months set aside to achieve it, he adds.

COUNCIL Durham CC
Highly commended, Local Government Chronicle Awards,
CATEGORY E-government
SPONSOR Northgate