Data can facilitate early intervention and prevention while salvaging council’s finances, Mark Smulian reports.
- Victoria Evans, London local public services lead, EY
- Peter Fahy, director of adult services, Coventry City Council
- Mark Golledge, programme manager - care and health digital lead, Local Government Association
- Abdool Kara, local government lead, National Audit Office and Solace spokesman on evidence based policy
- David Paine, acting news editor, LGC (chair)
- Helen Sunderland, director, adult social care, EY
- Carol Tozer, director of adult social care and housing, Isle of Wight Council
- Guy van Dichele, executive director, health, wellbeing and adults, Croydon LBC
- Kate Waterhouse, head of performance, research and intelligence, Manchester City Council
As the demand-led pressures on social care join with a scarcity of resources to plunge some councils into crisis – most prominently Northamptonshire CC – and creating widespread trouble, does data offer a way out?
Properly collected and used, data might allow councils to plan and target care resources more effectively, providing something more than the ‘core offer’ to which some have retreated.
That was the feeling of participants at LGC’s recent roundtable, held in partnership with EY. But formidable questions remain. Can the relevant data be collected? Do councils have the skills to analyse and interpret it and improve services? And will the public be willing to have their data retained and shared?
As LGC news editor David Paine, who chaired the roundtable, noted: “Financially and operationally there is a very challenging context, and no-one is under any illusion that austerity is over for local government. There is some hope on the horizon in the data and information you hold and the ways we can use it as a sector to more intelligently configure services.”
Participants had varied experiences of managing demand, but all agreed that having better information could help make the most of resources.
Kate Waterhouse, head of performance, research and intelligence at Manchester City Council, noted her city had attracted plenty of regeneration projects but wanted to ensure they benefited their communities, which generate “some of the worst health inequality data in the country”.
The council had used the Troubled Families programme’s requirements to kick start evidence-based planning. “It gave us an opportunity to have a legitimate basis to join up data over partnerships and geographies, which we had not done before,” she said. This gave the council insights into “what interventions were actually needed, rather than what was first presented, which might not be the underlying issue”.
Croydon LBC’s executive director for health, wellbeing and adults Guy van Dichele had integrated services for older people with providers, the local hospital, the clinical commissioning group and Age UK.
“Our working with them is based on loads of data and is intelligence-driven, and we have become quite good at keeping people out of social care for the over 65s, though less so for those under 65. That is the next stage,” he said.
“We have a data intelligence team we use quite a lot, a public health team and a digital chief officer who is from digital sector, and we try to get as many people using data as possible.”
Croydon LBC has been able to look across its area at prevention and early intervention spending data and found pockets of people spending in isolation. “Now we know what we are spending,” Mr van Dichele said.
Peter Fahy, director of adult services at Coventry City Council, has an insight team devising services based on data about electoral wards – despite some internal disagreement – as they were a geographical level commonly understood by residents.
“We can map local government and health spend in the ward,” Mr Fahy explained. “It’s partly austerity-driven, but we’ve pulled a lot prevention spend as we’ve found no evidence that it was preventing anything. It was creating dependency by providing a lot of things people expected more of.”
It’s partly austerity driven, but we’ve pulled a lot of prevention spend as we’ve found no evidence that it was preventing anything
Peter Fahy, Coventry City Council
Carol Tozer, director of adult social care and housing at Isle of Wight Council, said she had used “pivotal” improved better care fund money for data work to support the council’s Care Close to Home strategy. Since its introduction in April 2017 there had been a 58% reduction in permanent admission to residential care among elders, and a 33% reduction for adults of working age.
The council worked with the voluntary sector as 42% of the referrals it received were from people not eligible for adult social care, for whom nothing had previously been done.
“We knew that to be short sighted,” Ms Tozer said. “We brought together voluntary groups to offer wrap-around early help and support. As of September, of 1,574 files that came into the service only 42 have been re-referred into adult social care. It’s been massive.”
These experiences from the frontline inspired other participants to suggest ways in which data could better inform policies.
EY’s London local public services lead Victoria Evans asked: “How do you overcome challenges about local authorities and public confidence on the use of data, and how do we use data more effectively by thinking through key principles?”
She said using ‘early help’ approaches to prevent costlier later interventions was “the holy grail”, but this would not be reached if the public was suspicious about handing over data.
“Individuals are comfortable with Google and Tesco knowing more about us than our close relatives do, but the challenge is whether it is being used for the right purposes. So how do we shape that debate?” she asked.
Manchester City Council had had this problem, Ms Waterhouse said. “Local government is quite low down the list for the public trusting us with their data and personal information, so if we are going to do the kind of work we want to do, we need to do something about addressing those issues and build confidence in local government as a safe pair of hands.”
Ms Tozer said: “Trust with data comes back to good social work practice. If you talk to people and ask permission to share this as in their best interest I’ve never come across anyone who says no. There are good data sharing protocols out there and we must be clear we’re not doing this for our intellectual curiosity but because putting this information together means we can better respond to need.”
Mr Fahy said: “We get confused on data and consent to share, but a large proportion of people will complain they have to tell different people the same thing, asking why we can’t share. People expect us to share, so why not get consent?
“The thornier issue is the people we don’t directly engage with are those on the edge of care. We need to get the narrative right. How do we say: I’ve put together data about you and think we need a conversation?”
Ms Waterhouse found similar caution among the public. She said if councils ask whether people want children’s services to know about their housing benefits, the answer is negative.
“Local government does not have a great reputation with data security,” she said. “They think we can’t fill a pothole, so how will we stand up to Russians when they come for their data? How can we convey we are a safe pair of hands?”
We need proof of concept and there is a real role there for the LGA and professional bodies, as hope lies in technology and data
Abdool Kara, Solace
Mark Golledge, programme manager, care and health digital lead at the Local Government Association, thought this factor affected partners’ willingness to share data with councils. “External organisations’ perception of local government includes not just the council, but links with other organisations. They think if they give councils information they will share it with lots of other departments.”
The fundamental problem was distrust of authority among some, former Swale DC chief executive Abdool Kara said. Mr Kara, now local government lead at the National Audit Office, said local authorities were “no worse than any other sector” at data security. Refugees and homeless people were among groups that mistrusted authority and thus data sharing.
On a separate issue of trust, Ms Evans stressed the need to build confidence among staff that the object of using more data was not to replace their judgment with machines “but about how professionals do their jobs and add value working with families and communities”.
She said masses of data existed that could give valuable insights but “only 0.5% is being used in local authorities from analysis we have done. How do we share it in a sensitive and proportionate way, on a need-to-know basis, and how do you garner insights from things that aren’t personally identifiable but concern communities and demographics?”
Ms Evans gave two examples of how data could be used to better meet need and avert future costs: “In children’s services, a predictive model shows how likely a child is to need statutory intervention in the next six months. But if you add a data lens a social worker can respond differently. It can be those who shout loudest who get support, and if you have a data lens you will have better visibility.
“Another question is: how do we use data in homelessness to understand who will present as homeless, and how can we intervene earlier to support them?”
Mr Kara said increased use of data to drive policy was part of moves over the past 20 years “from universal to targeted services and from bricks and mortar to face-to-face”. He added: “Both play to early intervention and prevention agendas to catch people on the edge of care, and we need to know how to predict and identify them.”
These processes had been helped by the move of public health to local government, which had brought a data science capability with it, and by the encouragement of data sharing in the troubled families agenda, he said. But Mr Kara warned progress was impeded by “those who won’t play”, which included parts of the NHS, and some academy schools.
“The Department for Work & Pensions is notorious for not playing,” he said, adding that. joint working with the third sector had been hampered by overcautious responses to the General Data Protection Regulation (GDPR).
Mr Kara also stressed that even if problems with gathering and using data could be solved, using it effectively required a level of investment difficult for small or financially-stretched councils. He called for the development of sector-wide models that could provide ‘proof of concept’ for others to follow with confidence.
Mr Golledge said the LGA had a number of relevant programmes but with social care the problems went beyond technical ones to differing outlooks in councils and health services.
“Local government is focused on outcomes and community, but health is very medical-based with statistical data,” he said. “Also, a lot of data we hold in councils is about people who come into contact with us, but what about people who are not touching services? How do we make better use of data about them when doing that involves communities and third sector organisations?”
Turning to technical issues, Helen Sunderland, director of adult social care at EY, advised against councils thinking they had to develop their own data technology solutions from scratch, rather than taking existing ones and investing in people.
“Some of the more challenging conversations concern technology,” she said. “They think they will build their own, but it seems a waste. Build a human, not a system.
“There is a fear of getting into one licence model on a permanent basis, but if there is a finite amount of investment what bits can we harness and prioritise from elsewhere rather than always build our own asset?”
Ms Evans urged councils to value the experts they already had who “may not have the job title ‘data scientist’ but are skilled and want to make a difference”. She added: “They have been put in a cupboard to do statutory returns, but we should utilise them more,”
Participants felt one problem in gaining investment was that Whitehall viewed social care through a health ‘lens’. Mr Kara welcomed a “dawning of some recognition in government that what makes for well people and communities is having a home and job”. But he added: “When push comes to shove the blame is put on in social care.”
Ms Tozer said: “What people would like us to say is ‘invest a pound here and save a tenner in that hospital’ and that is difficult for us as it does not value social care apart from reducing length of stay [in hospitals], with nothing on the importance of supporting people in their own home because of the positive impact on wellbeing.”
She called for a few pilot projects to provide an evidence base from which councils could learn, as “trying to get 152 councils to do it will never happen”.
Mr Kara agreed: “As a sector we need proof of concept and there is a real role there for the LGA and professional bodies, as hope lies in technology and data”.
Public trust, making investment cases and knowing how to act on data all have their problems, but given what social care is doing to councils’ budgets they are ones that must be faced.
This roundtable discussion was sponsored by EY. The topic was agreed by LGC and EY. The report was commissioned and edited by LGC. See LGCplus.com/Guidelines for more information.