Health and social care - data strategy: 2024 update - progress and priorities

Technology and Infrastructure

We want to make sure that we have the technology and infrastructure in place to equip us to better collect, store and use data. This includes: structured data held within databases, unstructured data and information held in paper records, near real-time data from sensors and the Internet of Things.

What we have achieved so far

In our first year we have:

• New Community Health Index (CHI) System. We have concluded a long-standing programme to establish the new CHI system, which went live in October 2023 and is now fully embedded within NHS systems. The new system is a significant improvement in NHS infrastructure as it consolidates legacy systems under one cloud-based technology, enabling consistent identification of patients throughout Scotland. There are many potential benefits associated with new CHI including:
  • the potential to move away from the current numbering format so that personal information is no longer contained within CHI number which would provide better patient confidentiality,
  • better infrastructure, the new system is capable of holding multiple addresses so patient data can be updated from multiple sources, improving the accuracy of patient data,
  • 24/7 functionality.
• Discovery work is underway to consider how, and if, the new system should be leveraged to take advantage of these benefits.
• COSLA and COSLA’s Digital Office are currently rapidly exploring the benefits of using CHI in Local Government to support Social Work and social care. This will enable better data linkage across health and social care.
• National Digital Platform (NDP). Building on the capabilities of the National Clinical Data Store which was developed to store national vaccination data and supports the aim of capturing health data once and using it many times, the following NDP developments have been progressed in either discovery or development:
  • a FHIR interface to the New CHI system aligning to the International Patient Profile standard which will provide a modern, consistent way for other systems to perform searches to uniquely identify patients,
  • further development of the NDP Access Management capability to determine what resources a user can access based on known data attributes about their employment and professional roles,
  • development of the NDP Care Summary service that will broker foundational data sets for programmes such as DFD and the Integrated Social Care & Health Record and can expand to include other source systems and data sets over time,
  • expansion of the NDP structured and unstructured data storage capabilities to support specific data workloads like medical device data and dermatology images along with the design of an end-to-end service that supports the data storage needs of individual programmes.
• Additionally, the APIs used within the NDP have been published via an API Catalogue, which allows developers to use APIs to integrate applications to provide information that is held within NDP and will expand overtime as common APIs used across health and care become available. This will reduce interface and interoperability costs for systems and will support professionals to have easier access to health and social care data.
• Seer Platform. The Seer 2 platform went live in November 2023 which enables greater scalability and flexibility for data and analytics. This includes going live with the Near Time Data Service for Winter 2023-24 and beyond, which tests out how Seer 2 works across health and social care. The new platform enhances innovation by providing access to new technologies and opportunities for collaboration across health and social care.
• Shared Telecare Alarm Receiving Centre (ARC). COSLA’s Digital Office and Scotland Excel completed the procurement of a Telecare Shared Alarm Receiving Centre in October 2023. The Shared ARC is cloud based allowing for greater systems interoperability with social work and social care providers and NHS systems. This expedites the transition from analogue to digital and provides the opportunity to improve innovation and resilience across services. Overall, the introduction of the Shared ARC allows, for increased data sharing between service providers, Local Authorities and Health Boards. The Shared ARC now hosts its first Health and Social Care Partnership, with a further eleven planned in the coming months. Additionally, in July 2023 the Telecare Information Framework (TIF) was launched. This will support services to maximise efficiency, improve data accuracy and generate the insight required for ongoing improvement and innovation. This data set will provide a consistent and standardised view of the social care provided across all 32 Local Authority areas. The TIF supports the shift to early intervention and prevention by providing the necessary details for professionals to plan and develop services effectively.
• Ethical use of Artificial Intelligence (AI). COSLA’s Digital Office has delivered workshops for Local Government to highlight the opportunities, risks, and ethical considerations on the ethical use of AI. One workshop was delivered in partnership with the Equalities and Human Rights Commission, others have been delivered with the Alan Turing Institute which has provided Local Government with the opportunity to provide input into draft AI Ethics and Governance in Practice Handbooks that have been developed by the Institute.
• Artificial Intelligence. Scotland’s AI Strategy published in 2021 remains the key cornerstone influencing the policy approach to AI in Health and Social Care. The principles for the use of AI in Scotland are closely linked with the principles of our Data Strategy. The Scottish Government has been engaging with key stakeholders across health and care, the wider public sector, and the devolved nations to monitor the developing AI landscape. AI continues to be used successfully within the health and social care sector. This is predominantly supporting research as well as advanced diagnostic imaging, reducing the time required for analysis significantly and this will only continue to grow. The ICO have published guidance, an Innovation Advice Service and Toolkit for organisations in relation to the use of AI and we are supportive of their approach.

Additionally, Scotland’s AI Alliance launched an AI Algorithm Register in March 2023. The register aims to provide the people of Scotland with a single source of information of how AI is used to inform decision-making in the public sector by cataloguing where AI is used, and how it is used to be transparent and to build trust.

Case Study – Expanding the Use of CHI in Social Work and Social Care

COSLA and COSLA’s Digital Office have been exploring the benefits and risk of using CHI in Local Government to support more effective data matching and data sharing.

Engagement is underway with a wide range of stakeholders including Local Government professional groups, NHS colleagues, Third and Independent sectors and people with lived experience to inform our thinking and ensure alignment with broader Local Government and national work.

There are many potential benefits to adopting CHI in Local Government such as:

• supporting Councils to link data and improve data quality,
• act as a verification tool for accessing the Digital Front Door and the Integrated Social Care and Health Record,
• support sustainable person-centred public services and reduce inequalities within Scotland’s current fiscal challenges, ageing demography and recruitment and retention challenges,
• support integrated health and social care and delivery of better outcomes to people accessing services,
• reduce duplication in the system,
• reduce the need for people to repeat information multiple times,
• increase capacity in an already stretched system.

Case Study – Seer 2

The Seer 2 Platform provides national technology and infrastructure capabilities for data management and analytics for health and social care in Scotland. It enables over 20,000 users across government, health boards and other public sector bodies to access high-quality, well described data sets. This allows users to access the data they need to undertake analysis supporting the development of insights to improve services.

The investment in Seer 2 has allowed for continuous improvement and new ways of working such as:

• Moving from on premise infrastructure to the cloud. This provides an environment that can scale to meet the needs of customers and provides greater reliability than the previous platform.
• It allows us to access capacity and tooling and to deploy this rapidly, to enable new datasets to be brought together and to provide a better experience for developers, customers and users.
• Provides well described data which supports users to understand what data exists. This data can be used for a variety of purposes such as analysis, research, and innovation.
• Enables data from many sources and across sectors to be integrated, enabling the creation of insight to improve outcomes.
• Provides a technology platform which is secure, trusted, and responsive to user needs and new technologies.
• Creates new opportunities to collaborate, innovate and scale.

Case Study – Shared ARC

Telecare Services are at the interface between health and social care. They contribute support that is person-centred, using various types of sensors in the home to alert and enable intelligent rapid responses where adverse events have occurred, or to allow prompt notification of a sudden risk to the person’s health and well-being.

The Shared ARC is a cloud-based technology solution that assists Telecare Service Providers as they progress with their transition from analogue to digital Telecare. It provides a unique platform for innovation which can support the wider Health and Social Care sectors ambitions around better use of data, and early intervention and prevention. The platform provides many benefits such as:

• providing a unified approach to data enabling joined up working across the sector,
• improved access to and use of data,
• greater interoperability with other datasets and systems across health and social care,
• reduced technical burden of adopting digital telecare for services,
• provides a resilient and flexible approach to telecare service delivery,
• delivers a platform to foster innovation and power pro-active services,
• the ability to leverage data from wearable devices, and other digital devices.

This work has been an important step in improving the data landscape in social care. The national programme is working with a group of 17 adopter organisations to onboard them to the new platform.

How this helps to achieve our vision

Health and social care data is currently recorded and stored across multiple systems which often have limited interoperability which limits the number of people that can access the data. We are aware that we need to modernise our data infrastructure and have started to make improvements in our technology and infrastructure which will be key to enabling best use of data in the design and delivery of services. The development and launch of platforms such as NDP and Seer 2 ensures that we have the right infrastructure to allow storage and integration of data that enables data to be used for multiple purposes. By bringing data products, reports, dashboards, and tooling together in Seer 2 this allows health and social care data to be brought together in the one platform for the first time. This improves our analytical capabilities and supports collaborative working to create insight to inform decision making to improve delivery of services. Modernising our technology by moving multiple services to cloud based systems will ultimately be the first step in enabling easier, secure, access to data across the sector. The modern, standards based, interfaces of these systems are also already supporting better data linkage and enabling staff within the health and social care sector to have access to up to date, accurate data.

What’s next for 2024-25?

Our priority for 2024-25 is to:

• Develop an Architectural Blueprint. The Technical Design Authority was established in February 2024 to provide assurance on the development of the blueprint for Scotland’s digital and data systems. A blueprint will be published to set out the architecture required to support services such as the Integrated Social Care and Health Record, Digital Front Door and Digital Prescribing and Dispensing. This will reduce the variety of architecture in use and bring consistency to improve and align data infrastructure across health and social care. In addition, it will provide suppliers with clarity and understanding of the system and help us to better manage contracts.
• National Digital Platform. We will continue to grow the capability of the National Digital Platform and expand the services available by ensuring the underlying data requirements and systems integration is in place to enable easier access to data.
• Automation. We will explore the use of innovative technology to automate the collection of data to understand and set out our intention for the use of automation within the health and social care sector.
• Seer 2. We will build on work in Seer 2 to enable collaboration across health and social care.
• AI. Develop guidance and provide support and advice as required for the use of AI within health and social care.
• Shared ARC. Continue to develop the capabilities of the Shared ARC including:
  • incorporating open protocols and APIs to improve interoperability of data exchanges across systems,
  • deploying Artificial Intelligence to support predictive analytics for early intervention,
  • enhancing data utilisation to support informed decision making.