Cheshire County Council brings its social service agencies together to deliver person-centric care

Published on 09-Sep-2008

Validated on 07 Feb 2014

"We’re not only helping Cheshire to be at the leading edge in the way it provides services to its older citizens. With IBM’s help and insight, we’ve also developed a whole new model of how local government can provide services to citizens in an innovative and joined-up way." - Alan Allman, Senior Manager for Business Strategy, Planning and Performance, Cheshire County Council

Customer:
Cheshire County Council

Industry:
Government

Deployment country:
United Kingdom

Solution:
Business-to-Consumer, Enabling Business Flexibility, Information Integration, Service Management, Smarter Planet, Transforming Business

Smarter Planet:
Smarter Government

IBM Business Partner:
Esprit Ltd.

Overview

Cheshire County Council, in the UK, was one of the first local authorities to address the government’s requirement of a uniform, standardized way to assess the healthcare and social services needs of its senior citizens, known as the Single Assessment Process. The solution it created now has 1,000 users and is expected to add thousands more in the coming months.

Business need:
Driven by growing resource constraints and a government mandate, Cheshire County Council sought to coordinate the way its various agencies served its growing senior population. Manual, unconnected processes within its agencies stood in the way.

Solution:
Cheshire County Council built a new needs assessment solution that enabled its agencies to function as a single, “virtual” community of providers—and served as the nucleus of a process automation effort that has drastically improved the efficiency and quality of senior care.

Benefits:
20 percent reduction in time and cost required to perform in-home senior visits; improved ability to proactively manage the course of health and social care for senior citizens; reduced administrative costs through improved coordination between healthcare providers and social agencies

Case Study

“We’re not only helping Cheshire to be at the leading edge in the way it provides services to its older citizens. With IBM’s help and insight, we’ve also developed a whole new model of how local government can provide services to citizens in an innovative and joined-up way.”

—Alan Allman, Senior Manager for Business Strategy, Planning and Performance, Cheshire County Council



Cheshire County Council, in the UK, was one of the first local authorities to address the government’s requirement of a uniform, standardized way to assess the healthcare and social services needs of its senior citizens, known as the Single Assessment Process. The solution it created now has 1,000 users and is expected to add thousands more in the coming months.

Business Challenge
Driven by growing resource constraints and a government mandate, Cheshire County Council sought to coordinate the way its various agencies served its growing senior population. Manual, unconnected processes within its agencies stood in the way.

Solution
Cheshire County Council built a new needs assessment solution that enabled its agencies to function as a single, “virtual” community of providers—and served as the nucleus of a process automation effort that has drastically improved the efficiency and quality of senior care.

Business Benefits
20 percent reduction in time and cost required to perform in-home senior visits
Improved quality and continuity of care by gaining a single seamless view of a citizen’s case history
Improved ability to proactively manage the course of health and social care for senior citizens
Lessened burden for senior citizens to fill gaps in provider or agency records
Improved utilisation of health and social care resources
Reduced administrative costs through improved coordination between healthcare providers and social agencies

Transformation at a glance
To better coordinate the activities of its social service agencies, Cheshire County Council created a single shared service delivery platform that enabled its agencies to form a virtual community of providers. This, in turn, enabled the council to create a series of standardized and automated processes that not only lowered costs but also tightened the social safety net for the council’s senior citizens.

Key Components
Software
IBM WebSphere® Application Server
IBM Tivoli® Access Manager
Esprit ShareCare for e-Enabled Single Assessment Process

Servers
IBM System x®

Services
IBM Global Technology Services e-business Hosting Services

Business Partner
Esprit Ltd.

Timeframe
Deployment: 8 Months
End-User Training: Ongoing


Within any given community, the social service agencies that serve it have two very important things in common: first, that they promote citizens’ best interests through their services, and second, that they rely on public funds to achieve it. But by and large, that’s where the commonality ends. Like the needs of the citizens they serve, public agencies—whether it’s home health services or the fire department, to name a few—are a highly diverse and specialised lot. It is seen in the unique mission that drives each of them, down to the mix of resources, expertise and practices they bring to bear in their day-to-day activities. Not surprisingly, the notion of specialisation has become deeply embedded in both the culture of social service agencies and in what citizens have come to expect in dealing with them. Put simply, the requirement that local social services be delivered and received through a series of parallel—but unconnected—channels has long been seen as a fact of life.

However, important changes in the social services landscape are causing governments to reassess the need to change their practices. One of the most basic drivers is resource availability, with demand for social services growing as a result of demographic changes and government funding struggling to keep up. In the realm of health and human services, an equally important factor is a growing awareness of the need for continuity to maximise the quality of care that aged, infirm or vulnerable citizens receive. When agencies deliver services to a given citizen independently of one another, there’s no way to get a comprehensive picture of that citizen’s care history. This at best deprives caregivers of the information they need to provide a seamless, coordinated course of care going forward, and at worst makes elderly patients vulnerable to not receiving the follow-up care they need.

Leading the way
Calling for a better way to handle case management for senior citizens, national government laid the groundwork by providing a general framework for local authorities to streamline the way they collect, manage and communicate case information between agencies—a set of activities known collectively as Single Assessment Process. Cheshire (www.cheshire.gov.uk), a county of just under a million residents located in North West England, has emerged as an early leader implementing the Single Assessment Process. Working with IBM and IBM Business Partner Esprit Ltd., Cheshire County Council developed and implemented a collaborative case management platform and an accompanying set of process improvements that have proven to be highly successful. The following is an example of how achieving this success required fresh thinking along a number of dimensions, not least of which was the practical challenge of making a solution flexible enough to accommodate the needs of multiple agencies.

Cheshire County Council’s “before” state typified the shortcomings of disconnected social service delivery channels. Each time an agency worker visited a senior citizen at his or her home, the worker was required to fill out his agency’s paper-based assessment form in full—from demographic information to that citizen’s specific health or mobility needs. That paper form was then stored in a file folder within the agency. If, for any reason, another agency working in Cheshire visited the home—say the fire brigade or emergency medical services—the same process would unfold. In pinpointing the disadvantages of this process, wasted time and effort for both the citizen and the agency employees were only the most obvious. More insidious and costly were the lost opportunities to use existing information to deliver services more intelligently and effectively. Achieving such an ideal state would require all of the County Council’s departments and collaborating agencies to function as a single virtual entity, capable of viewing all aspects of a particular citizen’s requirements in its totality, and responding to the citizen in a coordinated, integrated fashion.

“We needed a provider that could offer us access to broad and deep resources and expertise. IBM’s edge was that it had this while at the same time giving us the focus, flexibility and attention you would normally only get from a smaller provider.” — Alan Allman

Enabling process change
Cheshire County Council realised that as long as senior citizen case assessment information remained compartmentalised within each agency, its vision of coordinated service delivery would be impossible to achieve. It also realised that while having the technological capacity for sharing this data was essential, changes at the business process level—enabled by technology—would play a bigger role in making the council’s vision a reality. The solution designed by IBM and Esprit directly embodied this view. Its foundation is Esprit’s ShareCare for e-Enabled Single Assessment Process platform, which combines tight security, flexible device access and advanced forms technology to enable agency workers to create, access and change assessments remotely. The solution runs on IBM WebSphere Application Server and employs IBM Tivoli Access Manager for end user authentication.

Leveraging the system’s powerful workflow capabilities, Cheshire County Council worked closely with IBM and Esprit to design a whole new set of standardised assessment processes that are employed by all agencies using the system. Automation is a strong point—not only for efficiency’s sake—but because it facilitates the kind of seamless, cross-agency coverage that prevents individuals from “falling through the cracks” because of undetected needs. When agency employees make their initial visit, they populate a standardised electronic form, which (if the citizen gives approval to share the data) becomes the core of that citizen’s profile. On each subsequent visit, from any agency, employees can retrieve and modify that profile as necessary, instead of having to rebuild it from scratch. The automation comes in on the backend. Based on changes in the profile—such as a recent medical procedure or change in mobility status—the solution automatically flags a citizen as potentially needing one or more additional social services and sends a notification to the appropriate agency for follow-up. Built-in confirmation tools ensure that all agencies and providers fulfill their respective roles.

Among the biggest barriers to small government projects even getting off the ground are the issues of funding and accountability; Cheshire County Council’s single assessment process initiative was no exception. IBM was instrumental in resolving this issue by proposing that the solution be deployed as a shared service, hosted and managed by IBM e-business Hosting Services and paid for based on usage levels. The advantages are many. First and foremost, hosting the service means that each of the council’s agencies can focus on its mission instead of worrying about the technology. Moreover, since it is based on usage, hosting also provides an inherently flexible framework for resolving and managing budget issues across different agencies.

Built for growth
Then there’s scalability. As new agencies are brought on board, the solution’s modular architecture (built on IBM System x servers running in IBM’s Warwick data center) enables low-cost, incremental capacity growth as needed. With the solution having grown to a thousand users in the year plus since it went live—and thousands of new users expected to come on board in the next several months—the benefits of scalable growth have already become apparent. So, indeed, has the inherent flexibility of the shared services model. Based on the success of the Cheshire County Council solution, the counties of Devon and Cornwall—located in South West England—are deploying their own solutions using the same scalable IBM infrastructure.

Cheshire County Council expects the solution to ultimately save an estimated 20 percent in the time and cost of delivering in-home social services to seniors. The planned introduction of a self-service solution—which will enable service users to create and maintain their own assessment profiles online—will enable the county to stretch its social service resources even further. With its population of seniors growing, Cheshire, and any other county using the system, is able to provide the most efficient and high quality care to them. Perhaps the strongest vote of confidence in the solution came from England’s National Health Service (NHS), which selected it and three others from a large pool of applicants to connect to the NHS Spine, a key part of the NHS’s nationwide Care Records Service initiative. Alan Allman, Senior Manager for Business Strategy, Planning and Performance, expects the solution to add momentum and provide direction to similar efforts nationwide. “We’re not only helping Cheshire to be at the leading edge in the way it provides services to older citizens,” says Allman. “With IBM’s help and insight, we’ve also developed a whole new model of how local government can provide services to citizens in an innovative and joined-up way.”

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Contact your IBM sales representative or IBM Business Partner.

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Products and services used

IBM products and services that were used in this case study.

Hardware:
System x

Software:
WebSphere Application Server, Tivoli Access Manager for Business Integration

Service:
GTS Strategic Outsourcing: e-business Hosting

Legal Information

© Copyright IBM Corporation 2008 IBM Corporation 1 New Orchard Road Armonk, NY 10504 U.S.A. Produced in the United States of America August 2008 All Rights Reserved. IBM, the IBM logo, ibm.com, e-business Hosting, System x, Tivoli and WebSphere are trademarks or registered trademarks of International Business Machines Corporation in the United States, other countries, or both. If these and other IBM trademarked terms are marked on their first occurrence in this information with a trademark symbol (® or ™), these symbols indicate U.S. registered or common law trademarks owned by IBM at the time this information was published. Such trademarks may also be registered or common law trademarks in other countries. A current list of IBM trademarks is available on the Web at “Copyright and trademark information” at ibm.com/legal/copytrade.shtml. Other company, product or service names may be trademarks or service marks of others. This case study illustrates how one IBM customer uses IBM products. There is no guarantee of comparable results. References in this publication to IBM products or services do not imply that IBM intends to make them available in all countries in which IBM operates. ODC03085-USEN-00