Integration and devolution: Why the Ripple Community can make an impact - Ripple OSI

We hear a lot of talk in the NHS about integration and those conversations have grown louder and more frequent with the move towards devolution in areas throughout the UK.

At it is simplest, integration in health and social care is the joining up of services, making sure that information, treatment plans, appointment letters etc about a patient are shared with the right people at the right time – that is easy to say but far more difficult to do.

In most areas, healthcare services (provided by the NHS) and social care services (provided by the local authority) do work together but how they work together and what the outcomes of this joined up work differs from place to place.

In a number of areas, multidisciplinary teams are now working very well. These are teams of people from different services or different organisations who work together to plan a person’s care. Sometimes these teams are actually all located in the same building despite the fact they are employed by different organisations (this is called co-location) or the team may come together regularly in care planning meetings.

This is an example of integration, of the bringing together of people and the information they have about a person into one place. Integration relies on having processes and protocols to share information with the right people at the right time. However in many instances, although professionals from different services come together to share and exchange, the IT systems that they use cannot. The processes used are often not IT enabled or the main IT system used is email.

To make sure that services are delivered in the right place at the right time and by the the right people, we need to bring together people with the right processes enabled by the right technology. This will help deliver the person centred care that is at the heart of the Ripple Programme.

The drive towards devolution, towards decisions about service provision being made at a local rather than national level, means that local systems have to provide robust data and information and related tools so that the decisions are properly informed. The effective use of data and the right data sharing agreements and levels of integration will mean that these informed decisions can be about individuals, communities or whole geographies.

The roots of the Ripple Community effort came from Leeds where disparate teams from across the Leeds health and social care system are integrating their teams and reshaping their patient and citizen care processes with an integrated care record, the Leeds Care Record. The Leeds care record is now gaining momentum and national recognition.

In Manchester, Devo Manc “will enable health and social care spend in the Greater Manchester community to be managed and invested locally. The Greater Manchester Combined Authority (GMCA) represents ten local authorities in the region and has established a Devolution Agreement to drive forward economic growth and improve the lives of the population through greater local responsibility and the reform of public services.

Devo Manc will have a significant impact on the way the NHS operates in Greater Manchester and health and social care innovation will play a huge part in enabling the delivery of streamlined, efficient and effective services.”

From TrustTech, the North West NHS Innovation Service

This streamlining cannot happen if information systems remain disconnected. There is neither the money nor the inclination to invest in whole new IT systems to enable integration of devolved health and social care systems and alternative solutions are now being sought. The Ripple Programme is offering to support the drive towards an integrated digital care record in a most cost effective way, offering a set of open source tools to do so. We are proposing and adding value in many senses of the word.

The Ripple Community and the development of an open source integrated digital care record platform can offer a solution for joining up defined and particular aspects of health and social are information about patients and citizens that is currently held on a vast number of different systems. Patients often have to navigate through disconnected services or process to get to where they need to be and we want to change that. In essence, the Ripple Community hopes to have a pivotal role in supporting devolved authorities. We want to make a difference at the very frontline of patients’ experiences of 21st Century integrated care.

This is a companion discussion topic for the original entry at