Digital social care records: choosing and implementing solutions

Introduction

Digital social care records (DSCRs) are software solutions for recording a person’s care information. They replace paper records. 

These solutions are sometimes called electronic or digital care plans, care records or care management systems. 

DSCRs do not normally include rostering or electronic medication administration records (eMAR), but you may be able to find a solution that also offers these features. 

Using DSCRs will allow you to share up-to-date information more easily and securely, and reduce time spent on administrative tasks. This improves the safety and quality of your care records, helping you to provide person-centred care. 

This guidance will help you to find and choose a DSCR solution and prepare your organisation for the change. 

Making the case for DSCRs 

The first step in setting up a DSCR is to identify why the change is needed. 

You may need to put together a case to share the reasons for the change with other members of your organisation. 

When making the case for change, consider: 

• which aspects of the way you currently document care plans are time consuming 
• what you want the new solution to achieve 
• how DSCRs could help you meet Care Quality Commission (CQC) requirements and organisational objectives
• your timescales for the project 
• the risks involved  
• who needs to be involved  
• your budget for the project 

Digitising your care records may involve a big culture change in your organisation. Bring people along with you on the journey by identifying the benefits DSCRs will have for them.  

For example, implementing digital care records could allow you to:  

• free up time so that staff can spend more time providing care - DSCRs can free up over 20 minutes per care worker per shift, by enabling faster handovers
• save on long-term costs of printing and storing paper records or maintaining multiple systems 
• share information with people who use your services and (where relevant) their families more easily 
• share more comprehensive information about a person receiving care with clinicians  
• better protect sensitive data 
• avoid duplication and wasted effort caused by having multiple systems  
• provide information to commissioners and regulators more easily, including how you are meeting CQC quality standards 
• access and record notes from anywhere so staff can use them on the move 
• review and analyse trends - both for the organisation and the people receiving care 
• integrate and share data with other health systems, such as the NHS GP Connect system

Choosing the right solution 

Once you have decided to start using DSCRs, you will need to find the right software solution for your organisation. There are many different options available, so it’s important to take time to consider your needs thoroughly.  

Involving people in your decision 

Identify who you need to involve in the decision-making process.  

The people you support and the staff who will use the DSCR should be central to your decision. They will help you to understand what the solution needs to do, and they’re more likely to adopt new ways of working if they have been involved at an early stage.

You may want to involve: 

• staff and management teams 
• the people you support and their families
• local authority commissioners
• the governing board
• clinical and allied health professionals you work with
• consultants you work with
• your internal quality colleagues 

There may be others, depending on how your organisation is set up.  

When speaking to staff and management teams, find out: 

• what they need to do in their job day to day
• what their frustrations and challenges are with current systems and processes
• their level of experience using technology
• what other systems they use that the DSCR may need to interact with  

When speaking to people who draw on care and family members, find out what they want to know or see about their care. 

Getting advice from other organisations 

You could speak to other providers in the sector who have set up DSCRs. Find out what went well and what would they have done differently. Ask what solution they chose and why they chose it.  

Even if you are smaller or larger than other providers, or provide a different type of care, many care providers will have similar requirements for DSCRs.  

Bear in mind that if you ask DSCR suppliers for references, they may only give the names of their most satisfied customers. Ask the references in-depth questions to understand the positives and negatives of their experience.  

Assured solutions list  

The assured solutions list is a list of DSCR software solutions that have been assured by NHS England.

Every solution on the list:

• offers the essential features care providers need, such as care planning, recording, reporting and audit trails
• meets national standards for quality and security
• helps you comply with CQC regulations on good governance
• can connect with GP records and will be able to connect with more NHS systems in the future

NHS England regularly reviews these standards based on what care providers need. Solutions that do not continue to meet the standards may be removed from the list.

Working out what you need 

When choosing the right DSCR for your organisation, you need to decide what the system needs to do. Think about what’s essential and what’s optional. 

All assured suppliers offer basic, required features, so it’s important to consider what additional features you might need.  

You will also need to consider whether you have the infrastructure you need to run your new solution effectively, such as:

• a good broadband connection and wifi
• enough computers and plug sockets
• access to mobiles and other devices if needed

Writing a specification  

Before deciding on which solution to use, prepare a specification setting out who you are and what you’re looking for.  

Your specification should include: 

• information about your organisation (number of staff, number of people receiving care, number of beds)
• the type of care you provide (for example, care home services or supported living services)
• the type of technology you already use, which the system may need to integrate with 
• what you want the system to achieve - specify which features are essential and which are desirable
• what type of reporting you need to do (for example, direct care, management information, regulatory or contract compliance)
• your main hours of operation, when the system must not have planned maintenance
• your specific performance requirements, if you have any
• what type of training you need (for example, on-site training, video guides or written guides)
• timelines for installation - when you need the system to be operational by
• what resources you have in-house to manage the system installation (for example, a project manager who can spend 2 days a week on the project)
• the type of support you need during and after installation (for example, a 24-hour help desk, dedicated account management)
• your budget  

You may also want to consider: 

• the values and ways of working you are looking for from a supplier
• whether you want a free trial to try out the software
• the support you need after implementing the new solution 

Your specification should form part of the final contract you agree with your supplier.  

Evaluating prices 

Most suppliers will provide a pricing estimate based on a minimum term commitment (for example, one year), including a monthly charge and one-off costs for extras, such as training.  

The monthly charge may be based on your number of: 

• staff
• core system users
• clients or bed capacity  

There may be additional costs that the supplier has not included, such as the need to buy new hardware or additional customisation, set up and training costs.  

You may be able to negotiate the price with the supplier during the buying process.  

Public sector procurement 

There is no formal public sector process for DSCR procurements. Organisations subject to public sector procurement regulations should follow their local procurement processes. 

Refer to the assured solutions list to find a list of solutions that meet your requirements. 

Implementing your solution 

Implementing your chosen DSCR solution will involve setting up new ways of working and making sure staff are prepared for the change. 

You’ll need to consider how to engage staff in the implementation process and train them in using the new DSCR. Your supplier should support you with this (make sure you include this in your specification if needed).  

Preparing staff for the change  

Staff who are less comfortable with digital technology may find the new approach challenging. Consider how you can involve less digitally confident team members early in the process and continually support them to use the new system. 

You may want to: 

• map all the stakeholders who will need to use the new system, their level of involvement, and their level of comfort with new technology 
• appoint ‘digital champions’ responsible for helping other staff learn the new system. These may be the staff who were closely involved in choosing your new supplier, or those who have more experience with technology
• plan a phased implementation - you may need to maintain some paper records while you set up the system and start using new features gradually
• reassure staff that it’s OK not to get it right the first time - this is a journey the organisation is going through together
• continually reach out to the team and monitor how they are getting on with the new system, so you can deal with any issues
• find training courses to help staff feel more confident using technology 

Be transparent with everyone who will be affected by the process, including people who use your services and their families. Make sure that you have backup plans during the transition period, such as maintaining paper records temporarily while the system launches.  

Acknowledge that adopting DSCRs is a continual process and be realistic about the time it will take. 

If you’re developing an in-house DSCR

If you’re a provider with an in-house DSCR, there is currently no requirement for your solution to be on the assured solutions list. However, as we move towards universal digital working, we recommend that in-house solutions meet the same standards as assured solutions.

You should ask your in-house digital team to start the assurance process with NHS England to check that the DSCR:

• meets national standards for quality and security
• is able to connect with GP records - as well as more NHS systems in the future
• is recognised by commissioners and regulators

NHS GP Connect - accessing GP patient records for care 

The NHS GP Connect system shares patient information with appropriate staff, so you can deliver better care.  

CQC-registered care providers can use GP Connect to access a restricted view of a person’s GP record. 

To do this, you must have:  

• a DSCR solution in place from NHS England’s assured solutions list that integrates with GP Connect  
• reached ‘standards met’ on the Data Security and Protection Toolkit (DSPT) 
• signed the National Data Sharing Agreement (NDSA)  

Conditions for using GP Connect  

Before using GP Connect, you must also agree to:  

• honour an individual’s choice not to share data for their care through GP Connect  
• create and share information materials to tell people about their right to object to sharing their data 
• update your privacy notice to include this data sharing
• make sure staff are trained in managing data, in line with DSPT requirements 

GP practices will only give access to patient records if they’re assured that it’s to provide direct care. They will only share information which is necessary and proportionate to your role.  

Clinical staff (for example, nurses) will be able to access the full record, which includes clinical information they need for their role.  

For non-clinical staff (for example, registered managers, carers and social workers), access will be limited to:  

• allergies 
• medications 
• immunisations
• the last 3 interactions with the GP practice (for example, the date, time, and comments made by GP practice staff)

For more guidance on managing data safely read the Better Security, Better Care page on the Digital Care Hub.