It’s long been said that a journey of a thousand miles begins with a single step. In the context of such an inter-connected and complex landscape as health and social care, we’d be forgiven for asking who should move first! The truth is that it’s vital to get the underlying principles right – governance, infrastructure and – crucially – standards.

For a number of years in Scotland, we have been working to map out the key priorities, and we are now beginning to realise tangible benefits as we enter the delivery phase. Crucially, we are not starting from zero as there are many excellent examples of where we are using data and using it well. However, there are things that we need to do better and these are at the heart of our data strategy.

The national Digital Strategy identifies the need to adopt information standards across Scotland’s public sector; and our over-arching Digital Health and Care Strategy similarly commits us to a cloud-based infrastructure based on common standards, with fully aligned systems, standards, and regulation in place across all services to ensure their effective delivery to the benefit of service users and providers alike.

Most recently, from extensive dialogue and engagement, we published the Data Strategy for Health and Care, that commits us explicitly to improving the quality of health and social care data and increase interoperability through adoption and use of common standards making it easier to re-use and to link data.

So where are we now, and where do we want to be?

We all recognise that in terms of digital, the health and social care landscape is fragmented, with a lack of consistency in the way that data is recorded. This is true not just within and between Health Boards, but also in social care and across the system that has been officially integrated since 2011.

In social care, for example, there is an acknowledgement of the need for agreed information standards and data definitions, with increasing focus on the development of common social care standards such as PRSB’s HL7 FHIR UK. In addition, there is recognition of the need to achieve consistent governance in publishing, approving and maintaining information standards as seen with the Data Alliance Partnership Board that has mandated the use of some PRSB standards in social care settings.

Work in this area has identified a number of recommendations such as ensuring a new National Care Service aligns with existing Scottish and UK government commitments on information standards; and ensuring that any new system procurements consider interoperability and open standards, as well as seeking to align with the standards published by the Open Standards Board.

In the context of the Data Strategy, we are already working with central and local government colleagues developing the National Care Service to ensure consistency of standards and agree shared priorities and deliverables, most notably in working together on the provisions of the National Care Service Bill on the creation of an integrated health and social care record. The Bill, currently at the start of the Parliamentary process, has provision for mandating information standards across health and social care, and more immediately we will explore preferred standards.  The Health and Social Care Data Board will oversee and approve the initial programme of this work.

Immediately following the Strategy’s publication, we embarked on a major mapping exercise – our first Digital Maturity assessment in three years, initially focusing on NHS Health Boards. We will look to organisations to reflect on their capability and complete assessments every two years, to target improvements on the use of data, with funding for identified priorities made available based on these assessments.

The Strategy highlights existing commitments that will underpin successful delivery through the use of common and preferred standards – for example terminology standards such as SNOMED-CT; and classification standards such as ICD11, where Scotland is among the first countries to take steps towards its implementation. We began this work in November 2022 and the next phase will focus on the coding transition from ICD10. This is an example of Scotland taking the lead on implementing national data standards to improve interoperability. And, overall, we have published a specific commitment to putting the FAIR principles and data quality at the heart of all data work in health and social care. This work will drive up interoperability and bring clarity to suppliers in what is expected when supplying technology and digital services in Scotland.

So, what’s next?

We have begun a programme of focused engagement work with our delivery partners, as identified in the Strategy, to further explore the issues, commitments and priorities we have identified. These conversations will help us develop our first Delivery Plan for the Data Strategy.

Alongside this, we remain committed to learning from the experience available from the rest of UK and our international partners – and, during our own work, where we learn lessons, we remain keen to share these too.

We all recognise these issues have been evident for some years and, as I began by saying, presenting a clear challenge in scale and complexity. But, with the publication of the Data Strategy and, with the support of our partners, we are ready to take that next step. In all of this, we greatly value the work and support of the PRSB – and would welcome members’ views and contributions as we move forward.

Please take part in the conversation – you can reach us at HSCDataStrategy@gov.scot.

[This blog was first published by PRSB in June 2023: Scotland’s data strategy aims to set the standard – PRSB (theprsb.org)]