Guidance

Care data matters: a roadmap for better adult social care data

Published 20 December 2023

Applies to England

Foreword from the Minister of State for Care

Data matters in social care.

It matters for making sure people get the right care, planning how care is organised and joining up health and care services.

Data can make a life better, or even save it.

The coronavirus (COVID-19) pandemic taught us many lessons, not least the importance of having good social care data. Some care providers and local authorities are leading the way by using data, digital tools and technology. But as a sector, adult social care still lags behind healthcare.

As part of our far-reaching reforms to social care, we want to increase the quantity and the quality of care data available. That’s why we’re joining up health and social care records and harnessing digital technologies.

If we get this right, we can make a real difference. By improving our use of data and digital technologies, we can deliver:

• more joined up care for people, with information shared effectively between professionals
• more time and resources for people who provide and commission care and support, so they can focus on providing high quality, personalised services
• greater understanding of people’s care journeys - whether that be for people who draw on care or unpaid carers
• good practice, areas for improvement and research into how care is commissioned, provided and integrated with healthcare
• better management and oversight of the health and care system at local, regional and national levels, making more effective use of resources

Much of this work is already underway. Central government is working in partnership with people who draw on care and support, care providers, unpaid carers, local authorities and NHS England (NHSE).

We also see many great initiatives on the ground, such as the development of interactive analytical tools to strengthen monitoring of performance and outcomes. I very much welcome all this work - it demonstrates the sector’s strong commitment to change.

Our plans

People at the Heart of Care outlined the department’s plans for data, digital and technology within our 10-year vision for adult social care. Data saves lives situated this in the context of the department’s overarching vision for health and social care data.

As we set out in the Data saves lives implementation update and Next steps to put People at the Heart of Care, we have made good progress. In February 2023 the department underscored its commitment to improve adult social care data by publishing the strategy and roadmap, ‘Care data matters: a roadmap for better data for adult social care’, in draft. Since then, even more progress has been made in achieving our vision for data.

For example, over 6 out of 10 care providers are now using digital records, local authorities are contributing person-level data into the national client-level data collection, and the Adult Social Care Outcomes Framework (ASCOF) has been updated with stronger metrics to measure the outcomes that matter most.

We published a draft of this strategy earlier in the year to seek your views on the data you need, as care providers, local authorities, unpaid carers or people who draw on care and support.

I would like to profoundly thank all those who shared their views; they have been invaluable in shaping this final product.

Your views are reflected within this new version, and I will continue to make sure your voices are heard as we implement the strategy and deliver the best outcomes for people.

This strategy outlines our collective priorities for how social care data is collected, shared and used, and how we improve the quality and availability of adult social care data, at both national and local levels. These priorities will ensure that people - both those who draw on care and support and unpaid carers - have access to timely information to support them to make informed choices about care and support, and care professionals can improve the quality of care delivered. That’s why I’ll work with you over 2024 on every issue, from local barriers to data-sharing, to transparency and data protection, so that we maintain momentum and can achieve the transformation of social care data that ultimately improves people’s lives.

Together, we’ll find solutions to benefit everyone interacting with adult social care data.

I am determined that we unlock the potential of data to enable high-quality care, improve outcomes and strengthen accountability. I am confident that, together, we can transform social care data and succeed in making a real and lasting difference to social care.

The Rt Hon Helen Whately MP, Minster of State for Social Care

Executive summary

‘Care data matters: a roadmap for better adult social care data’ summarises national data projects, outlines the positive progress made on these projects in fulfilling the department’s ambitions, and describes how we want to build on these to ultimately improve how we collect, use and analyse adult social care data. If we get this right, it will make a real difference to the outcomes of people who draw on care and support and unpaid carers. Better social care data will support:

• better joined up care for individuals
• more staff time to care
• greater understanding of people’s care journeys
• better management of the health and care system

Sector feedback

We first published the roadmap in February 2023 as a draft to seek the adult social care sector’s view on the data needed to commission, deliver and oversee care and support effectively. When we first published, we deliberately set it out as a draft because we wanted to hear from those who use and submit data about how we could best meet their data needs. We consulted widely, and received contributions from individuals and organisations, such as Think Local Act Personal (TLAP), the Homecare Association, the Local Government Association (LGA), the Association of Directors of Adult Social Services (ADASS), various providers, as well as input from 40 workshops attended by more than 250 sector representatives.

Key conclusions from that consultation were:

• stakeholders are supportive of our vision and recognise that better data and insights will help improve the quality and transparency of social care
• there is widespread recognition of the challenges faced across the sector in achieving this vision, and stakeholders flagged that they can be subject to numerous and competing data asks
• stakeholders across the sector are keen to see our principle of “collecting data once, and shared and/or used many times” become a reality
• where data is being collected, stakeholders also want the department to make clear why the data is being collected, what the data will be used for and how it will be shared

Progress so far

We are not starting from scratch. The COVID-19 pandemic showed the potential of data to make a real difference. Prior to the pandemic, national adult social care data collections were limited in scope. They often took the form of aggregated returns submitted annually by local authorities and hence lacked consistent and timely data on elements of care. As an early response to the pandemic, we introduced emergency measures to collect new data from providers, which enabled the sector and government to respond more swiftly to emerging problems and to provide insights to plan for the future. There are more lessons to learn from this, but the immediate benefit has been a step-change in our understanding of care and support and of the sector-wide benefits from better data sharing.

To embed these benefits and other lessons learned from the pandemic, we developed ‘Data saves lives’, setting out our strategy for harnessing the potential of data and driving innovation across health and care.

Working with the sector, some excellent progress has been made with real transformation achieved. More than a year on from publication, over half of the commitments made have been delivered. Full details of this progress were provided in the ‘Data saves lives implementation update’.

We provided more detail, in ‘People at the Heart of Care’, on how data underpinned the department’s 10-year vision for adult social care. And we went even further in developing this strategy, specific to adult social care, to underscore the department’s commitment to data transformation.

Since we published the first draft ‘Care data matters: a roadmap for better data for adult social care’ in February 2023, together with the sector we have:

• launched, in April 2023, a revised ASCOF. This included feedback following engagement with stakeholders that considered what outcomes matter most to people who access care and support
• implemented client level data (CLD), the first national collection of person-level social care records. We now have a submission from all 153 local authorities and developed a dashboard to support local authorities with planning, commissioning, monitoring and understanding operational performance. CLD will become the primary source of information about the delivery of adult social care by local authorities, with detailed information about care provided and services received
• completed the discovery phase for a new digital product that will provide access to adult social care data, for all those who need it, in one place. The initial discovery exercise engaged with over 300 adult social care representatives
• published in May 2023 a data access policy update as a response to the consultation that considered data standards and data safeguards issues in relation to hosting person-level data on NHSE’s new secure data environment (SDE). This brings major improvements to security and transparency, which will help improve public confidence in secondary uses of NHS data
• increased adoption of digital social care records (DSCRs). Sixty per cent of CQC registered adult social care providers have now adopted these, up from 40% of providers in December 2021. DSCRs support care teams to deliver outstanding, safe, personalised care by having the most accurate, up-to-date information at their fingertips, reducing the time care workers and managers spend on administrative tasks. They also enable greater information sharing between social care and NHS systems, supporting collaboration, and improving opportunities for joined up care around the person between local health systems and CQC registered care providers
• launched the Adult Social Care Technology Fund, to drive innovation in care delivery by harnessing technology, digital skills, cyber security and connectivity. Projects funded in the first wave include: a falls prevention programme; an electronic medication administration system; and projects to support independent living and delivery of virtual care
• worked with care providers and local authorities, as well as the NHS Business Services Authority (NHSBSA) and the North of England Care System Support (NECS), to improve the flow and quality of vital data into the national Capacity Tracker and response rates have risen to 94% in September 2023 from 89% in April 2023. This has included implementation of The Adult Social Care Information (Enforcement) Regulations 2022
• provided support for the case management system (CMS) market, used by local authorities to record information relating to care, by developing specifications which set out ‘what good looks like’ for a CMS. This will provide both local authorities and suppliers with the clarity they have asked for when procuring, implementing, developing and delivering these systems more easily and more efficiently. These specifications will be published in March 2024 following consultation with CMS providers
• announced the retirement of the short- and long-term (SALT) activity data collection to reduce the data burden on local authorities. Statistics collected via SALT data collection will be derived from CLD in future

Contents

This updated version of the strategy replaces the February 2023 draft. It now contains substantial updates in chapter 3, with the views and feedback received during the consultation exercise reflected. Chapter 4 outlines the data projects happening nationally to drive forward our ambition for social care data and improve the quality and availability of social care data.

‘Care data matters: a roadmap for better adult social care data’ sets the strategic direction to improve the quality and availability of adult social care data, so that it is available to all those who need it.

This document is intended for:

• staff in delivery and leadership roles who hold, use and submit data about people who draw on care and support
• local authority staff wanting to understand how changes will help them meet their responsibilities
• organisations representing people accessing care and support

Chapter 1

This chapter sets out the importance of adult social care data and our vision for what we can achieve through the better use of data across the sector, through:

• streamlining and improving existing data collections
• establishing data collections and bridging data gaps
• improving data access to produce better insights
• driving sector digitisation, to streamline data flows including through the adoption of digital social care records

Chapter 1 also outlines guiding principles to support making the data vision a reality. The principles of streamlining, security, accessibility and transparency will underpin the data transformation work in adult social care and ensure data drives better outcomes in adult social care.

Alongside the principles, chapter 1 includes 2 commitments to the sector, on joint working with the sector to continuously develop and achieve the vision for adult social care data transformation, and to build the governance required to oversee and monitor changes to adult social care data to ensure that they are necessary, appropriate and proportionate.

Chapter 1 also sets out our updated roadmap for how and when we intend to transform adult social care data nationally.

Chapter 2

Chapter 2 summarises the work we have done to map and understand the current adult social care data landscape and outlines the different data flows and data collections at both a national and local level.

Chapter 3

Chapter 3 provides an update on our understanding of key data needs and limitations across the sector, using findings identified from the 2023 engagement exercises, and summarises responses to the feedback survey included in the February 2023 draft ‘Care data matters: a roadmap for better data for adult social care’. This chapter also provides some examples of key data needs apparent across the sector.

Chapter 4

Chapter 4 provides an update on the key projects and workstreams underway within the data strategy to deliver our ambitions of data and digital transformation, including the digitising social care programme.

Next steps

Thank you to everyone who took part in the engagement exercises early this year. This document highlights the progress that the people, organisations and government have made together to transform social care data. This publication is not an end point but represents another step in the government’s strategy for adult social care data transformation. We recognise we are on a journey with much to be achieved and many benefits to be realised for people delivering and accessing care. We cannot do it alone.

That is why we remain committed in 2024 to continue working with the sector and responding to the sector’s desire expressed in the engagement exercises to co-design the approach to delivering the vision set out in the strategy. We intend to work jointly with the sector on challenges raised in feedback but not yet fully addressed, to continuously improve the constituent parts of the strategy, so it is strengthened and drives better outcomes for people from better social care data. We look forward to bringing together the results of the work in a progress update in 2024.

Chapter 1: our vision for adult social care data

‘People at the Heart of Care’, published in December 2021, outlines the department’s 10-year vision for adult social care. Included within this is a commitment to establish an adult social care data framework that would support the improvement of data quality and availability at national, regional and local levels. In February 2023 we published this framework in draft, and this ‘Care data matters: a roadmap for better adult social care data’ document fulfils this commitment in full.

This document sets out the government’s framework for improving the collection, sharing and use of data in adult social care. It is a necessary first step to realising the benefits of data as an enabler for changing and improving people’s lives and the care they receive.

Data is fundamental to achieving all 3 of the objectives underpinning the 10-year vision for adult social care:

• people have choice, control and support to live independent lives; people have transparent and easy access to information about local care and support services and the quality of those services
• people can access outstanding quality and tailored care and support; the sector has access to the right information that supports them to deliver personalised care for people and better plan how to improve services for their local populations
• people find adult social care fair and accessible; better quality data underpinned by digitisation will support integration with local health systems and help oversee the quality and continuity of a person’s whole care journey

What we are trying to achieve

We want to unlock the potential of data alongside digital technologies so that we can make a real difference to people who draw on care and support and unpaid carers. If we get this right, we can deliver the following outcomes:

Better joined up care for individuals

We want people who draw on care and support and unpaid carers to have the confidence that those who plan, commission and deliver their care have access to the right information, at the right time, to meet their needs. Through initiatives such as the introduction of DSCRs, we will reduce the need for people accessing services to repeatedly supply information about their care needs, while also minimising the risk of incorrect care, such as medication errors. Greater transparency will also empower people to make informed choices about their care by giving them access to reliable data about local care and support services and the quality of their care.

More staff time to care

For the staff who work tirelessly to deliver care and those in leadership roles, support from the right data infrastructure will give them access to the information they need to plan and deliver personalised care, improve the operation of services, develop the workforce and inform future planning. Data infrastructure that gathers and retains timely, accurate and accessible information on care needs will also free up staff time to focus on providing direct care and support.

Greater understanding of people’s care journeys

Better availability and more consistent use of data alongside improved technology will support effective integration across local health and care systems, by allowing health and care providers to share information more effectively and to monitor the quality and continuity of care across every person’s whole care journey. Better data will support local authorities in having the right information and tools needed to continue to meet their responsibilities, such as ensuring their local markets provide sufficient choice and capacity across the full range of social care provision and delivering their safeguarding responsibilities, by enabling them to identify risks of harm and reduce or prevent this, and to manage and monitor safeguarding concerns and enquiries.

Better management of the health and care system

Nationally, improved data will give government a better understanding of how to keep the public safe, to monitor the safety, quality and continuity of care, and to reach well-informed and well-targeted decisions to improve care and evaluate its impact. Data is also key to enabling transparency and accountability at every level - local, regional and national - and to inform research into how care can best be delivered locally and nationally.

Our principles to support making our vision a reality

We should be guided by some key principles when delivering our digital and data ambitions. These aim to build confidence and trust among stakeholders in our plans for collecting and using data, by ensuring that it is done safely and securely, and that people have a say in how their data is used.

Streamlined - we aim to collect data once and re-use it to reduce data burden and duplication; we will also automate data collection as far as possible to reduce the time spent on manual data submission and related processes.

Secure - we recognise that data about people’s care and support needs are highly sensitive, and that providers’ data can be commercially sensitive; we will therefore ensure that all data are stored safely and securely, with due regard for confidentially. When that data is accessed, for example through a secure data environment, data will be appropriately anonymised or pseudonymised prior to use for research or other purposes, and go through clear project and user approvals.

Accessible - we will aim to make data routinely available, sharing it back appropriately and in an accessible format with those who provide it and with those who use it, for example to design or monitor service delivery.

Transparent - we will ensure that data-sharing is done transparently, and that data is processed in accordance with data protection and other relevant legal frameworks, including common law duty of confidentiality, and with due regard to peoples consent and privacy where appropriate.

These principles were formulated to ensure that data collection in adult social care is streamlined to reduce the burden on the sector and that the data collected is accessible and available for reuse by the sector for benchmarking and innovation as well as for research and other analysis.

Our commitments to you

Commitment to ongoing involvement of the sector

Achieving the adult social care data transformation vision will benefit by working together with people and organisations from across the sector.

To ensure we jointly deliver the initiatives set out in this framework, we are committed to:

• seek to work in partnership with stakeholders across the sector wherever possible, including local government, care providers, people who draw on care and support and unpaid carers and other organisations when developing and designing the initiatives set out in this framework, including reviewing existing data collections
• work across government, including with NHSE and other government departments, to seek ways to maximise the sharing of existing and new data in safe and appropriate ways
• further develop our commitments and do so openly, involving stakeholders through regular engagement

Commitment to proportionality of data changes through good governance

Governance structures provide oversight and approval of information standards, changes to data collections and extractions across health and adult social care.

The Data Alliance Partnership brings together key national organisations representing local authorities and providers from across health and social care and is focused on placing a minimal burden on the frontline. Wherever changes to adult social care data or standards affecting adult social care data are introduced, the partnership will review and ultimately provide approval for the collection to be added to a single list of approved data collections.

The Data and Outcomes Board is the sub-board of the Data Alliance Partnership Board that oversees adult social care data. It is responsible for reviewing additions and amendments to adult social care data, including to the single data list of data that local government is mandated to submit to central government, and for advising the department on adult social care data issues.

All proposed changes are considered by the appropriate governance structures prior to implementation to ensure that they are necessary, appropriate and proportionate.

Our roadmap - how we will achieve our vision for adult social care data

The roadmap in figure 1 shows a number of important overarching milestones over the next 5 years, and highlights the good progress made towards achieving the transformation of adult social care data.

Figure 1: important milestones on our roadmap to transforming social care data

Description text for figure 1

Milestones on the roadmap:

February 2023: external report setting out options to improve Adult Social Care Survey and Survey of Adult Carers in England (published)

March 2023: outline of data set for digital social care records (DCSRs) (published)

April 2023: strengthened metrics launched in Adult Social Care Outcomes Framework (complete)

April 2023: the Care Quality Commission (CQC) began assessments of local authorities’ social care responsibilities (complete)

April 2023: local authorities mandated to submit client level data every quarter (complete)

Spring 2023: study underway to explore the feasibility of a new survey of unpaid carers (complete)

July 2023: Office for Local Government (Oflog), a new local government performance body in England, launched (complete)

October 2023: over 60% of CQC registered care providers have adopted a digital social care record (complete)

December 2023: discovery for data access (complete)

From 2024: CLD replace the annual SALT collection

Early 2024: publication of findings from adult social care workforce employee survey

By March 2024: publication of the minimum operational data specification (MODS) for assured DSCR systems to implement

March 2024: findings of new survey of unpaid carers from scoping study published

Winter 2024: data access tool available to the sector

By 2024: client level data collected from local authorities replaces the annual short- and long-term collection

By 2025: some MODS data starts flowing and is collected from care providers that is improved and streamlined

By 2025: submission of CLD becomes automated and project implementation completed

By 2025: implementation of MODS

By 2025 to 2026: updated Adult Social Care Survey and Survey of Adult Carers in England go live

From 2025 to 2025: second phase of updates to the Adult Social Care Outcomes Framework to commence

By 2028: data collected from care providers is now streamlined as far as possible

The milestones are grouped around themes of:

• streamlined and improved data collections
• new data collections and bridged data gaps
• improved data access and data insights
• digitising social care

Chapter 2: our understanding of the data collection landscape

This chapter summarises the work completed to understand the current data collection landscape.

The importance of collecting the right data

As the ‘People at the Heart of Care’ white paper set out, data is essential to delivering the vision of data transformation. Data can be used by people who draw on care and support and carers to make more informed choices and have control over their care. It can be used by the workforce who deliver care and support, to tailor care to meet people’s individual needs and deliver more joined-up care services. Better data and insights across local authorities and care providers, together with a new way to assess how well local authorities are supporting people with care and support needs and unpaid carers, will help us know whether our social care reforms and investment have been successful.

The data collection landscape

A considerable amount of data is already collected, stored and shared across adult social care. Below summarises the data landscape and its limitations.

National data collections and publications

Currently there are over 50 national data collections (see annex A), which centrally collect adult social care information from across the sector. Some of this data is collected primarily for operational purposes, to support the commissioning, management and delivery of care, and to help organisations meet their statutory duties such as safeguarding adults. For example, the Capacity Tracker collects national real-time data on key areas such as care home vacancy, and the Adult Social Care Finance Return (ASC-FR) collects data on local authority spending on social care.

In December 2023, the department launched a public consultation on health and social care statistical outputs. This was in partnership with NHSE, the Office for National Statistics (ONS), the UK Health Security Agency (UKHSA) and NHSBSA. The purpose of this consultation is to understand how clear and valuable all types of users find the health and care statistical system as it stands, and to seek feedback on proposals to both improve and streamline the system going forward. We will utilise the findings of this consultation in developing our delivery plans next year.

Many of these national collections feed into publications or other outputs such as data insight dashboards. For example, Capacity Tracker data is published as part of the monthly Statistics for adult social care publication. Most national data is currently only published annually. Annex A lists the outputs for each national data collection.

Local data collections and publications

Local authorities and providers carry out many local and regional data collections to support a range of uses, such as quality and risk monitoring, understanding capacity, identifying areas for improvement, and supporting local authorities in meeting their statutory duties. For example, local authorities in the north-west are already sharing their spend and placement data to compare their own performance with that of their region, to support better and more efficient commissioning. Integrated care systems (ICSs) and integrated care boards (ICBs) also use national data collections as a source of information.

Box 1: how data flows through collections from the adult social care sector

Data collections are formed by a series of steps that come together to create a data flow. Data collections often involve more than one person or organisation who may have a role in submitting, collecting or holding data.

Figure 2: how data flows through collections in the adult social care sector

Description text for figure 2

Data is collected from people and organisations across the sector. These include:

• individuals who draw on care and support
• care providers and their staff
• carers who provide informal or unpaid care
• local authorities and care commissioners

Data about experiences and delivery of care is recorded either through management systems, information returns or surveys.

This data is received and used by national government departments, local governments, research organisations and care providers. Data is then stored in over 50 national data collections across 12 different organisations (such as NHSE, ONS, the CQC and local authorities). These data collections are then shared publicly or within organisations.

Chapter 3: our updated understanding of the sector’s data needs

To ensure that the right data is collected, held and shared across social care, it is vital that we have a clear understanding of the information that people and organisations need. We also need to understand the limitations and constraints of the data landscape.

To gain a thorough understanding of the sector’s data and information needs, the department has conducted extensive engagement since February 2023, including the open feedback survey accompanying the draft, and carrying out 40 workshops with over 250 sector representatives, several one-on-one discussions with key stakeholders, and received numerous additional responses from individuals and organisations. This work has helped give us clarity about what providers, unpaid carers, people who draw on care and support (including those who fund their own care), local authorities and central government need to know and why.

This chapter summarises the findings of this engagement. It builds on our previous understanding and includes the examples of data needs that we set out in February 2023.

As demonstrated in this chapter, our engagement has confirmed that many of these needs are still a priority for stakeholders.

Examples of data needs across the sector

Data needs of unpaid carers and people who draw on care and support

People who draw on care and support and unpaid carers should have access to timely, high-quality data to improve care quality and inform choices about their care and support, and have confidence that those delivering their care also have this information, including:

• personal information: for both people who draw on care and support and unpaid carers, access to their own information about their individual health and care and the ability to give access to everyone supporting them, including unpaid carers
• local information: access to data about the type and quality of local care and support services to make better informed choices about care, support, and preferences, as well as access to user-friendly and up-to-date information to provide respite and support for unpaid carers

Data needs for providers surrounding care markets and supply of service

For providers, data is needed regarding the care market to support delivery of continuity and quality of care services and enable the care market to respond quickly to changing demands. This broadly covers the following areas:

• local authority commissioning practices: including data on capacity, market sustainability and hospital discharge with care arrangements data
• information on users of providers’ services: access to individual level data, aggregates of safeguarding data to assess resource constraints, shared feedback from people who draw on the provider’s services, risk assessments, detailed care plans, outcomes information to understand the care user’s journey
• oversight of the market: customisable reports to support benchmarking (such as hours of overtime paid, hours of employee time paid, hours of absence recorded, vaccination rates and the ratio of private to local authority funded beds and room availability), data on local authority spend including prices paid for care across local areas, information on market resilience and financial stability of the market, and data to inform future strategic planning and promote innovation in care provision

Data needs of local government surrounding unpaid carers

Broadly, local government needs the following data to ensure the right support is being offered, to manage demand for services and to improve services locally:

• demographics and characteristics of unpaid carers: size and location of the population including those not receiving formal support from their local authority, age, gender, ethnicity, employment status
• formal support for unpaid carers: access to carers’ assessments, waiting times for carers’ assessment and support, the number of unpaid carers receiving support, types/duration/frequency of support, hours of care provided per week
• outcomes for unpaid carers: their health and wellbeing, quality of life, employment activity
• satisfaction with services among unpaid carers: particularly those in contact with and receiving support from their local authority

Data needs of central and local government surrounding the workforce

Broadly, central and local government need the following data at a local authority level to gain a true picture of the workforce, to support decision making and to ensure the right funding, resources and policies are in place to cultivate a robust, resilient and professional workforce:

• demographics and characteristics of the care workforce: as far as practicable, comprehensive data such as on age, gender, ethnicity and disability
• workforce size, capacity, and employment characteristics: data on the current size of the workforce across different settings and roles, hours worked, vacancy rates, turnover rates, levels of absence, contract types and terms and conditions
• career paths and progression: current skills and qualifications, uptake of training, reasons for recruitment and retention, progression through a care career path, reasons for exiting the sector, pay rates and pay progression
• outcomes of the workforce: wellbeing and work-related quality of life (including measures of job satisfaction or attachment)

Findings from engagement on data needs and limitations

The sector feedback received from the engagement process has supported us to improve our understanding of where we need more data, better data and improved data access. Feedback also highlighted key requirements to transform the adult social care data landscape.

We recognise that we can do more to act on the feedback that we received. In 2024, we intend to work with the sector to investigate and seek co-design solutions to the complex issues that were raised by the sector in the engagement process and highlighted as important but challenging to overcome.

As demonstrated within chapter 4, we are already making good progress in addressing key sector data needs and limitations through transforming adult social care data. A key focus for 2024 will be to better map and link our national data projects, to improve clarity on how we are directly addressing the data needs and limitations raised by the sector. This will provide greater visibility on how the various data projects will change things for those across the care sector.

Data gaps highlighted by the sector

The feedback included several suggestions for data that would be beneficial to the social care sector and people who draw on care and support. We summarise below the points most often raised by stakeholders, and the benefits that getting them right would provide.

Workforce data

A key ask from across the sector is for better data on the social care workforce, to complement that already available from Capacity Tracker and Skills for Care. This means data that will provide information on:

• the national, local and provider-level workforce, including recruitment rates, retention rates, reasons for leaving the sector, vacancy rates, staff turnover, capacity, pay and conditions
• demographic data, including on protected characteristics
• data on skills, training and qualifications
• staff wellbeing - to further understand the impact on workforce retention and care quality

This information will also provide a better understanding of capacity in social care, assist with planning for future emergencies, such as pandemics, and allow forecasting for future population needs.

For social care providers, having a comprehensive understanding of their workforce is pivotal. This data not only ensures the delivery of high-quality care but also aids in workforce management, development, and retention. The right data allows providers to match the skills and expertise of their staff to the unique needs of their service users, ensuring optimal outcomes.

Outcomes and user experience

There is a need for more information on people’s experiences of care, their quality of life and their outcomes, beyond those that are measured through the ASCOF.

For central and local government and providers, this information would improve understanding of the impact of care packages and ‘what works’ in terms of care provision.

There is also a need to link experience information from those who use care and support with quality-of-care data due to the strong impact of one on the other.

The Adult Social Care Survey (ASCS) and the Survey of Adult Carers in England (SACE) are currently the primary sources of information and insight into people’s experiences of, and satisfaction with, care services. As outlined in chapter 4, ‘Improving adult social care data’, we are committed to revising these surveys. We will use the feedback provided to seek to ensure future surveys are better aligned to the information needs of stakeholders.

Demographic data

It is important to gain a more detailed picture of the care population, and this was reflected in feedback from the sector. Stakeholders particularly flagged the need for better data on protected characteristics and condition-specific data. Population data disaggregated by protected characteristics will support councils with profiling communities and equalities work. This data would also improve our understanding of those who draw on care and allow us to explore any variation and disparities in their experience in access to and outcomes within social care.

Understanding the demography of people accessing social care and unpaid carers is of vital importance in anticipating demand and developing timely solutions while whole population-level data should provide a basis for longer term demand and capacity forecasting.

CLD and DSCRs will improve the picture on demographic data, although this data will need to be shared effectively to maximise its benefits.

Information on unpaid carers

The sector highlighted the need for better data on unpaid carers, including the size of this population, the type of care they provided and the amount of time they spent caring.

Understanding the demographics of unpaid carers, the nature of the care they provide, and the challenges they face is crucial for both policymaking and for ensuring that both carers and those they care for receive the support they need.

Feedback also highlighted the need to understand disparities within this population, by improving our knowledge of its demographics, including information on protected characteristics and health and wellbeing.

The department has commissioned ONS to undertake a scoping study for a new regular survey focused on unpaid carers. This will explore how a survey could be representative and inclusive of all unpaid carers and aspects of unpaid care provision, to fill a crucial evidence gap and provide an updated and more accurate estimate of the number of unpaid carers and their lived experience.

Planning and forecasting provision

Many stakeholders including central and local government need better data to support planning, including data on capacity and demand for services, care quality and, as mentioned above, the workforce.

Providers and local government need to be able to better forecast and plan for future need and this type of data would support that. This data should also support the identification of gaps in provision and help identify any unmet need. Better data will also support the understanding of which models of care are most successful in supporting an independent life and meeting people’s needs.

The CLD dashboard for local authorities, launched in November 2023, will over time evolve to include metrics which will enable benchmarking to support service planning and commissioning, as data quality and completeness improves. The first version of the dashboard provides a way for the Department of Health and Social Care (DHSC) to share summary data derived from CLD submissions back to local authorities. It visualises each local authority’s demand and activity, and highlights where improvements in data quality can be made.

Limitations of the current data landscape

The adult social care data landscape has changed in recent years. We have seen improved timeliness and accessibility of data, but there are still many limitations. The OSR highlighted in its 2020 report on adult social care statistics that the sector was hindered by the lack of good quality data and identified 3 key areas of focus:

• lack of leadership and collaboration
• significant gaps in data that is collected
• a lack of accessibility, coherence, quality, timeliness and granularity of existing data

As part of work, we have engaged with the sector to explore these limitations in greater detail. We set up a data governance board, supported by advisory boards and task and finish groups, and we held a series of workshops and surveys to develop the provider dataset. This engagement has identified 5 important areas, which echo the OSR’s findings (see figure 3).

Figure 3: the limitations of adult social care data

As these limitations are interlinked and span the sector, we need a systematic approach to addressing them. The sector has already started collaborating to overcome these barriers, as outlined in the following chapters.

Description text for figure 3

The 5 limitations identified are:

• limited digitisation: approximately 50% of social care providers have digital care records. Providers highlighted the lack of digital infrastructure as one of their main challenges, with the use of paper records increasing the burden of data management and sharing
• lack of data availability: data and information is not always accessible to the right people or at the right time, so individuals and their families have to repeat information. This leads to support not being tailored to needs, the workforce not having access to information needed to deliver the right care, and national and local government being unable to have proper oversight and the necessary information for decision-making
• duplication of data collected: a lack of data sharing means data is often collected more than once. Reducing this can free up staff time to focus on delivering the best possible care
• lack of standardisation and harmonisation in how data is collected: due to the nature of social care being delivered by various people and organisations, data sources are numerous. Differences in practices can lead to inconsistent data insights that inform people’s decisions
• gaps in the data collected: gaps exist in social care data, indicating that not all data needs are being met. This leads to those across the sector not having appropriate or reliable information to make informed decisions

Through our engagement with the sector since February 2023, we received feedback that improved our understanding of the factors that currently limit the sector’s ability to maximise the value of data that is already collected. As a result, even where good data already exist, systemic barriers prevent people and organisations from accessing this information.

Limitations to maximising the value of data

Data sharing

From what we have heard, it is clear that a lack of access to data and the need for better data governance are key limitations in the current data landscape. For example, fluid data sharing between providers can be impeded by the considerable variety in the digital systems used for processes such as care planning, medication requirements and clinical governance.

Efficient and timely data sharing would not only reduce duplication and the burden of data collection, but it could create beneficial spill overs from the better use of currently available data, supporting collaboration and innovation. It is also important to ensure access to data is flexible and data is easy to use.

Linked to this, there can be a significant lag in data being made available, which can reduce its value. Access to data also needs to be timely in order to ensure that its benefits are maximised.

Data protection

However, data sharing creates concerns about data protection, and so, while stakeholders generally support the improvement of access to data, it is clear that data should also be collected ethically (ensuring it is needed and appropriate), effectively protected and only accessible to the right organisations and people.

One of our embedded principles is that we will ensure that data-sharing is done transparently, and that data are processed in accordance with data protection and other relevant legal frameworks, and with due regard to peoples consent and privacy where appropriate.

Data standardisation

Feedback emphasised the current lack of consistency in terminology across the whole adult social care system. This leads to difficulties in comparing data and can create duplication where 2 datasets collect a slightly different version of one variable.

There is a need to improve consistency in data and terminology definitions to reduce regional and local variations. This will improve the ability to compare data and do benchmarking across the sector - both nationally and locally.

Integration of services

We understand that the sector is made up of multiple complex systems and approaches and this was reflected in the feedback we received.

An example of where this creates issues with information is in the lack of integration between health and social care, such that, when moving from hospital to social care, data may not be appropriately shared and data asks may be duplicated.

Stakeholders generally support a whole system approach, improving integration between health data and social care data, child and adult social care data and better integration within social care itself. This would help to deliver clear and consistent information between health and social care and lead to more joined up care for people, with information shared effectively between professionals. This would ultimately improve outcomes for people who draw on care and support.

DHSC’s data needs

We have conducted a thorough assessment of government’s data needs. We believe it is important to be transparent about our internal data priorities to demonstrate the basis for our evolving data strategy. Ultimately, the aim is to focus on the right information to achieve appropriate, streamlined and accessible data that allows us to deliver better outcomes for people. Greater clarity on DHSC’s core data needs can also support sector data development.

DHSC’s data needs are similar to those of external stakeholders, with workforce data, demographic data, unmet need and unpaid care all being raised as areas where a better understanding is needed.

It’s important to note that government would use this data to try to make better and more impactful policy so as to bring benefits to the sector and its users. Better policy making is reliant on monitoring and evaluation information and, as outlined above, data on outcomes and joined-up data across services is lacking. Effective monitoring of the impact of policies is also impacted by a lag in data collection and access.

That is why, in addition to establishing new collections and improving existing data collections, this data strategy includes the work underway to improve access to data and drive digitisation. A move to more digitised collections should ensure more timely data, support collections being collected in a less burdensome way, and where possible make sure data is collected once to be used many times.

To strengthen work in this area, we are developing a new social care data access solution that will improve data access and strengthen data insights by making it easier for care providers, local government and DHSC to access social care data and insights. This will lead to better data about carers and those who receive care, made more accessible to those who make decisions, improving the quality and provision of care for people.

It will represent a ‘single source of truth’ that everyone in the sector can use to make better, more informed decisions to improve the experience of carers and care recipients, and will reduce the burden on the sector to develop their own tools so that they can focus more on care.

Case study: social care client-level data development in Liverpool

Liverpool City Council and Liverpool Clinical Commissioning Group, along with key partners across Cheshire and Mersey ICS, have introduced a demand and capacity model for bed utilisation. The project built on an integrated data and intelligence pool for Liverpool. It provides an architecture from which we can effectively map the entire end to end process for capacity and demand management, from A&E attendance to discharge management and community service interventions.

Initially focused on A&E discharge planning, the data pool allowed a joint team of analysts from health and social care to process map and model our whole system, introducing a scenario planning toolkit for joint health and wellbeing strategies and decision making. In real terms we can now see how individual patients and service users move through our various pathways. This has led to faster provision of reablement services, reduced waiting times for those services and an overall faster journey for people to get home.

Person level data allows us to model our dynamic and complex systems allowing for flexibility and responsiveness to changing demand. For example, the model has been used to test winter planning strategies to predict the impact and effectiveness of specific actions prior to implementation. This moves the health and care service delivery and management to a truly intelligence-led and collaborative model, allowing resources to be used more efficiently. At a ground level this has meant services, like our specialised reablement centres, have access to real time intelligence to help deliver the best service possible. In the last 12 months alone the time taken for a person to go home from one of the reablement centres has reduced by just under a week, meaning we have more capacity to offer this service to more people.

Plans are underway to increase the scope of this work to cover more areas and intervention types, including prevention, early intervention and hospital admission avoidance within the community.

Liverpool want to expand on the intelligence we now have from client level integrated data to inform a plan to address health and wellbeing inequalities, and to monitor the long-term sustainability of the social care sector.

Some of the information required by DHSC will inevitably come through more ad hoc research, for example, through piloting of schemes or through the evaluation of a policy. It is important that these types of exercise draw on available data where possible and do not duplicate or overburden the sector with additional data asks.

People who draw on care and support

Just as the sector needs information to better understand, monitor and improve the provision of adult social care, people who draw on care and support should be able to access and understand their data, to help inform their choices and support independence.

Access to the right information could support and empower people to make choices about their care. To do this, people need enough information to be able to understand local services and their entitlement to support. Alongside this, people need the right data to enable them to make informed decisions on their care and support. This will support the delivery of choice and control to allow people to live independent lives and access high quality services that work for them.

Addressing these issues is, again, in part about making the most of the data we already have by improving access, but further data collection is also likely to be necessary.

Case study: utilising Capacity Tracker to empower people through improved access to information

North England Commissioning Support, the team behind Capacity Tracker, are developing CareFind, a new tool to help members of the public search for care home vacancies via a new public facing website. Once this website has been launched, this will be a free service for providers and has been developed with the support of DHSC and NHSE.

Through the selective use of Capacity Tracker data, which is already collected and publicly available, CareFind will allow members of the public to search for care homes with vacancies matching their chosen criteria. This provides transparent, easily accessible information for people to understand local services, and allows for more choice and control over where they access care and support. We expect that this tool will be of great benefit to those looking for care homes, as well as to care home providers.

Next steps on understanding and addressing the sector’s data needs

We understand that data needs differ across the sector according to the user, from individuals to providers to local government to policymakers. We also understand that data needs change and evolve over time, and that we must be flexible and respond to the ongoing work to support the sector to embed innovative approaches as part of the department’s Innovation and Improvement Unit.

It is vitally important that we to continue to work with the sector to ensure a thorough and evolving understanding of what data is required, so that we can all use it to develop insights to continuously improve adult social care.

The need for flexibility has informed our approach to data, which is grounded in the principle of continuously reviewing data needs and adjusting data collection as needed (see figure 4).

The review process aims to assess data quality needs, for example whether data with national statistic status is required, or whether raw unchecked data will be sufficient. It also aims to ensure that changes to collections are made only if there is significant benefit and if adequate notice can be given to data providers and collectors, to help manage data burdens.

Figure 4: using data needs to strengthen data flows

Description text for figure 4

Data life cycle: review data needs and adjust data collection accordingly

First, identify data needs.

Next, review existing data flows.

Implement new or revised data flows as necessary, or remove flows which are no longer needed.

Monitor data flows.

Make improvements if needed.

Begin cycle again by identifying data needs.

In this document, we are committing to further investigate the complex issues raised by the sector as part of our consultation, and to seek to co-design tangible solutions with them.

Chapter 4: improving adult social care data

This chapter covers national data projects underway that, in close partnership with the sector, will deliver the department’s vision to transform adult social care data and improve the lives of those who deliver and access adult social care.

The projects led by central government aim to drive sector digitisation, through the adoption of digital social care records.

Streamline and improve existing data collections through:

• developing a national provider level minimum dataset
• rolling out client level data collected from local authorities, moving from aggregate to non-identifiable person level data
• strengthening the Adult Social Care Survey and Survey of Adult Carers in England to ensure they are fit for purpose

Establish data collections and bridge data gaps by:

• implementing a social care workforce survey to understand wellbeing and quality of life among the formal social care workforce
• developing a survey of unpaid carers to broaden the scope of information on unpaid carers beyond those receiving support from their local authority

Improve data access to produce better insights by:

• improving social care data sharing and dissemination via a new social care data access solution
• improving how we monitor outcomes through strengthening ASCOF
• better use of data supporting insights to improve CQC assessments of local authority performance
• increasing transparency and accountability of local government performance through the new Office of Local Government (Oflog)
• extending our use of secondary data to generate better evidence

Digitising adult social care

In 2021, the government’s white paper on adult social care reform, ‘People at the Heart of Care’, committed to investing at least £150 million to digitise the sector, improving the quality, safety and personalisation of care.

Realising a digitised and modernised social care sector is essential to delivering wider ambitions for transforming how data and information flows, and is used, across the system.

We want to ensure the foundations are in place to support the delivery of direct care so that the right people across health and care can access the right information at the right time. Alongside this, we want to ensure that data is collected and shared efficiently across the system - where possible, collected once to be used many times.

This journey of digital and data transformation has already started with significant progress made, delivered thanks to central government funding and large-scale investments by the social care sector, and supported by local authorities and ICSs.

Key achievements

Through the Digitising Social Care (DiSC) programme, the government has invested over £50 million so far to ensure that care providers have the key building blocks in place to support further digitisation in the future.

Investment to date has focussed on 4 enablers: technology, digital skills, cyber security and connectivity.

Increased adoption of DSCRs. Sixty per cent of CQC registered adult social care providers have now adopted this, up from 40% of providers in December 2021

In May 2023, we published an updated Digital Skills Framework, setting out the digital skills needed by staff working in social care, and launched a training database to help employers and staff plan and access digital learning and build transferable digital skills.

Supported by the Better Security, Better Care programme, over 66% of CQC registered care providers have completed the Data Security and Protection Toolkit (DSPT) - improving understanding of data and cyber security risks and measuring compliance with key cyber standards. As of October 2023, 64% of care providers meet (or exceed) these standards.

The NHSE Future Connectivity Programme have developed a care home ‘connectivity dashboard’, which illustrates current and forecasted connectivity across care home locations to support national and local decision-making.

Transforming adult social care data with DSCRs

Supporting the widespread adoption of DSCRs across the social care sector is the DiSC programme’s flagship project. DSCRs support care teams to deliver outstanding, safe, personalised care by having the most accurate, up-to-date information at their fingertips, reducing the time care workers and managers spend on administrative tasks.

They also enable greater information sharing between social care and NHS systems, supporting collaboration, and improving opportunities for joined up care around the person between local health systems and CQC registered care providers.

The first example of the integration of health and care systems is the requirement that DSCR systems must provide care staff with secure access to core patient information in the GP record (via integration to GP Connect) - directly improving the safety and quality of an individual’s care. By integrating with GP Connect, DSCRs will ensure care staff have visibility of a person’s current health profile, their last 3 interactions with GP practice professionals, and up-to-date information regarding allergies and adverse reactions, immunisations and medication.

Working with the sector, we have also been able to define what the essential information is for care providers to record, via DSCRs, to support the delivery of care - a “minimum operational data specification” (MODS).

The development of the MODS is a significant milestone in the sector’s digitisation journey - ensuring that consistent data is recorded digitally by all care providers once and can be used many times.

This is just the beginning of improved interoperability between health and care - there is still a significant amount of work that needs to be done. In time, it is intended that DSCRs and other health systems will be able to integrate with one another as required in order to ensure that care and support is personalised, safe and delivers the outcomes people want.

This year we have led a discovery exercise across NHSE, DHSC and external care and health sector partners to examine how best to integrate national and local health and social care systems. The discovery focussed on the needs and use cases for interoperability and information sharing from the perspective of social care, with a specific focus on the quality and safety of care.

Key programme achievements

• published 14 data security and interoperability standards that DSCR systems must comply with by early 2024
• currently 3 assured DSCR systems provide access to core patient information (via GP Connect integration). As of August 2023, over 5,000 authorised staff across 1,350 CQC registered care providers, were able to access the records of over 64,000 people
• MODS defined and published in draft - outlining the core information required to be recorded by care providers to support the delivery of direct care.
• interoperability discovery report finalised

Next steps

We want to go further in supporting digital and data transformation across the sector. We have set out our vision below and next steps in this journey and priorities for 2024 to 2025. We will continue to support the sector to continue to implement DSCRs and will press ahead with our plans for improved information sharing and interoperability between health and care.

The publication of the final MODS in 2024 will represent another major achievement for the sector. For the first time, social care will have a defined information standard which will act as a springboard for delivering further quality, efficiency, and organisational improvements across health and care.

Building on the success of the MODS, we will continue to work with the sector to define the essential information that care providers should record via DSCRs for reporting processes. The DiSC programme teams and DHSC data teams will work in close collaboration to ensure that any changes made to provider level reporting will also deliver improvements in quality and efficiency wherever possible.

To achieve this, we also need to take our interoperability discovery project to the next stage. This will involve clarifying the long-term model for supporting data and information sharing transformation ambitions for the sector, both for direct care and research purposes, including the role of regulation and legislation. This work will be led by the DiSC programme, working in close collaboration with colleagues from across DHSC and NHSE.

We continue to monitor and analyse the DiSC programme’s progress and delivery of benefits on an ongoing basis, which will inform transition plans from 2025. We will ensure this work and the interdependencies with concurrent data projects and discoveries across DHSC and NHSE are brought together in a cohesive implementation plan for delivering digital and data transformation.

Streamlining and improving data collections

This section outlines the progress made, working closely with the sector, in delivering data projects that are improving, adapting, and integrating existing data collections.

Provider level data collection

Data collected from providers offers timely information and direct intelligence on how the commissioning and delivery of care is operating.

During the pandemic the department used Capacity Tracker as the main solution to collect specific provider data, and on 31 July 2022 in recognition of the value of this information a subset of data was made mandatory for providers to submit.

The current provider data landscape is complex and involves providers submitting data to several national collections, such as CQC’s provider information returns (PIRs), Skills for Care’s Adult Social Care Workforce Dataset (ASC-WDS), the department’s Capacity Tracker, and to local authorities for multiple localised data requests.

The department is working closely with the NHS England Transformation Directorate’s (NHSTD) DiSC programme on a provider data project to both streamline ‘what’ data is collected from providers into a core minimum dataset, and ‘how’ the data is collected.

To streamline ‘what’ data is collected, we are developing a core long-term provider minimum dataset to meet all user needs and to fill existing information gaps, such as on home care capacity. The project’s approach to how data will be collected will focus on minimising the burden placed on providers.

The minimum dataset and data collection approach aims to reduce duplication by ensuring providers submit data once so that it can be used many times. Our ambition is that providers will no longer have to submit what is often the same data through different national collections and local data requests. This will help overcome data reconciliation issues that currently exist when trying to compare data from different sources. For example, some similarities exist between Capacity Tracker, CQC PIRs and Skills for Care’s workforce dataset, and some local authorities’ data collected on workforce.

As outlined in the previous section, DSCRs can be harnessed to deliver improvements to how data is collected and shared. DSCRs have the capability to collect more timely and frequent data that can reduce burden on providers and support streamlining the data collecting process. Working with care providers, local authorities and ICSs, we have been able to define the minimum data that should be captured via DSCRs. Our ambition is to continue to build on this progress, exploring opportunities for automating data collection wherever possible to help provide an accurate picture of the quality and safety of services.

The findings from several other data-related discovery exercises will be used to look at ‘how’ the provider data collection should be implemented. It will look at how best to collect and flow data by making use of the sector’s digitisation and, using other data access and sharing platforms, to then make the data available in a secure manner to providers and other organisations.

By 2028, the provider data project is to complete, with a streamlined core provider minimum dataset and transition to streamlined data collection approach using DSCRs and other data sources, and data will be available in a secure manner to providers and other organisations.

Person level data, delivered through the client level data project

Person level data, delivered through the client level data project has the potential to transform our understanding of pathways and interactions of people in social care and their experiences and outcomes. For the first time at the national level, we collect quarterly, person-level social care activity data and organisations with appropriate data sharing agreements will be able to access the pseudonymised (non-identifiable) data to:

• improve our understanding of adult social care, with new and more detailed information about the characteristics of people who use adult social care
• provide more timely insight to understand demand for, and use of, adult social care services, covering requests for support, assessments, reviews and services provided or commissioned by local authorities as part of their duties under the Care Act 2014
• improve our understanding of how people move between health and social care settings with the ability to link health and care data

Through the more frequent and detailed reporting about adult social care activity and service delivery, CLD will support improved benchmarking, care market oversight, service planning and commissioning. It will also be possible to link pseudonymised health and social care records on a national scale, enabling in-depth analysis of the delivery, quality and integration of local health and care services. It will allow people’s journeys - which will be non-identifiable - to be tracked through health and care, and it will allow for much greater understanding of people’s outcomes and how the system is working for individuals. This will enable local and central government to understand people’s needs in greater detail, to plan and improve the quality of care and support, while also enabling local authorities, ICBs and ICSs to undertake benchmarking, market oversight and care planning.

CLD became a mandatory requirement for all local authorities from 1 April 2023. Over the first 2 quarters (covering April to September 2023), we received data from all local authorities containing records of over 5 million interactions between local authorities and nearly 2 million individuals, covering requests for care, assessments, services and reviews. We have seen improvements in volume and completeness of data across the first 2 quarterly submissions which means we have improved coverage of different activities and expect to be able to represent a timely and accurate view of social care from 2024 to 2025.

Uses of person level data within CLD

When developing analyses and metrics from CLD, we are committed to bringing in the views of people who draw on care and support as well as working with local authorities and other sector experts to determine appropriate uses for the data, develop methods and metrics, and interpret and contextualise analyses.

CLD will become the primary source of information about local authority adult social care activity. CLD responds to the need for timely and granular data on local authority activity and service delivery. The current annual SALT data collection return will be discontinued after 2023 to 2024, with a last submission in spring 2024 covering the financial year 2023 to 2024 activity. Metrics derived from CLD will replace statistics currently collected via SALT data collection and will be published in the Adult Social Care Activity and Finance Report, alongside SALT data collection in 2023 to 2024 and alone from 2024 to 2025 onwards. DHSC is committed to publishing statistics using client level data to provide useful new information to the public, local and national government. As set out in our principles for using the data, we will engage with local authorities and sector representatives on the contents and timing of publications. Any publication would contain only aggregated, anonymous data that could not be used to identify individuals.

The updated ASCOF, which demonstrates how social care enables people to achieve the outcomes that matter most to them, will include 5 metrics derived from CLD and we will explore how the data can be used in any future updates.

We are exploring ways that CLD can be used to monitor waiting times for local authority care by linking individual (pseudonymised) records. We will work with sector representatives, ahead of 2024 and 2025, to identify a core suite of suitable waiting times metrics that are agreeable to and adopted by a range of stakeholders including local authorities, DHSC, CQC and service user representative groups.

We regularly meet with the CQC to explore how metrics derived from CLD could potentially be used to inform their assessment of how well local authorities are discharging their Care Act 2014 duties, through the CQC’s new local authority assessment framework. DHSC is also working with the new Office for Local Government (Oflog) to explore how social care datasets, including CLD, are used in its assessment of local authority performance.

We are continuing to work in parallel with the roll-out of digitised care records by NHS England to enhance integration of health and care, by standardising terminology and supporting interoperability across the health and care system.

DHSC launched the CLD dashboard for local authorities in November 2023. The first version of the dashboard provides a way for DHSC to share summary data back to local authorities derived from CLD submissions. It visualises each local authority’s demand and activity, and highlights where improvements in data quality can be made. Over time, the tool will evolve to include more metrics, such as the existing short- and long-term activity statistics and ASCOF measures, derived from CLD (based on the published Central Transformation Principles). It will also include metrics which will enable benchmarking to support service planning and commissioning, as data quality and completeness improves. DHSC has established a local authority working group to develop and review iterations of the dashboard, in which we will continue to work with alongside LGA and ADASS to develop appropriate benchmarking and meaningful metrics.

We have set out how DHSC’s approach to using client level data in the DHSC CLD transparency statement, which we have published as annex D to this document.

The Adult Social Care Survey (ASCS) and the Survey of Adult Carers in England (SACE)

The Adult Social Care Survey (ASCS) and the Survey of Adult Carers in England (SACE) are the primary sources of information and insight into people’s experiences of, and satisfaction with, care services.

These surveys were established before the Care Act 2014 and therefore do not cover all groups of people within scope of that act, such as those who access care and support on a short-term basis. We are committed to revising the surveys, including their methodologies and collection mechanisms, to ensure that they ask the right questions of a broad group of people who draw on care and support, while keeping burdens proportionate.

We have begun developing the surveys, including scoping options for reviewing the questionnaires, increasing accessibility through easy-reads and simplifying the collection mechanism. An initial discovery phase for this work was completed by Ipsos; the final discovery report is published alongside this framework (see annex C). Further development will continue in 2023 to 2024, with the revised surveys intended to be launched for the 2025 to 2026 ASCS cycle.

Establishing new data collections and bridging data gaps

The following collections propose to address specific data gaps remaining after existing collections have been improved. Any new burdens resulting from these will be assessed and addressed as an integral part of their development processes.

Adult social care workforce employee survey

While detailed worker level data is collected through Skills for Care’s ASC-WDS, gaps currently exist around workforce wellbeing and work-related quality of life. ASC-WDS data is also collected from employers, which may make it less suitable for capturing more sensitive information, including some demographics (for example religion or sexual orientation), which may not always be readily disclosed to employers.

Measuring workforce work-related quality of life and wellbeing is a long-term policy interest, as improvements in workforce wellbeing play a role in increased productivity (as improved wellbeing is associated with fewer days of sickness absence) and improvements in retention (as staff are more likely to stay in their role if supported), as well as being an important outcome itself. Richer and better data on demographics and the experiences of the workforce will also provide us with the means to:

• assess equality impacts within the workforce
• evaluate workforce reforms

These data gaps are best filled through a direct, employee-level survey. However, existing omnibus surveys, including flagship labour market and business surveys run by the ONS, are limited - in part, by their small sample of social care workers, but also because potential classification issues and other differences can result in very different definitions and estimates of the care workforce compared to those obtained from the ASC-WDS.

To address this, we are developing a workforce employee-level survey to collect data directly from care staff. The survey launched in August 2023 and closed at the end of October 2023, with findings aiming to be published in early 2024.

Survey of unpaid carers

While various sources capture information on unpaid carers, they lack consistency and coverage. For example, SACE only covers unpaid carers known by local authorities.

The department has commissioned ONS to undertake a scoping study for a new regular survey focused on unpaid carers. This will explore how a survey could be representative and inclusive of all unpaid carers and aspects of unpaid care provision, to fill a crucial evidence gap and provide an updated and more accurate estimate of the number of unpaid carers and their lived experience. The scoping study will also consider how any new survey would sit alongside the existing SACE.

Improving data access and strengthening data insights

It is vital that we also strengthen how we as a sector use and share data, improving the insights and evidence we can obtain including through linking to wider health data where possible, and disseminating these back to all who would benefit.

Improving social care data sharing and dissemination through a new social care data access solution

Currently, social care data is not always accessible or shared at the right time, nor with the right people. During the COVID-19 pandemic, the department developed a COVID-19 dashboard to collate and share key infectious disease monitoring data with local authorities. Providers are also able to view their data in Capacity Tracker and use this for benchmarking purposes as is done through ASC-WDS. We are working with providers to improve and strengthen the data they can view in both the Capacity Tracker and other digital access products, and we will explore whether extra data sources can be added to this view to offer a richer source of data to providers.

These existing digital tools have shown the potential benefits of a centralised approach to data sharing that is co-designed with those who use data. We want to build on this and develop a new digital tool that will allow care providers, local government, and central government better access to adult social care data. It is our ambition that the product will share access to existing and new national social care collections, such as client level data. We are taking a user-centred design approach to build the product and started with a sector user-needs discovery supported by Deloitte.

We intend this new tool to be available to the sector in winter 2024. It will:

• give the sector secure access to vital ASC data which already exists, but which they don’t always have access to
• provide a single source of truth for the sector to refer to, so that care providers, local authorities and DHSC have the same information
• reduce the burdens and costs associated with data processing, analysis and access to insights across the sector

This will make data sharing easier and better enable more people and organisations to unlock the value of data for the delivery of good quality care. It will provide appropriate access to data across the social care sector, ensuring that people are offered the best quality support which is tailored to their needs.

Our discovery finished in December and in the process we engaged with hundreds of representatives across care providers, local authorities, national member organisations, NHSE and CQC, which provided valuable insights to future development. This helped us to identify and evaluate the best options and requirements for the tool, and provided many wider insights which will inform the future of adult social care data developments beyond the data access tool.

The outputs of the discovery, together with responses to early market engagement we conducted with potential suppliers for the tool, are informing our work to prepare the scope and next steps for the tool. In 2024 we will begin alpha development and will continue to work closely to the sector to ensure it is designed collaboratively to solve shared data access problems.

Improving how we monitor outcomes through the Adult Social Care Outcomes Framework (ASCOF)

Measuring the outcomes of people who draw on care and support, unpaid carers and the professionals delivering care through ASCOF is vital for tracking whether services are providing the best care and support.

We want ASCOF to demonstrate how social care enables people to achieve the outcomes that matter most to people and meets their needs, setting out the outcomes that we as central government expect social care to deliver both locally and nationally. Given recent changes to data and further changes over the next few years that will transform the potential of outcomes metrics, including the now mandatory collection of CLD from April 2023, we are committed to delivering updates to ASCOF in 2 phases.

In April 2023, we launched the first update to ASCOF, and the first annual publication with data will be in October 2024. This update ensures ASCOF reflects the Care Act 2014 and refocuses ASCOF on 6 priority outcomes, removing and strengthening existing metrics to reflect the latest available data (see annex B), focusing on what matters most to people. We are additionally working to publish the final version of the ASCOF handbook of definitions over winter 2023. This will provide detailed definitions for each ASCOF metric, alongside worked examples where possible, to support consistency in reporting and interpretation of the metrics.

We will continue working with stakeholders, including people with lived experience, to develop the second phase of the refresh, over the next few years. This will seek to utilise new data streams coming online, such as updates to SACE and ASCS, and explore metrics that will better reflect the full suite of people’s outcomes, such as their emotional wellbeing.

Sat alongside CQC’s single assessment framework, used to set out CQC’s view and assessment of the quality of health and social care, the metrics would strengthen transparency and accountability, providing a stronger lens on the performance of social care and its success in delivering good outcomes for all.

Case study: using data insights to benchmark

Devon County Council has developed tools such as using PowerBI for benchmarking performance, including comparing ASCOF indicators against other comparable authorities or regions. These tools enable the council to drill down into survey data to better understand people’s lived experience.

The council’s annual report also includes benchmarking of activity, cost and spend data, which informs financial planning and provides an evidence base to develop their strategies and delivery plans. The council have now developed over 100 PowerBI tools using national and local data to inform their performance management, needs analysis, market shaping and other activities.

Data and insights improving CQC local authority assessments

The Health and Care Act 2022 conferred a new duty on CQC to review and assess local authorities’ delivery of their regulated care functions under part one of the Care Act 2014. CQC worked with local government, the care sector and people with care and support needs to develop a framework for these assessments, drawing on a range of evidence. CQC assessment of local authorities in respect of these functions will increase transparency, highlighting where good practice is taking place and identifying where improvements need to be made. This will improve accountability for delivering reform.

Assessors need access to data at a local authority level to use as evidence in making these assessments. CQC has used the datasets and metrics at this level currently held or published by their organisation and others in the sector as part of these assessments. CQC has worked with the department, along with other stakeholders, to ensure the development of future data collections and indicator development limits duplication and promotes consistency. Publishing data and insight at a local authority level will also help increase transparency, by providing the public with information about the performance of local services.

CQC’s duties to assess local authorities went live in April 2023, starting with 5 ‘pilot’ assessments before formal assessments later in the year. An initial set of indicators has been developed, using existing data. These will be reviewed as the system rolls out to ensure that they are providing the information needed.

Increasing transparency and accountability of local government performance through the Office of Local Government (Oflog)

The Office for Local Government’s (Oflog) aim is to provide authoritative and accessible data and analysis about the performance of local government and support its improvement.

Oflog will improve the transparency of local government performance through the publication of carefully selected data on the Local Authority Data Explorer. This is a new online tool which brings together a selection of existing metrics across a subset of service areas for data that is available at different levels of authority, including the publication of adult social care data.

DLUHC worked closely with DHSC to agree suitable adult social care metrics that are already published, so that we could minimise burdens and ensure there are no duplicative asks of the sector through Oflog. The metrics selected are a first step, and will be iterated further to deliver a well-rounded, meaningful and carefully curated collection of adult social care metrics.

Further information on Oflog can be found on the Oflog website which sets out the strategic basis for Oflog.

Extending our use of secondary data to generate better evidence

A breadth of wider, secondary data collections exists in social care in addition to primary use data collections; these are wider data collections that are not specific to adult social care, but account for approximately 60% of current national collections. These could be shared and used more widely, to fill existing data and evidence gaps. For example, ONS is further developing our understanding of the size and composition of the social care workforce in England, which can be used to inform the direction of future research. In a blog post on Taking care of the carers: why good workforce data matters in supporting social care, ONS stated that Skills for Care’s workforce report is the most comprehensive publicly available source of workforce statistics, but ONS recognised the need for further work to address evidence gaps. The ONS census analysis plans also include analysis on unpaid care and geography, protected characteristics, health, economic activity and life expectancy. We anticipate that outputs of this work will be published by ONS in due course.

NHS England is also changing how health and social care data is made available for research and analysis, moving away from data sharing to a model of data access through the implementation of SDEs. This aims to enable analysts and researchers to harness the potential of health and social care data, which will facilitate research intended for the public good while ensuring the highest privacy and ethics standards are upheld.

We will continue to work with other government departments to support, promote and make best use of their social care data: for example, working with the Department for Work and Pensions to better understand Carers Allowance data.

External research projects also provide useful evidence and insights which can inform social care policy and delivery. For example, DACHA (Developing research resources and minimum data set for care homes; adoption and use) is an NIHR Applied Research Collaboration East of England study (running from November 2019 to November 2023), which aims to establish what data is needed to support research, service development and innovation in care homes, and to synthesise existing data to deliver an agreed minimum data set. The VIVALDI study (running from June 2020 to March 2023), led by UCL with Four Seasons Healthcare and DHSC, aims to establish how many care home staff and residents have been infected with COVID-19, and to better understand how the virus spreads in care homes to inform national policy decisions around testing and prevention in care homes. We must continue to support the development of such research projects and use the evidence and insights they provide to inform decision-making at all levels.

Next steps and forward look

Together we have made a huge amount of progress towards achieving our ambition to transform adult social care data. Together we can make more.

The forward look highlights the roadmap over the next 5 years. To deliver this roadmap, and the vision outlined in this strategy, we will:

• work in partnership with stakeholders and people who draw on care and support to develop and design the implementation of the measures set out in this document
• explore with local authorities, care providers and other key stakeholders how we can address local challenges such as data-sharing, and the interoperability of systems
• engage with a diverse range of voices across the sector, including those who draw on care and support to ensure we have the right data to drive the changes that we want to see and to measure the success of the outcomes that matter most to people

We will publish an update on progress in 2024.

Forward look

See also chapter 1, figure 1, ‘Important milestones on our roadmap to transforming social care data’.

Finally, we want to put on record our huge thanks to everyone who has already engaged with us in the development of this work - we know that people who draw on care and support, providers and local authorities are busy and their time is at a premium. The huge volume of feedback we have received, and the high levels of attendance at our public consultation events, show just how important data is. We remain absolutely committed to ensuring that data is collected and used in the support of our vision for adult social care - to enable people to have choice, control and support to live independent lives, knowing that they can call on high quality care and support when they need it. We look forward to continuing this work in 2024.