Uniting Scotland’s health & social care data

“A single source of truth” - Christopher Wroath on Turas, the digital platform bringing together health and social care data for the first time

Sunday 4th August 2019

Director of NHS Education for Scotland’s (NES) digital group, Christopher Wroath, spoke to healthandcare.scot’s Sarah Nimmo about Turas, a pioneering new single unified digital platform for health and social care professionals.

NES has a remit to provide the right training and education for NHS staff in Scotland to ‘ensure that patients and their families get the best healthcare possible’.

In 2014, Christopher Wroath was brought in to NES to deliver a ‘digital transformation’. Now NES is increasingly leading the digital way in Scotland.

Integrated workforce planning

Following an Audit Scotland report in 2017 on health and social care workforce planning, the Scottish Government promised a fully integrated workforce plan, separated into four parts.

The first three parts – related to healthcare staff, social care staff and the primary care workforce – have been published.

In the initial draft of part one, the Scottish Government identified they wanted an integrated data platform that would allow workforce planners - whether at national regional or local level - to be able to access as much data as possible in a fully integrated way…and enable workforce planning based on a single set of data”, explains Mr Wroath.

For a long time [NES] has held the data on what we call the pipeline - so we have information about student nurses and midwives, doctors and dentists in training, all the people coming through the system going into healthcare.

We have had a long history of having access to that data so if you take our digital expertise with a history of supply-side data the logical conclusion is to put those two things together and get a supply-side data platform.

In 2015 it became clear to me as a director of digital transformation that there wasn’t going to be any kind of off-the-shelf solution to the integrated delivery of the services.

From the people who keep the wards clean to those who perform cardiothoracic surgery, we have a responsibility to deliver services to them.

In order therefore to be able to achieve the vision of a single unified set of services for all 160,000 NHS staff members, I decided we needed to take a platform approach, so we started  with building our own platform - which is now called Turas.”

The NHS in Scotland is in the midst of an ambitious transition to deliver Microsoft’s Office 365 across the NHS. PowerBI is the Windows visualization tool that is being used to analyse, map and then fish the “data lake” that NES has developed under Mr Wroath’s stewardship, enabling workforce planners, through Turas, to access and use information in a more “meaningful way”.

Some of the challenges for NES have been around finding solutions that could reduce licensing costs, ensuring good information governance, and embedding appropriate security and data-sharing protocols – allowing the organisation to build the digital infrastructure that has now unified health and social care staffing data. Collaboration from stakeholders, however, has been easier says Mr Wroath by enthusiastic buy-in to the project from key parties.

While he says  differences in governance structures can make it harder for the social care sector to act as one, there was an underlying appetite  for using data as a means of delivering better services.

If you build something like the Turas data intelligence platform, you tend to garner engagement in a much more direct way. If I talk about things it can be very difficult to get engagement, but if you actually build something people can interact with it and see what it can do.

I’m of the view that the way to move forward with regard to more integration of data from healthcare and social care is to build somewhere to put that data.

That’s why I’m really excited about this agile system going live and the next six months of getting really constructive feedback, engaging with people about what it could do because people are only now beginning to see what it can do for them.”

A single source of truth

In December the British Medical Association published an analysis of consultant vacancies in Scotland which disputed the figures produced by the Information Services Division (ISD), the branch of National Services Scotland that provides health information, health intelligence, statistical services and advice to support and inform decisions related to the delivery of NHS Scotland services.

While such discrepancies were not uncommon, everyone involved in workforce planning is keen to see a platform that removes inconsistencies.

We are not there yet, but one of the outcomes that we are driving towards”, Mr Wroath explains, “is that what we will deliver in the end is a single point of truth so that if you ask a question and you’re sitting in a Royal College or in NHS Greater Glasgow & Clyde, you will get the same answer because there is only one set of data that will be used.

Looking at what comes next for Turas, he outlines that “for the first three months from now we are focusing on resolving technical interface issues. In the second three months will be looking at feedback and function sets, and in the last six months of the financial year we will be doing specific work on data quality and gaps in the data.

Until we have had a period of time we actually engage with key stakeholders using the platform we are not really going to be able to develop it in the way that we wanted and this is fundamental in an agile approach; we are only on day two and they have already got back to me about stuff which is great, we are really excited about it.

In the financial year 2019-20, this project to go through two or possibly three development cycles entirely led from the feedback from the workforce planning stakeholders who are going live on the platform right now.”

I’m keen to not just use [Turas] for workforce planning but to start seeing what else we can do with it and I have a particular interest around how we can use financial data to start getting more insight into how much money we spend and why.”

Conversations between NES and NHS 24 have begun about how the platform might help move it into a much more data driven environment.

I can’t be any more clear at this point in time but we now have the platform, we now have the tech, so why wouldn’t we use it for other things as well? That’s going to be some more work that I’ll be undertaking in the next three months.”

What we have done is we have built the supply side of things…but where the gold lies will be in being able to connect the set of data with activity; looking at what is actually happening in the NHS in terms of what the services are demanding because once we know that we can marry that up with the supply-side that will give us a much more holistic picture.

That is something that over the course of the next financial year I will be working at an executive and political level; to start moving into how we are going to marry the supply-side with the demand side.”