Social care is in crisis across Great Britain. With responsibility for social care being a devolved matter, each country has its own system in place but all share common problems. Given the urgency of the crisis, which is exacerbated by the current Covid-19 pandemic, there is growing interest in what others are doing and what works and what doesn’t. While a fair bit of work has been done looking at the international picture, we know less about what is happening closer to home. What are the other British countries doing, what do they have in common and where do they diverge? What can we learn from each other’s successes and failures, and what solutions can we adopt?
At the Nuffield Trust, we have spent the last couple of months immersing ourselves into the different social care systems across the UK, trying to get underneath their peculiarities and identify common ground and points of learning. But what we found was a frustrating lack of high-quality, comparable data. Delving into the data landscape across the UK countries, we quickly learned to realise the limitations of our undertaking and the urgent need for data improvements.
Within this context, we welcome the publication of the review of adult social care data across Great Britain by the Office for Statistics Regulation (OSR). The call for better data and greater collaboration across the countries is timely, and the individual country reports are an invaluable resource for understanding the strengths and weaknesses of social care data within each country and the underlying policy differences.
Why data matters
Lack of funding in social care does not only mean that services are unable to meet demand. Equally important is the under-investment in data and analytics. This is not just a frustrating problem for the small group of social care researchers and data enthusiasts. Poor data matters in very practical terms. It hinders the development of a strong evidence-base to solve problems and guide effective policy making aimed at improving care delivery and the quality of life of service users and their families. It means that we cannot understand if one country’s approach has been successful and how it might work in another place.
For instance, during the run up to the 2019 general election, some proposed the introduction of free personal care in England akin to the system established in Scotland. To assess whether this or other proposals would be a viable or desirable option for England, we need to look at data. It sheds light on the distinct contexts, the nature of the different social care systems and the impact of different policies and initiatives. It allows for comparisons and evaluation of best practice and it lends concrete evidence to lived experience and anecdotes. Sounds simple but such a comparison proved far from straightforward.
So what would help?
Ease of access
Easy and straightforward access to relevant data is crucial to aid research, policy making and the public in making informed decisions. However, similar to the data users the OSR spoke to, we struggled to find relevant statistics, often having to navigate different websites and sources, in some cases with data deeply hidden. Of help were portals aiming to collate all available data, such as the National Social Care Data Portal for Wales. Seeing this realised across the countries will help to increase the use and profile of social care statistics.
Once data has been accessed, we need clear definitions and improved guidance on what statistics entail, as well as detailed statistical commentary. Across all countries, data quality issues and missing returns are a problem where their impact was not always clear.
Another core issue identified by the OSR report, and in our work, is the comparability of data across social care activities, time and regions. Wanting to compare key social care indicators across the countries, we often struggled to understand what exactly is captured. Even comparing headline figures such as the number of people receiving care in each country was far from straightforward. For instance, does access data include signposting to services as opposed to actual delivery of some form of social care activity? Does it include meals on wheels or are those reported separately?
In addition, wanting to evaluate the impact of different policies and approaches, we require consistent data collection and reporting over time, but are faced with breaks in timelines and changing definitions and processes. As highlighted by the OSR, where possible, data producers in all countries should follow harmonised principles, such as on informal care, which would aid comparability across regions and settings.
Linked to this, data did not always meet our needs. We would have liked to get more understanding of characteristics of those receiving care, such as more granular age breakdowns, their level and nature of needs, and the type of care and care setting. And we identified many gaps in the data that limited our ability to understand the intricacies of the different systems. Across the board, robust data on informal caregiving or self-funders are lacking and estimates at best. Likewise, we have little understanding of undermet and unmet need, making it difficult to appreciate how well the different systems meet demand and planning for the challenges ahead.
The way forward
The publication of the review of adult social care data across GB is very timely and welcome. It is an important advocate for change, calling for improvements to existing statistics, including data coherence, standardisation and quality, filling data gaps, and sharing of best practice. Given the Covid-19 crisis, the need for good data has become more apparent than ever, as has the crucial role of social care in our society. Implementing the report’s recommendations will aid researchers in developing solutions through a robust data landscape and facilitating cross-border cooperation and learning. This will ultimately improve care for all citizens across the UK.
We hope that respective bodies will take the findings to heart, seeking to improve ease of accessibility and data quality to facilitate greater use of high-quality data, standardising processes to ensure comparability across settings and countries, and filling the gaps in the data. Where resources are low and problems are shared, this is best done in collaboration.
This is a guest blog from Laura Schlepper (Research Analyst, Nuffield Trust)