Electronic Up Heaval

You know you had your hands on it yesterday, but in the space of
24 hours that critical piece of paper has vanished. Panic sets in.
What on earth did you do with it? Could you really have been so
stupid as to throw it away? Five minutes and a frantic rummage
later, you finally locate it, hiding under a book.

We’ve all experienced such paper-panic, but for social services
staff, misplaced papers are soon to be a thing of the past. By
October this year all social services departments must be able to
electronically store information about new service users, and by
October 2006 this needs to have been extended to all current cases.
The aim eventually is for all documents in every case to be kept

In theory, the electronic social care record (ESCR) is set to
revolutionise the way services are run. Service users’ details will
be available in one place, including statutory recording forms,
financial assessments, letters, e-mails, and notes from meetings.
These records will be available 24/7 and practitioners will not
need to be in the office to access them. Different workers will be
able to update records at the same time and being able to access
electronic records will help new and temporary staff to get up to

Anyone familiar with social services bureaucracy will be fully
aware of the enormity of the task involved in transferring all
documents into an electronic system. Councils are at different
stages of the process but it seems that a fair number have made
good progress towards meeting the government’s targets. In August
last year a survey of 93 English authorities found that nearly half
were able to electronically store and retrieve social care records.
By contrast the government had anticipated that only 20 per cent of
social services departments would be doing this by October

That’s not to say that implementing the ESCR has been easy. Mike
Custance, head of information systems at Hackney social services
department, was seconded to the Department of Health to work on the
ESCR project. He says that introducing the electronic record
requires a dramatic shift from practitioners.

“It’s a culture change from handwriting on bits of paper to
recording on a computer system. That’s a big change,” he
As in other authorities, the paper file is currently the prime
source of information in Hackney. While staff record details
electronically they then tend to print them off and file the

About one third of files in Hackney cannot be found straightaway.
An electronic retrieval system should significantly improve this
statistic, but in order to be able to use it effectively, staff
need the necessary IT skills. Custance says that more recently
qualified staff use the new technology confidently but those who
have been in the workplace for longer have more difficulties with

Ultimately, the implementation of the ESCR means that more
practitioners will need to carry laptops with them on visits and
the practicalities of this need careful consideration.

“There are parts of Hackney we don’t want people to take a laptop
out to on a dark winter’s evening,” says Custance.

Each local authority will have its own electronic demons to face.
In East Sussex, all new users of older people and physical
disabilities services in one part of the county, Eastbourne, now
have their records kept electronically. When the system was
introduced, practitioners had to grapple with a software

“Basically, the software wasn’t ready to go. For three or four
months it was absolute bedlam as we had scanned all the files but
couldn’t get into the records,” says Ray Hart, assistant director
in the social services finance and business support team.
Two years ago the council started scanning old paper records into
the system and has so far scanned 17,000 adult files and 20,000
financial assessment files. But the scale of the process has been
overwhelming. Four people have been employed solely to scan in
documents and, although about 500 files are completed each week, it
still cannot be done fast enough.

As for practitioners, they can see the potential of the ESCR system
but are “going through the pain”, says Hart – and they are not
alone with having concerns.

“The admin staff are deeply worried about what we’re doing. They
can’t see any work for them in the future,” he says.

The plan in East Sussex is to roll out the ESCR to children’s
services by the summer. Meanwhile, Hart has advice for other
authorities: “Start now. Two years on it’s amazing how much we
haven’t done. Work out how much you have got to do. When you look
at how many files are in your offices and the data around them –
it’s huge.”

By October 2004 Gloucestershire Council had introduced electronic
social care records for all new service users in children’s and
adults’ services. The system, Electronic Records for Integrated
Care – or Eric as it is fondly known – was piloted in seven areas
before being rolled out to about 650 practitioners. 

Eric builds on the previous client service system – the Star system
– but requires more of an  internet-style navigation. Information
can be typed directly into the system or forms can be inputted
using one of the 50 scanners that have been installed around the
county. A unique bar code identifies the service user and after a
document has been completed and filed in the system it cannot be

In addition to introducing electronic records for new service
users, it was decided that documents could be added electronically
to existing service user files provided all the case information
had been scanned into the system. Fine for adults’ services where
case files tend to be 20-50 pages long, but not so easy

“We underestimated just how thick the files for children were. If a
looked-after young person has been in care since birth there could
easily be 1,500-2,000 pages,” says Alan Miles, the council’s ESCR
project manager.

Consequently it was decided that, in large cases, paper files would
remain until the final referral, from which point the records would
be electronic.

The next phase of implementation will see support staff brought on
board with the ESCR. At present the council is continuing to run a
dual recording system with paper social care records also

From a practitioner’s view, Eric has made the job easier, says
Kathryn Atty, assistant home care organiser at the council.

“For what I have to do it’s been a godsend,” she says. She often
needs to retrieve data in her job and Eric provides her with all
the stuff that would normally be in a paper file, including the
user history and care plan. 

Using Eric has also made things clearer. “I don’t have to worry
about hand-written care plans and when I have to fax agencies or
other providers there’s a good clean copy, so that makes
communication easier,” she says.

Atty says she would not want to go back to the old system. “I can
pull up information in 30 seconds. Before it could take me five

Her advice to other practitioners? “Just stick with it because it’s
worth it.”

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