Systems to support care management: information systems and bulk purchasing

<p>This short paper was presented at a workshop on care management at an Anglo-US Study Seminar Community Care in the New World: Learning from each other, at Boston University in August 1992. As work on implementation of the Community Care White Paper 'Caring for People' (1989) has progressed, local authorities (LAs) and health authorities (HAs) have increasingly realised that care management cannot be developed in isolation from other structures, systems and procedures inherent in the new legislation, such as the purchaser-provider split, the devolution of budgetary control, and the design of information systems (see also SSI and SWSG 1991, pp66-7). Furthermore some of the functions of care managers which they conduct on a micro-level for individual clients, are conducted on a macro-level further up the organisation, such as planning, purchasing, and monitoring quality. Given that the emphasis in 'Caring for People' is on putting the client first and providing a needs-lead service, the purpose of macro-level functions should be to support the care management process. The emphasis of this presentation is on the relationship between these functions at the micro- and macro-level.

<p><p><p>The paper picks out two particular issues that arise from the relationship between care management at the micro-level, and the rest of the SSD at a more macro-level:

<p><p><p>i) The development of information systems to link care management with planning, purchasing and contracting decisions<p><p>made at area and HQ level;

<p><p><p>ii) The problem of reconciling micro- and macro-purchasing arrangements to match bulk provision with what is required by<p><p>clients.

<p><p><p>The paper assumes that a contract culture will emerge as a result of implementation of 'Caring for People', and draws on<p><p>the experience of Kent Social Services to demonstrate the points raised.

<p><p><p>The paper concludes that until effective information systems are up and running in local authorities, services will continue to<p><p>be planned and purchased on the basis of inadequate top-down information and may fail to be responsive to needs.