The Key to Implementing an Accessible Information Standard Across Complex Adaptive Health and Social Care Organisations

Abstract

Background Digitising health and care is now a strategic priority within the English National Health Service (NHS). A major component is NHS England’s commitment to a new information standard supporting those with special communication needs—ISB 1605 Accessible Information Standard (AIS)—co-produced with a range of voluntary organisations and with disabled people themselves. The standard has been called a “step change” in disabled people’s access to healthcare. The standard aims to ensure that disabled patients, service users and carers with particular information or communication support needs have those needs met. The focus of this study, conducted by UCLan’s Health Informatics Research Team, builds on the previous published contribution to Handbook of Systems and Complexity in Health (Ellis, An Overview of Complexity Theory: Understanding Primary Care as a Complex Adaptive System. Springer, New York, pp 485–494, 2013) and The Value of Systems and Complexity Sciences for Healthcare (Ellis, The Value of Systems and Complexity Sciences for Healthcare. Springer, New York, pp 217–229, 2016) that describes the complex, non-linear, innovative and adaptive network of relationships and flow of energy (information) that underpin the delivery of care, which includes implementation of AIS that supports those with special communication needs.

Objective To identify key features relevant to implementing locally a national Accessible Information Standard across complex adaptive health and social care organisations.

Method Proof of concept study including a literature review, survey and workshop.

Results Delivering on each stage of the standard—to ask, record, flag, share and provide. Changes in behaviours emerge that include listening, whole-system learning, evaluation and reflection, focused on making informed choices that leads to quality improvement. Findings suggest an imperative to the implementation approach within a CAS environment, in which learning processes, end-user and other stakeholder involvement, continuous feedback supported by informatics and a willingness to foster innovation and diversity are facilitated.