Social care policy is actively promoting integrated and personalised care. Local organisations are starting to re-engineer their business processes, review front line practice, develop new operational tools and revise their information systems to support and deliver these new approaches. This article draws on a study undertaken in one local organisation as it began to implement its response to these expectations. It uses structuration theory to explore how the macro agendas described by policy and legislation are translated into local perspectives and then further refracted through the lens of operational practice, shaping the business tools which deliver the change. The evidence suggests that there needs to be a better understanding of how the expectations of policy are interpretedand potentially distorted -through their translation into local practice, and of the role that information and information services play in enabling, or disabling the delivery of those expectations at the front line.
IntroductionSocial care is experiencing a period of rapid, radical change: shifts in policy have emphasised integrated and multi-agency working; a drive towards citizen focused services has introduced the concepts of personalised and self directed care; and greater emphasis has been placed on preventative, rather than remedial, service delivery. Implicit in this policy agenda, which advocates personalised, person-centred care and encourages cross agency, seamless service provision, lies an expectation that information technology will enable both effective practice and integration across the organisations and professions involved in its delivery. This expectation has featured in a number of strategic information initiatives over recent years (SCIPU, 2001; Department of Health, 2003, 2010, highlighting the roles that information and information systems play in the delivery of care services (Harlow and Webb, 2003;Wilson et al., 2008).The implementation of these policies, and the achievements of their aims, depends on the ability of the sector to implement innovative information systems across health and social care. Yet very little research has been undertaken into the contribution that information and information systems make in supporting care practices, or how they will need to change in order to respond to these new initiatives (Rigby et al., 2011).
593This article draws on a recent study looking at information issues underpinning social care process and practice within one English Local Authority (Countyshire), and uses it to examine some of the challenges that arise when attempting to translate the expectations of policy into day-to-day practice.
Background and context