Health and social care: data strategy - fairer Scotland duty assessment
Fairer Scotland duty assessment for the data strategy for health and social care
Data Strategy for Health and Social Care: Fairer Scotland Duty Assessment
Fairer Scotland Duty Assessment
Title of policy/practice/ strategy/legislation etc.
Data Strategy for Health and Social Care
"Greater access, better insight, improved outcomes: a strategy for data-driven care in the digital age"
Cabinet Secretary for Health and Social Care
Directorate Division team
Directorate for Digital Health and Care on behalf of Scottish Government and COSLA
Fairer Scotland Duty Assessment – an evidence based assessment of the potential direct or indirect socio-economic and inequalities of outcome impacts from the development of Scotland's first Data Strategy for Health and Social Care.
Summary of aims and expected outcomes of strategy, proposal, programme or policy
As part of the refreshed Digital Health and Care Strategy we committed to publishing Scotland's first ever Data Strategy for Health and Social Care. The vision of the Data Strategy for Health and Social Care is to improve the care and wellbeing of people in Scotland by making best use of data in the design and delivery of services.
To achieve this vision, the Scottish Government and COSLA will work to three key ambitions:
- To empower the people of Scotland by giving individuals clear and easy access to, and the ability to manage and contribute to, their own health and social care data where it is safe and appropriate to do so.
- To empower those delivering health and social care services to have the confidence and ability to gather, safely use, and share data to sustainably improve services and ensure outcomes are being met.
- To ensure fit for purpose data is readily accessible through secure and safe means for planning, research and innovation. Data will be used for the benefit of individual wellbeing and the public collectively, including the development of new and innovative ways of working, improving care, developing new treatments and technologies.
The Fairer Duty Impact Assessment has been developed by drawing upon evidence from a literature review, outputs of engagement with stakeholders, public engagement and the responses from the formal consultation.
A literature review was undertaken to inform the thinking on the use of health and social care data and to identify areas where there were existing gaps.
A bespoke public engagement exercise was commissioned based on the analysis of gaps as identified in the literature review, or where it was felt more information was required in the Scottish context. This exercise was in addition to collecting the views of members of the public and organisations in meetings arranged with the help of partners in the third and independent sectors.
A public consultation to inform the development of the Data Strategy ran from 16 May to 12 August 2022. This was an opportunity to understand a wide variety of stakeholders' views on how data should be gathered, stored and used. The consultation received 162 responses; 62 from individuals and 100 from organisations. The analysis of the consultation was published on 10 November 2022 and was used alongside the bespoke public engagement and our engagement with stakeholders to inform development of the Strategy and the associated impact assessments, including this Fairer Duty Impact Assessment.
The key findings from the formal consultation were:
- transparency regarding the collection and use of data and allowing for informed consent,
- improving the quality and accessibility of data and having interoperable systems are key for professionals to make better use of data to improve the quality of care provided,
- there is broad support for using anonymised data to help drive medical advancements but there are challenges around the disparate nature of existing data sets.
Summary of assessment findings
We heard through our consultation and the research undertaken that accessibility to digital devices can vary particularly for those facing socio economic disadvantages such as material deprivation. Research also suggests that those on a low income are more likely to experience digital exclusion and are less likely to have internet connection in the home than those in the least deprived areas.  To mitigate possible negative impacts, we are committed to retaining viable non-digital routes to accessing health and social care data for those who wish to engage in this way. We will also work with the Connecting Scotland programme and other work across the sector to enable connectivity for those who wish to engage digitally but are excluded due to socio-economic disadvantage.
Research indicates that those from poorer socio-economic backgrounds are more likely to have poorer skills and attainment.  A report by Citizens Advice Scotland suggests that those living in the least deprived areas are twice as likely to be able to use a computer well than those in the most deprived areas of Scotland. There may be potential negative impacts associated with opening up access to data if the data provided is not understandable. Accessibility issues could be more acute for some groups of individuals from poorer socio-economic backgrounds. The Strategy seeks to mitigate this by committing to describing data and information using plain language where is reasonable and appropriate to do so.
Socioeconomic inequalities in health
Research indicates that those in lower socio-economic groups have worse health than those from higher socio-economic groups. The Data Strategy seeks to improve use of data in health and social care by providing access to the right data at the right time in order to deliver the best care, improving health and wellbeing outcomes for people in Scotland. While this will have a positive impact, it will be no different for those from lower socio-economic backgrounds than it will be for those from higher socio-economic backgrounds.
Data for Insight
Collecting health and social care data on a national level which can be analysed to derive insight allows health and care services to understand structural and systematic inequalities, such as those caused by socio-economic disadvantage. This allows for better targeting of information and services to improve outcomes for those who face greater risk of ill health or for those less likely to access health and care services such as those from poorer socio-economic backgrounds, allowing services to made available to those who need it most.
Making greater use of data for research and innovation purposes has the potential for enabling better understanding of inequalities, health outcomes and ill health of specific groups of people within society which has the potential to have positive impacts on the health and wellbeing of Scottish people. Where research is specifically undertaken to understand the links between socio-economic disadvantage and health, targeted action could be taken which would have positive impacts on those facing socio-economic disadvantage.
It is believed that this policy will not have significant impacts on the inequalities of outcomes associated with socio-economic disadvantage. Providing individuals with greater access and the ability to contribute to their health and social care data via digital channels can have a positive impact by allowing people to access information in a way that is convenient to them. However, this positive impact will be no different to those from socio-economic disadvantage backgrounds than it is to those from higher income backgrounds.
Similarly, by improving use of data in the design and delivery of services this will enable professionals to provide the best care possible to those in Scotland which will have a positive impact on those receiving care in Scotland however this impact will be no different for those who face socio-economic disadvantage.
Sign off of the Fairer Scotland Assessment
Name: Jonathan Cameron
Job title: Deputy Director of Digital Health and Care
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