Records 2: Flying the standard

'Records I' was posted last September, time to revisit this theme...

If I am a real champion of Hodges' model, convinced of the value and care-worthiness of this 21st century conceptual framework then why have I not been an agent of change@work?

Surely, I would not have stopped short of stepping on toes, or letting a lack of evidence get in the way of advocating the model as a solution to real problems? So why haven't I been the standard bearer where it really matters - on the shop floor? Excuses are many and include:

• the personal - part-time nature of my combined nursing-informatics interest;
• following local policy Care Programme Approach [CPA];
• professional accountability - risk assessment and management and working as a CPA lead;
• watching with interest as the Single Assessment Process joined the fray;
• and even more recently the Common Assessment Framework;
• plus, and this may be a cop out - I like people to decide/discover things for themselves.

Having been away from the clinical practice from Nov 2004 to last summer I was informed as to how much things had changed. After a short period of time I realised on the contrary how little things had changed.

We are still completing paper documentation designed for risk assessment, service engagement and case management of younger adults. Sometimes this focus and attention is justified with older adults, but this is rarely the case. Case files end up with pages of redundant white-space, white noise that slows what we might call conventional information retrieval.

It has been recognised for a long time that IT systems are key to unlocking multidisciplinary working and joining the dots of policy across health, social care and associated care sectors. The outcome of the CPA review is due later this month, it will be very interesting to see the direction this takes and what hooks there are for Hodges' model. The hooks I can see and well and truly intend to snag my lip upon here include:

• "paperless working";
• self-assessment;
• e-working at the point of care;
• collaborative working and treatment with education interventions;
• individual budgets and new commissioning models;
• social inclusion, social enterprise;
• social capital and employment.

Ultimately, I do believe Hodges' model will find its niche - why? Clearly, the 4P's with records and policy in particular are becoming ever more complex. At times like this a tool to -

simplify and summarise : engage and educate

- must have a place in our curricula, paper and e-record systems, client's and carer's hands and our cognitive tool sets.

Ack: links Care Services Improvement Partnership.