Evaluation of joint management by knowledge for the healthcare and social services. Final report (2018:23)
On 1 July 2015, the Council for Knowledge Management (the council) was established. The council's members represent nine government agencies that have central information for the central governmental knowledge management for healthcare and social services. The government agencies on the council shall collaborate with each other and with the principals, i.e., county councils and municipalities. The activities are governed by the ordinance (2015:155) on government knowledge management for healthcare and social services. Statskontoret (The Swedish Agency for Public Management) assesses whether the aim of the ordinance is achieved, on commission by the Government. In May 2016, Statskontoret submitted an interim report to the Government and Ministry of Health and Social Affairs. In this report we submit a final presentation of the commission.
Expanded collaboration but challenges remain
Statskontoret's assessment is that the collaboration between the government agencies on the council and between the council and the principals has been expanded further since submitting our interim report. The government agencies have improved the coordination of their knowledge bases and these resources are now more adapted to the needs of the principals.
Statskontoret finds that the council plays an important role and should continue its work. However, we also note that there are several challenges still to be addressed by the council's government agencies before the knowledge management fulfils the aim of the ordinance concerning coordinated, effective and need-oriented knowledge management.
Develop a strategy and accompanying work plan for the council's priority areas
Statskontoret noted in the interim report that the council should draw up a strategy for the work with knowledge management and clearly state the priorities the council is going to make. We now note that the council has developed clear priorities for the work which are based on the wishes of the principal group as regards what the principals need. However, there is no strategy for the government agencies' joint work within the respective priority areas. Statskontoret is therefore of the opinion that the council should develop a strategy and a work plan in order for the government agencies to be able to implement the priorities.
A special assignment for the National Board of Health and Welfare and SBU concerning a plan for cooperation
In conjunction with the establishment of the council in 2015, the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) was assigned the overall responsibility of producing scientific knowledge overviews. The authority thus assumed the National Board of Health and Welfare's responsibility for this activity within the field of social services. In 2016, Statskontoret concluded that it was unclear which authority did what in the work with the scientific knowledge overviews. The challenges relating to the government agencies ' cooperation are still evident in autumn 2018. Statskontoret therefore finds that the Government should instruct both these government agencies to develop a joint plan for how to handle the challenges.
A common terminology for the government agencies' knowledge products
There is a need for a more detailed sorting of the government agencies' respective knowledge products and a common terminology that the government agencies can use when classifying these. A common terminology for the products would make it easier for employees within the areas to find the products and use them appropriately. A common classification can also help the government agencies in identifying any overlapping products. It is therefore Statskontoret's view that the council should develop a common terminology and classification of the government agencies ' various knowledge products.
Strengthen the links between healthcare and social services
Statskontoret concluded in the interim report that the council initially worked to integrate healthcare and social services. The council has also continued this work. Examples of productive integration between the two areas include the common policy for user and patient collaboration and the project concerning the mental health of the elderly. However, challenges still remain. It is therefore the opinion of Statskontoret that the council should continue focusing attention on the fact that the links between healthcare and social services need to be strengthened in issues where both areas impact on each other.
Develop support for systematic follow-ups of the social services
Statskontoret finds that the Government's initiative to improve the systematic follow-up of healthcare is in line with the needs of the government agencies and professions in question. However, our assessment is that there is also a need for the follow-up of activities within social services to be developed and become more coherent. Statskontoret therefore recommends that the National Board of Health and Welfare develop a proposal on how the authority can develop support to the municipalities in order to monitor the activities of the social services.
Continue developing the systematisation of proven experience
In the interim report, Statskontoret's assessment was that the government agencies should prioritise the work of obtaining local knowledge and systematising proven experience. This applies in particular to the social services, where there is often a lack of scientific studies. Our analysis shows that there are still major challenges in this respect. We therefore conclude that the council should continue to work to systematise proven experience within the social services to a greater extent.
Secure long-term financing for Kunskapsguiden
In the interim report, Statskontoret proposed that the government agencies on the council should decide on how an updated website for knowledge management with improved data and functions should be financed. The website Kunskapsguiden is currently financed for the most part by the National Board of Health and Welfare. Statskontoret's assessment is that the government agencies intending to publish their knowledge products on the website should further develop Kunskapsguiden with the social services as the primary target group. It is also Statskontoret's assessment that these government agencies should develop a plan for securing continued financing for the website.
Modify the principal group's working methods to increase participation
Statskontoret's assessment is that the principal group will continue to have an important function in the future. However, the members' involvement in the group varies and attendance at meetings is relatively low. Our assessment is that the principal group can reduce the number of physical meetings for the entire group during certain periods. This may contribute to the members prioritising the meetings that take place to a greater degree. The group's work committee should maintain continuity of work through ongoing information. The substitute system should also be reviewed.
Develop structured dialogues between the council and representatives of professions
Statskontoret's analysis shows that the government government agencies in general do not sufficiently involve healthcare professionals when developing knowledge products, and to some extent the same is true for the social services. Statskontoret therefore finds that the council should engage representatives of professions within both healthcare and social services and pursue structured dialogue. The purpose of the dialogue should be to prepare a common policy on how the government agencies should cooperate with the professions within healthcare and social services when they develop knowledge products.
Statskontoret proposes that the Government
- give a special assignment to the National Board of Health and Welfare and the Swedish Agency for Health Technology Assessment and Assessment of Social Services (SBU) to draw up a joint plan for how the two government agencies' assignments relating to knowledge overviews and national guidelines can be implemented effectively for both government agencies
- give a special assignment to the National Board of Health and Welfare to produce a proposal on how the authority can develop support to the municipalities in order to monitor the activities of the social services. The National Board of Health and Welfare should formulate the proposal in close cooperation with the municipalities' regional support structures and with the Swedish Association of Local Authorities and Regions (SALAR).
Statskontoret proposes that the council
- develops a strategy and a detailed work plan for its continued work
- develops a common terminology and classification of the government agencies ' various knowledge products
- engage representatives of professions within both healthcare and social services and pursue structured dialogue.