We have fixed our links (and we know some of you won’t like it)

We have just completed deploying a new preview release which has a number of user interface changes.

Because we have always been developing new features as rapidly as possible, we have occasionally taken a short cut or two, and one of the ones that irritated us most was using programatic links rather than web standard links. This has meant that in a few places users have not been able to right click / Cmd+click on a link and open the page in a new tab.

Probably the worst offender was the drill down to a booking from a calendar, which meant that calendars had to be refreshed more often that you would want. Believe me, we felt your pain!

I am happy to announce that we have now removed a large number of these links, so almost all links should now support the right click / Cmd+click functionality. In fact we may have got rid of all of them, but we aren’t sure! Please let us know if you find one and we will get rid of it for you.

One of the problems of programatic links is that we had to decide for you whether to open the link in the current tab or a new tab. This is most anti-social, but we had no choice.

The unfortunate consequence is that now we have fixed the problem, some users are going to want the old behaviour, because it is familiar, even though it deprives them of options. We don’t entirely sympathise, but to head them off at the pass we have put in a new option at the organisation level and at the user level, to make all links open in a new tab. We hope that no-one is going to use it!

Other new features

Location added to employee resource pop-up

In these days of nearly £2 / litre for petrol, minimising carer travel is more important than ever. We have therefore exposed the client location on the pop-up on the Plan calendar. Please let us know if you have any other ideas about how we can make it easier for you to save travel time and distance.

The link takes you to a map (remember to right click / Cmd+click on it to choose where it opens)

Overdose warning

It has long been possible as part of the organisation medication setup to show the care worker when a medication was last administered.

The new feature in the image is that, if the medication (or one with the same active ingredient) was last administered within a time period set up in medication session, the green button has a flask instead of a tick. And if the care worker tries to administer it before appropriate time, they get a scarey alert.

You can start with the set up for this now, and the mobile release that it depends on has just gone into beta test and should be generally available in a week or so.

Fixes

As usual there are a number of small fixes, but worthy of note this time is that we have (finally?) got the recurring reports working properly with date parameters, so if you want an email every morning telling you what the bookings for the day are (in case your ISP or Amazon Web Services temporarily disappear) you can do so.

It’s hard to imagine a tougher time for a home care provider to roll out a new IT solution, but congratulations to Noel Williams and his team at Calon Lan Community Care who have done just that.

Only a few weeks after their (online!) training session, reallycare CIC’s mobile eMAR solution is now live across their North Wales branch network. And there’s no stopping there – Noel has already started extending the solution to his home care franchise network in England, Blue Ribbon Community Care.

Noel explained, “We serve hundreds of clients across a wide area and needed a way of monitoring medication without having to physically collect MAR paperwork. Real time alerts would enable us to deal with issues as they occur and, importantly, evidence our actions. The eMAR solution provides the latest medication regimes immediately to care workers - which can be advantageous when dealing with something like an emergency hospital discharge.

We considered a number of software providers over a six month period and already knew what Mark Chapman was capable of. We were looking for a low cost, flexible solution which was compatible with any mobile phone device. reallycare stood out as a fully featured, low cost solution, and they’ve been really keen to work with us to develop it further. They have provided us with a highly configurable piece of software, and several features we’ve suggested have already been made available.

The reallycare solution is open source and we’re not tied into lengthy contracts. However, we want stability for the future and so we’re already looking at other products in the reallycare portfolio to provide our teams with a one stop shop for medication, scheduling, record keeping and care planning”.

Mark Chapman of reallycare added, “We’re delighted the implementation has gone so well. It really is quite an achievement, particularly under the current circumstances, and we look forward to working with Noel and colleagues beyond this project”.

Further Information:

• Calon Lan
• Noel Williams
• Mark Chapman

As it became clear to me just how much of a mess NHS IT was still in I remembered my first ever Hack Day - “National Hack the Government” in 2012. I turned up at 9 on a Saturday morning, not even really knowing what a hack was, to find that three government departments were looking for developers to do something useful with their freshly released APIs to test / publicise them. Before the show-and-tell that afternoon I had: skimmed over the capabilities of the APIs; decided on a use-case; signed up as a consumer (there was some friction here, but the met office were paying someone to work at the weekend to sort it out); written a functional back end; written a simple user interface and rehearsed my demo. I must have had something that vaguely worked as the demo went well enough to win me a £250 prize.

Contrast that with my experience with the NHS APIs:

My first encounter was in (I think) 2004 when I went to a meeting in Leeds to learn about whether the National Program for IT would enable my company of the time to do things that seemed to me to be obvious. At the time we were developing a mobile system for care workers to tell them what their next visit was. I thought it would be great if we could check before each job if the customer had been admitted to hospital. This is still not possible. As was shown on a TV fly-on-the-wall show a little while ago, adult social care departments can still come to a stand-still while they phone round the local hospitals looking for a missing service user. It was clear that the powers that be had no real understanding of what social care was, what technology was available to social care providers or what budget was reasonable for them to connect to the NHS network. Their system was there to give information to those who met very strict Information Governance (IG) guidelines, could afford to go through the super-onerous process of getting access to it, and had the budgets to connect to their closed network. When I said that domiciliary care providers almost always had more up to date demographic data than the NHS (as they need to know where people move to in order to visit them, duh) and enquired how they might feed changes back, I was greeted with blank stares.

I was stupid enough to have another look at connecting a few years later, just before I sold that company, and nothing had changed.

After setting up ReallyCare, perhaps influenced by my good experiences of the met office APIs (and the 250 quid prize!), I went to an ‘attach to the spine’ workshop in about 2015. This proved that, despite pretty horrendous documentation, it was technically easy to access the test spine – at least when there were experts in the room. So I logically asked when a social care provider would get access. Over the internet. Still no prospect. Nothing had changed.

Recently, Matt Hancock announced that henceforth interfaces were going to be “internet first”, so I decided to go along to this week’s hack and build myself a proof of concept. Turns out that “internet first” translates to “we have a roadmap to port services onto a sensible network, but the timescales are pretty fuzzy and distant”. The Caldicott 2 IG principle that “The duty to share information can be as important as the duty to protect patient confidentiality” has kind of started having an impact but NHS Digital staff are quite confusing about it (perhaps because they themselves are confused). The nuts and bolts of taking advantage of this (possible) loosening up are far from clear or simple, however.

Once I realised that I could do nothing of value at the hack I went to the main REWIRED venue, where I watched Hadley Beeman (tech advisor to Matt Hancock) speak. She said that developers hate working with the NHS (+1 to that), and that NHSX aims to make it as easy for devs to interface with the NHS as it is to use OpenStreetMap’s APIs. Given the amount of innovation that has happened in mapping apps since OpenStreetMaps became a thing (or in public transport planning since TFL etc opened up their APIs) you would imagine that the same thing happening in health and social care would have a significant, even transformative, impact. Will it happen? Over to you Ms Beeman.

My first attempt to integrate domiciliary care software with the NHS data came (I think) 15 years ago. Mark Zuckerberg would have still been enrolled at Harvard. Thefacebook has come a long way in that time, but I’m not sure that accessing health data in the UK has. In the time that Zuck has taken to build the world’s biggest social network (and become the 8th richest person in the world) those in charge of technology for Health and Social Care in the UK have spent an amount close to Zuck’s net worth and achieved very little for health and, as far as I can see, nothing for social care.

If you want to shoot me down in flames over this, or if you want to add your voice, use Twitter and hashtag #TaleOf2Hacks

Nick Christodoulou, CEO of Bloomsbury, said “We recognised the need to modernise our care management systems and believe we have found the ideal partner in reallycare. By getting involved at this stage, we’ll be able to influence the development direction and ensure we get the solution we need to take us forward. One key advantage for us is that care managers will be able to get instant alerts relating to medication issues and deal with them as they arise, and no longer rely on paper MAR sheets.”

Mark Chapman, CEO of reallycare CIC said “We are delighted that Nick and the Bloomsbury team share our vision for the next generation of care management software, and grateful for the confidence they have shown by committing to reallycare. We are talking to a number of other care providers about this project, and of course the more that get involved, the faster we can deliver the solutions they need”.

About Bloomsbury Home Care

Bloomsbury provide home care and support to older and disabled people living in their own homes across Essex, Suffolk, the West Midlands, Lincolnshire and the home counties. CEO Nick Christodoulou has been a leader in the UK home care industry for 25 years, establishing Primrose Care in 1992, and going on to run Bupa’s home care division (comprising Primrose, Goldsborough and Helping Hands) before selling it to Nestor BNA in 2002.

So we are starting to check our site (which has been in operation free of charge with friendly users for quite a while) meets requirements in areas that we have not been specifically focussing on. So today when the Sainsbury’s Bank site got some poor publicity for getting an F in a security test we ran the same test on our hosted site. You can see below that we are doing OK (well - better than that - top marks!).

Our new site is up in the top tier - alongside Republican candidate for the presidential election Jeb Bush!

Hopefully it won’t be too long before you can see what else we have been up to…

Mobiles are increasingly used for internet access all over the world, and a recent (large) report from the International Telecommunications Union ranked the UK the fifth most tech-savvy country. The Google mobile-friendly test checks for a number of problems, including “Text too small to read” and “Links too close together”. In the table below sites that are deemed mobile friendly get a green tick. Sites that are not up to scratch (in a mobile sense) get a red cross for every failing. Kind of like a CQC inspection!

The results of our research (sorted by mobile-friendliness and importance, measured by Page Rank, with prices including VAT) are as follows:

So if you are a care provider and you have the time to enhance your listing on any of these sites you might want to consider saving your money.

Full disclosure: Better Care Guide, which appears second top in the table, is published by ReallyCare CIC. Care Opinion, which appears third in the table, have been helpful to ReallyCare CIC. But that isn’t why they are near the top of the table. They are near the top of the table because Google put them there.

While every effort was made to ensure the accuracy of this data there may be some errors - please add a comment if you spot one, and it will be corrected (though no attempt will be made to keep it up to date over time). Likewise if you spot any significant omissions (sites which have ever had a Page Rank of 4 or above should all be included) please add a comment.

They told me that few months ago (in the middle of the financial year) they were referred a service user along with another company (who I will call OTHER Care). Each company was allocated a certain number of visits of a few hours per week. The service user found she had a very generous assessment, and after a couple of visits where their care workers were being asked to clean the windows (which were already clean) ACME care told the purchaser that there was over-provision and that they should cut back. CHC responded by taking 30 minutes off each ACME Care visit, and adding it to the OTHER Care visits (and presumably the windows were very clean indeed).

We have now moved on several months, and are approaching the end of the financial year. ACME has been referred another case from CHC. The service user is very sick, getting frequent home visits from a district nurse and must not be left on her own. In the periods where there is no homecare provision and no district nurse visiting she is looked after by her husband, who has significant health needs of his own, and has frequent appointments at the local surgery to have dressings renewed (though presumably renewing dressings is within the capabilities of the district nurse, who visits the house often).

Unfortunately there is not quite time for the husband to get to the surgery and back within a home care visit, and (remember) the service user must not be left on her own. ACME asked for a 15 minute extension to the visits on the days when the husband has to go to the surgery. The request was refused. The husband asked if the district nurse could change the dressings. The request was refused.

Apparently these sorts of things happen all the time…

For me this is a huge shift from the current model, which you might call “Getting over a low bar” or “Avoiding starring in the next Panorama”.

Since the Care Quality Commission dropped the star rating scheme (and forgot to come up with a replacement) there has been very little incentive for a care provider to shine. In fact the only incentive I can think of is Pride (which is a deadly sin, surely). When the push to private provision was started we were told that the market would drive price down and quality up. I suspect it has done the former (though I don’t think the way public / independent sector hourly rates are compared is a level playing field), but I don’t think quality has improved as much as it has in other business sectors over the same period.

In retail, you can see very quickly whether you are doing a good job, because your customers exercise choice - both in coming into your store and (if they get inside) in filling their baskets. These decisions are being made all the time, and the retailers (and their consultants) measure and respond. The good retailers grow quite quickly (look at Tesco’s growth since Community Care Act in 1990) and the less well run fail (no shortage of data points here, unfortunately). Cast your mind back (if you are old enough) to 1990 and remember what super-market shopping was like: the lines that were carried, the quality of customer service, the car parking arrangements - I could go on. It is barely recognisable. I contend that the improvement is the market at work, in the way it was meant to work in care - but care has not moved on anything like as much.

The difference is that in retail the customers exercise their choice often - sometimes every day. In care the customers may make just one choice in a life-time. The only people who could buy care frequently enough to influence the market - the local authorities - have taken the decision, in the main, to make purchasing decisions once every 3 years, by going out to tender for block contracts or frameworks. Even where personalised budgets are available the service users are often strongly guided. Once a company has won a contract there is very little incentive to improve - they just need to defend. Not mess it up too badly.

This is failure by design.

I do hope that people with the word “Excellence” in their job title can sort it out. There is a finite number of years before I could be at the receiving end, and cultural change is very slow in government.

Please read this post - if you think that you cannot make a contribution to an open source project you are wrong!

We have taken the decision that the time has come to open-source BetterCareGuide.org, which we have delayed for ages because, frankly, the code isn’t anything like as good as we would like (since it was the first app I wrote after a break of several years from programming, using a stack that was all new to me). But I have heard from many people that the code quality of a new open source product isn’t the important thing - a road map, a vision and a simple working product are. So I am taking the covers off the codebase in the hope that people will contribute and improve the code quality of BetterCareGuide while I concentrate on the easy stuff.

Vision
To provide a simple web site where the public can go to get information about UK care providers (though it should be equally applicable elsewhere) and the quality of care they deliver. The information and its presentation should be independent of any financial involvement with the providers. Small independent providers should not be discriminated against. The licencing prohibits the software from being operated by a for-profit organisation.

Road Map (bold items need significant input from non techies)

• Move to a public continuous integration server
• Increase test coverage / quality of tests
• Add an introduction to getting care section (at least one for each UK country)
• Sensible splits of services by service type (elderly / PD / LD etc)
• Additional indicators - as per white paper (when / if it happens)
• Scraping improvements, esp required improvements (big red cross on CQC)
• APIs for reading ratings
• Monitor and flag changes of responsible person and care managers
• Handle anonymised requests for further information from multiple services
• Improve the visual design
• Improve UX - add double clicks and short cut keys where appropriate
• Add auto SMS send capability
• Have /town/ and /authority/ URLs and searches
• Security audit
• Sensible handling of services registered with multiple regulators

The pipe dream road map extends considerably further than this, but I will stop there for a while and see if anyone contributes with this bit.

So I have three requests:
Don’t laugh at the code. If you feel like laughing it is because you could do better - do that instead, and submit a pull request.
If you like social care and open source (well, Ruby on Rails, really) have a look at youangel.org - I would like some help open-sourcing that.
Please, please don’t laugh at the code.

I don’t think anyone sensible these days would question the first two objectives, but I have heard that Shaun Gallagher, Director of Social Care Policy at DH, fears that having one site will stifle innovation, and that progress comes from competition.

His view is not uncommon - indeed it is widely held - but that doesn’t necessarily make it right, and I think he should consider the following:

1. Competition isn’t working in social care IT. The solutions are not moving as fast as the market needs them to. I managed to get an invite to speak to the Information Management Group of ADASS last week because they recognise this.
2. Innovation can come from outside the initial developers if the product is open source. There is some science (well, economics) around this that is very entertainingly delivered in the 10 minute RSAnimate video Drive. (In an attempt to demonstrate this we have brought forward our plans to open source BetterCareGuide.org - see this blog post for details).
3. Offering information on websites to most of the demographics who are in receipt of social care is hard enough without confusing them by splitting the information across multiple sites. Having one place to go is one of the drivers behind www.gov.uk.

We would welcome your comments on this.

1. you can add information about your service to their site (which is of questionable value as the site will already have a link to your own website, which is surely a better shop window)
2. you get informed when a member of the public comments on your service

In order to subscribe you need agree to their draconian terms and conditions, which exclude:

all and any losses, liabilities, claims, damages, expenses or costs (whether arising as a consequence of negligence or otherwise) arising in connection with…the inaccuracy, incompleteness or tardiness of any information supplied through the service

We don’t think that this is fair on providers (particularly smaller providers) so we are launching a service that will let you know when someone comments on your business on the Good Care Guide site.

Our new version of BetterCareGuide.org launched today will send registered providers an email soon after a review of their business is posted on the Good Care Guide (as long as it remains possible - for obvious reasons we cannot offer any service level agreements) for FREE!*

If you are already subscribed to BetterCareGuide and set up to receive notifications of reviews then you don’t need to do anything (apart from tell other providers about this!). If you are a provider and want to know how to subscribe to the site then visit the guide for providers page.

• at least for the time being - we may need to introduce some charging at some point if the traffic increases too much and we don’t make enough from our pledgie, but if you sign up before that point the service will remain free

My thinking is that staff turnover is a key indicator in all businesses, and that it would be beneficial to many groups if staff turnover figures were to be made public on every corporate website (at /staff-turnover.html perhaps). So far as I can see this would be in the interests of the business themselves, their customers and potential customers, their staff and their potential staff and even recruitment consultants (who would doubtless try and place people where the turnover was highest to maximise their profits). My proposed metric, which would be reported every quarter, would be “what percentage of the workforce of 3 months ago is still employed by you?”.

As I say I have been thinking about it for quite a while and have discussed it with several people and so far nobody has come up with a reason not to do this. So I have taken a first step. Let’s see if it will catch on….

So let’s deal with the simple stuff:

• I was shocked by the amount of racism on the twitter stream. How people can take to a public forum to show how much they care about vulnerable people and then come out with such inhumane indefensible drivel is a mystery to me. At the worst times I think 10% of the tweets were borderline actionable under some form of equality legislation.
• The male carer should NEVER have been allowed to do the bed bath for two reasons : the care plan specified that personal care should only ever be provided by females, and the handling and lifting should ALWAYS be done by two carers. Both of these points have to have been known by managers in the home, and senior managers at Forest Health Care should have ensured that robust systems were in place to prevent this happening or report on it immediately. So when they say “isolated incident” (as they have done), the response should be “Yeah? How do you know?”. I expect heads to roll at Forest in the aftermath, but it may take a while. You can do a certain amount with systems and processes and these people just plain failed. I was a supplier to a company involved in a previous Panorama (they were by no means the worst) and I am glad to say that they worked quite hard afterwards on making procedural improvements – but admitting you have a problem is the first step in fixing it.

The hard stuff

This is massively outside my area of expertise (my Mastermind subject would be programming languages 1993-1996) but I think there are two fixes – one partial that can and should be implemented now, and one full, long term and almost certain (sadly) never to be implemented.

It is impossible - for the regulator, the management, service user relatives or anyone else apart from the service users (who are often not able to speak for themselves) and individual care workers – to fully monitor the way in which people are treated in their room in a residential home (and even harder in a domiciliary care setting). So the response should not be to throw more money at the problem, it should be to try to make monitoring unnecessary.

So how?

Make care workers feel like more than just cogs in the machine. I have long been in favour of stimulating the micro-provider end of the market simply because here care workers are closer to (or are) management. So management can more easily see how care is being delivered and care workers identify more with the business and its aims and ethos.

One of the problems with the care system in this country is that regulation and training are proportionately less of a burden for larger providers. In these businesses the distance between senior management and the coal face can be vast, both in terms of geography and levels of management. So you can end up with carers like we saw in Panorama – but you don’t have to, and I have met senior managers who I think are doing the right thing to keep standards high in their organisations, but it is clear that the management of Forest Healthcare were not.

Longer Term

Safe in the knowledge that nobody on earth is going to read this far down, I can now get a little bit more controversial / speculative: Poor care exists in this country because of income inequality.

I just made this up, but I suspect there is something in it, and it isn’t too big a jump from the research that has been done by Kate Pickett and Richard Wilkinson in The Spirit Level to my unresearched guess. Perhaps they will include it as a case study in a sequel.

Tonight Panorama will give weight to that by showing that regulator data is sometimes a long way from current reality, whereas (as many a hotelier knows from TripAdvisor) data collected from the fickle public can mount up very quickly if something is wrong.

Open data is very important to me and I believe that transparency and openness in the long term increases performance and eventually open organisations will always benefit over those who hide their murky ill-doings. I also like playing with open data and this weekend I took part in Rewired State’s National Hack the Government Day at the GDS offices in London. My hack (involving Met Office data) even won a prize, but my cup failed to completely run over as I never got to shake the hand of Mike Bracken who was meant to award the prizes (he didn’t turn up).

Our comparison web site BetterCareGuide.org has a commitment to keeping its data open, but actually collecting data about social care providers is non trivial because:

• people don’t sample as many social care providers as they might restaurants or hotels
• many of the people who do have experience of using providers don’t have access to the internet or a computer

There is nothing much that can be done quickly about the first point (though Panorama ought to be an incentive for people to share their knowledge) but today we launched (as a trial, initially) a new feature on the site that addresses the second problem – Review by Phone. Service users can call 020 3322 2611 from their landline and leave a spoken review about a provider (they tell the system who the provider is by dialling their phone number, which is already on our system). We hope that this will enable us to collect enough data to ensure that the public knows enough about providers quickly enough to ensure that in future Panorama has to go outside the social care space for its material.

The other day I was having a conversation with someone who works for a public body, funded by public money which prompted me to think about a more general culture of openness. They said that the organisation in question was ‘very open’ yet when I asked them how much of that public money had been spent on a particular project they were not happy to tell me - suggesting that if I really wanted to know I could find out though a freedom of information enquiry.

The Freedom of Information Act is a great tool for openness but that kind of misses the point. If openness is desirable (and the existence of the FOI tells us that government thinks that it is and I certainly believe that it is) then it needs to be baked in to the culture of the organisation and all employees should feel empowered (or even obliged) to respond to such questions.

As I see it there are five possible reasons why the person in question was not prepared to give me the information (which they admitted they knew). In ascending order of likeliness they are:

1. The information I was requesting related to national security and its disclosure was prohibited by the official secrets act
2. The information was personal data
3. They were contractually inhibited from so doing
4. They never give out information at all
5. They were embarrassed about the information and never give out information that reflects badly on the organisation

To which my responses would be:

1. Fine. A good reason. I don’t want to be killed in a terrorist attack any more than the next person, but I am pretty certain that the cost of a small computer system relating to social care is not in this category.
2. In this case the data wasn’t personal, but that is an acceptable reason for not being open. Summary or anonymised data should be offered as an alternative.
3. What would be the point of that? FOI requests cost much more to respond to than answering questions on the phone and it takes about a minute to make a request on WhatDoTheyKnow.
4. This is a failing on the part of the organisation. If (as I believe) openness is invariably a force for good, then the more it is practised the better. Organisations need to be clear about the importance of being open and evangelise about it.
5. While it is easy to sympathise with this, it is the worst reason of all. Positive change is far more likely to occur where people are required to publicly acknowledge weakness. An employee embarrassed every day by the performance of their organisation is surely a powerful lever for improvement – one who can skirt the issue is much less likely to be an active force for good (and costs the organisation money in FOI requests).

So if you run an organisation that is obliged to respond to FOI requests – please make sure your staff feel empowered (and indeed obliged) to respond to questions so you don’t ever even get an FOI request. And if they sometimes have to give answers they don’t like then so much the better – one way or another your organisation will benefit from them having had that experience.

I seriously hope 152 LAs are not going to develop their own #socialcare online marketplaces - urgent need for collaboration @GdnSocialCare

— Shirley Ayres (@shirleyayres) November 4, 2011

The online social care directory is an idea that has had currency for several years, and was given a boost by the Putting people first document that seemed to encourage it. It doesn’t really matter whether it is a good idea or not but it is not atypical of change in adult social care in that it has to happen fairly rapidly and 152 times. Big changes are required rapidly because the number of elderly is set to increase rapidly, and new systems will be required to implement the change, administer the new systems or count the beans or whatever. And social care (like highways, waste, education, libraries and many other services) is implemented at a local level.

Are Local Authorities so unique?

I have worked around local authorities since I had a hand in a poll tax system in the 1990s and I have been to many conferences and other events where I have heard chief execs and directors speak. Without exception they have always started with a slide or two about what makes their county / borough / district unique. I have never yet heard one of them stand up and say (though they surely all know it) “something like 95% of what we do is exactly the same as what every other county / borough / district does”.

So when a big change is required, such as an online social care directory, or a shift to re-enablement (and there will surely be other examples on adult social care in the next few years, and probably in areas I know nothing about as well) there is a danger that 152 (or a larger number, in the case of something run at a district level) wheels will be invented. Clearly this isn’t a good thing for the tax payer, and the more realistic scenario of 4-10 commercial companies all writing similar products and then having to go through hugely expensive (for both parties) procurement processes isn’t that much better.

Open source - a better way

I think that a deliberate move to open source could be a better way, and the time for doing it is now. Already we are seeing a significant shift to procuring and using open source toolsets in central government with the ongoing whole-government website project being written in open source languages and we are meant to see more of the same:

The days of the mega IT contracts are over, we will need you to rethink the way you approach projects, making them smaller, off the shelf and open source where possible.
Francis Maude MP, Minister for the Cabinet Office, 2nd December 2010

In general it is clearly a harder argument to say that it is worthwhile open sourcing the sites you develop (though alpha.gov.uk have done so). There are clearly extra steps to be taken (tidying up licensing, making sure all embarrassing comments are removed etc.) which don’t benefit a one-off project. If the project is general however there are benefits and in social care and health it is easy to see that there are as many users as there are PCTs / LAs / hospitals etc. At the moment they are paying, in the best case, companies to write products which they all pay for and none control, and in the worst case they pay £12.7bn for something that only serves to enrich the shareholders of large multi-nationals but doesn’t actually work. In health there are a few people banging this drum (@robdykedotcom is perhaps the loudest example) and some recent progess.

Organising Open Source need not be like herding cats

What I would like to see is something along the lines of an adult social care equivalent of Code for America - an organisation funded by various levels of government and the private sector who write open source software that can then be used by states, cities, counties in the US or elsewhere. Given that the desired outcome of software to improve the quality and efficiency of adult social care is one that is surely held by everyone you would hope that even people who are not employed in the public sector may want to contribute for nothing to improve the code base (see this brilliant video to see why). An organising company (and I am clearly hoping that it will be Reallycare CIC - the not for profit company I founded a few months ago) will co-ordinate the efforts of (if funding can be found) staff and volunteers.

I have made a start on two websites in the space that will be open-sourced. One is a site for running volunteering groups which is live as a standalone website in a small part of East Sussex and can be made available to voluntary organisations. The other is (funnily enough) a directory which has got a long way to go before it sees the light of day (unless I suddenly get an influx of Ruby and Rails developers who want to help).

The intention is to organise a hack weekend, probably in January, to try and take things forward. If you would be interested in taking part please leave a comment.