Scaling Digital Social Care Records: The case study

The unofficial (but completely factual) story.

This case study sets out how England doubled adoption of digital social care records (DSCRs) in 4 years - from around 40% of providers in 2021 to 80% by 2025, covering more than 90% of people receiving care.

It explains how we delivered a national digital transformation programme in a low digital maturity, highly fragmented sector: the context, delivery approach, and outcomes from the Digitising Social Care programme’s work on scaling.

I was the DHSC policy lead for social care technology for five years and became accountable for delivery, as the SRO, in July 2022, working alongside Peter Skinner, the NHS England programme director throughout.

I’ve written this, because I’m proud of the progress that we made, and as is often the case with long-running change programmes, it’s not all captured in one place. Everything here is drawn from the public record but it’s unofficial in the sense that it’s written by me.

Overview

Digitising Social Care (DiSC) was the first major digital transformation programme for adult social care in England. Jointly delivered by the Department of Health and Social Care (DHSC) and NHS England, it set out to accelerate the adoption of digital social care records (DSCRs) and to build the foundations for a standards‑based, interoperable care technology market.

DSCRs are systems used by adult social care providers to record direct care information in a structured, digital form - recognised as core infrastructure and as the digital capability needed for safe, high‑quality care, and information sharing with the NHS.

Before the programme began, fewer than half of providers had one, and adoption was increasing at just 3% per year. By its formal closure in October 2025, that had changed fundamentally - 80% of providers were using a DSCR, supporting more than 90% of people in receipt of care. This change is estimated to save more than 30 million hours of staff admin time per year, freeing up time for care.

Context and timeline

Care sector make-up

Adult social care in England is a large, diverse and fragmented sector. Around 18,000 providers operate across approximately 24,000 locations, ranging from large national groups to small and micro‑providers with fewer than ten staff. Provision spans residential and nursing homes, home care, supported living and other community‑based services. Ownership models include private companies, charities, not‑for‑profit organisations and local authorities.

Over the life of the programme the market also experienced high annual churn, with around 10% of providers entering or exiting each year. There were various reasons for this - and wider implications - but for the programme it created additional complexity, with a moving goalpost. New providers needed to be brought into scope, while those exiting the market could affect adoption figures.

Digital maturity

Digital maturity varied widely at the start of the programme. Some providers had relatively high levels of digital capability; most relied on pen and paper to manage care plans, and were dependent on basic office software and manual processes. Many lacked the infrastructure, skills or confidence to adopt digital tools at scale, and could not justify the time or financial investment to change.

Prior to the programme, there were no national standards for DSCRs, no assurance mechanism, and no consistent support for providers navigating the market. Providers bore the cost of digitisation - including upfront investment in systems and devices, double‑running paper and digital processes during transition, and staff training.

Timeline

COVID‑19 exposed the lack of real-time data available from social care providers, and the challenges experienced by a largely paper based sector needing to rapidly adopt digital working. Early work to support providers, such as rapid deployment of devices to care homes and temporary data collections, demonstrated what could be achieved quickly but also highlighted the fragility and inconsistency of the underlying infrastructure.

Work on DSCRs began in summer 2020, initially with just a 3-person team. User research with providers was conducted, baseline standards were set, and a catalogue agreement was established by March 2021, enabling supplier solutions to become ‘assured’. Throughout 2021/22 pilot projects were run across 8 integrated care systems, to gather evidence and learning.

Longer-term transformation funding was secured in the 2021 Spending Review and announced through the social care white paper in December 2021. The programme business case was approved by DHSC and HM Treasury by April 2022, enabling delivery to begin at pace and scale. It was at this point the programme joined the government’s major project portfolio.

Political, organisational and policy environment

The programme was delivered during a period of significant political and organisational change. Over its lifetime, there were seven Secretaries of State for Health and Social Care, and four Ministers for Social Care - with Helen Whately returning. NHSX, the organisation initially responsible for this programme, was absorbed into NHS England in early 2022, followed by multiple restructures, recruitment freezes and spend freezes. Despite this turbulence, the programme maintained consistent support from senior officials and ministers - an important enabling condition.

The policy context for the programme included Putting People at the Heart of Care, which set out a ten‑year vision for adult social care reform and committed funding for digital social care records; Data Saves Lives, which established a data strategy for health and social care; A plan for digital health and social care; and the Health and social care integration White Paper, which emphasised the role of digital and data in integrated care systems. Taken together, these commitments provided the policy foundation and visibility the programme needed to support sustained investment.

Programme approach and workstreams

Early on, the team developed a logic model - informed by user research with providers and by ‘lessons learned’ from NHS programmes such as Frontline Digitisation, GP IT Futures and Shared Care Records. This helped identify the functions required to address barriers to digitisation, including: reducing upfront costs, supporting local implementation, providing clarity on what systems were available, assuring the market, establishing data standards, and building evidence. These functions shaped the design of the programme’s interlocking workstreams: implementation, market assurance, standards and regulation, and enabling functions.

Implementation

Change delivery was managed through the 42 Integrated Care Systems (ICSs), providing funding, guidance and hands‑on support to engage providers and accelerate adoption. ICSs developed local delivery plans that set out how they would identify and support providers, what local capacity they would put in place, and how they would align DSCR adoption with wider digital and integration priorities. Progress was tracked quarterly, with ICSs reporting on the number and proportion of providers and people with DSCRs, as well as on local challenges and learning. Where ICSs demonstrated capacity and demand, they could access additional funding to accelerate adoption.

This approach was critical for reaching a fragmented provider market and ensuring that support was tailored to local contexts. ICS teams worked with local authorities, provider associations and other partners to identify providers, run engagement events, offer implementation support and help providers navigate our assured solutions list. A national offer was developed for large providers operating across multiple ICSs, providing a consistent approach to funding, assurance and implementation and reducing duplication of effort.

Market assurance

To give providers confidence in the safety, effectiveness and future‑proofing of DSCR solutions, the programme created an assured solutions list. Suppliers wishing to be listed were required to meet defined standards for functionality, interoperability, safety and data quality. A Catalogue Agreement set out commercial obligations, including requirements for ongoing support, data portability and compliance with future standards. A Standards Roadmap provided clarity on future requirements, giving suppliers a predictable pathway for development and helping providers understand how systems would evolve over time.

The assured solutions list and associated documentation were made available through the Digitising Social Care website, alongside guidance for providers on how to choose and implement a DSCR. A further 14 DSCR standards came into effect in March and April 2024, and supplier solutions were assessed against these as part of the assurance process. By October 2025, 21 solutions were fully compliant with the DSCR standards, with more working towards compliance.

Standards and regulation

As well as implementing existing standards, the programme developed the Minimum Operational Data Standard (MODS), to establish a consistent baseline for data recording across providers, supporting interoperability between social care and NHS systems. It was published as an information standard under section 250 of the Health and Social Care Act 2012, with an Information Standards Notice setting out scope and implementation timescales.

Enabling functions

The programme’s enabling functions covered governance, risk and issue management, planning and benefits realisation - alongside evaluation and communications.

The communications function refreshed the CARE brand, launched owned social media channels, produced a monthly newsletter, and ensured the programme’s visibility at national and regional events. These activities supported provider engagement and built confidence in digital transformation.

Evaluation and benefits teams worked closely with implementation and standards teams to ensure that data collection, analysis and learning were integrated into delivery. The programme developed a benefits framework distinguishing between cash‑releasing, non‑cash‑releasing and qualitative benefits, and identified where benefits would accrue (providers, ICSs, the NHS, people receiving care and their families). Benefits were communicated through dashboards, case studies, animations and engagement events. The Digitising Social Care website hosted case studies from providers and ICSs, illustrating how DSCRs had changed day‑to‑day practice.

Time and motion studies were conducted, with process mapping and interviews with over 100 staff across 22 care homes. This examined activities such as care plan creation, handovers, medication administration, audits and reporting, and compared the time taken using paper versus digital systems.

Governance structures brought together DHSC and NHS England leaders, external partners and sector stakeholders to oversee progress, manage risks and agree changes to scope or approach where necessary - helping to ensure transparency and buy-in.

People and culture

The programme was initially established in NHSX, before moving into the Joint Digital Policy Unit within the NHS Transformation Directorate following NHSX’s absorption into NHS England in 2022. The unit was a blended DHSC/NHS England team combining policy expertise, delivery capability, digital and technical specialists, analytical teams and communications support.

The team grew to a peak of 29 in 2023, and was deliberately recruited across disciplines - including people with direct experience of care provision, NHS and local government. That mix of backgrounds was a critical enabler. Policy and delivery staff worked side by side, with shared objectives and joint governance, maintaining alignment between national commitments and operational decisions, and bridging the gap between policy intent and practical delivery.

The joint model also allowed the programme to draw on wider NHS England expertise and infrastructure, particularly for standards development and assurance. Senior sponsorship from the Director General for adult social care ensured close alignment to wider social care policy, and meant intelligence from local delivery could inform national decisions.

The programme cultivated a culture of collaboration, challenge and continuous learning - widely recognised, including by external reviewers, as a key success factor.

Delivery trajectory and benefits

The original target for the programme was to achieve DSCR adoption by 80% of CQC-registered providers by March 2024. The programme estimated that the shift from paper to digital would save 20 minutes per care worker per shift.

This target was revisited in 2023 - in part due to the changing shape of the provider market, and the challenging operating environment. The target date for 80% adoption by providers was pushed back by 12 months to March 2025, and the scope of the target was expanded to include the proportion of people supported by a DSCR, recognising that larger providers account for a disproportionate share of people supported.

Measuring adoption accurately was more complex than it might appear. Forecasts were initially based on CQC’s provider information return (PIR), which is completed annually by providers, on the anniversary of registration, resulting in highly varied reporting sizes each month and a significant (~6 month) time lag. Data was later also collected through the monthly Capacity Tracker survey, and reported quarterly as official statistics with a 3-month rolling average. This data collection provided the programme with additional insights on providers ‘in the process of implementation’, and was triangulated with reporting from ICBs to develop more accurate forecasts.

October 2025 statistics, reporting on data up to July 2025, showed that the programme had met its target - 80% of providers using a digital social care record, supporting more than 90% of people in receipt of care.

Financially, the programme remained within budget. Annual benefits are forecast at £422.5m once 80% adoption was reached, and the programme’s net present social value (NPSV) was estimated at £2.9bn over ten years, with a benefit‑cost ratio of 6.6:1. Productivity benefits were the primary driver. While the original estimate was 20 minutes saved per care worker per shift, our time and motion studies found that DSCRs saved closer to an hour per shift.

The studies also identified qualitative benefits, such as increased one‑to‑one time with people receiving care, faster care plan creation, more frequent care plan reviews, improved legibility and completeness of records, and better access to information for staff. These are important examples of how saving administrative time through the use of technology can improve care quality and safety.

Impact

The programme delivered a doubling of DSCR adoption, a standards‑based market for care technology, improved quality and safety, reduced administrative burden, and the foundations for interoperability with the NHS. By establishing DSCR standards and MODS, and by assuring suppliers against these, the programme created a clearer, more predictable environment for providers and suppliers. Providers had greater confidence that systems would be interoperable, supported and aligned with national expectations. Suppliers had greater clarity about requirements and future direction.

The programme also created a national delivery model through ICSs, demonstrating how a central programme could work with local systems to reach a fragmented provider market. It strengthened the evidence base for digital transformation in social care, particularly in relation to productivity benefits and the conditions needed for successful implementation.

Externally, the programme received a green‑rated Gate 5 review from the Infrastructure and Projects Authority and was recognised in the IPA’s Seven Lenses of Transformation for excellence in vision and leadership. The government’s press release, “Digital revolution in care saves millions of admin hours”, reflected the scale of what had been achieved, and set out that the work is an essential part of the government’s plan to develop a single patient record.

For people receiving care, the foundations laid by the programme - of widespread adoption of standards-based digital social care records - will help ensure that the information needed to keep them safe flows with them through the system. The next phase of delivery is focused on supporting all providers to adopt a fully assured solution, and on developing the interoperability infrastructure to connect systems together with the NHS.

Conclusion

The Digitising Social Care programme showed that a standards‑based, market‑shaping approach can shift a fragmented, paper‑based sector at pace and scale. It delivered measurable improvements in quality, safety, efficiency and data availability, while laying the foundations for long‑term transformation.

This case study provides the context, timeline and facts of what we did to scale DSCRs. The Digitising Social Care programme delivered more than this - including work to test, scale and evaluate wider care technologies - and I will return to some of those topics in more depth over time.

There were, of course, also many lessons learned along the way. I have written a long-read covering my personal reflections that I’ll share soon.