Implementation Guidance - Use case 7: Sharing elements of care planning information across many systems – components or "building blocks" of care plan

Adult Social Care Digital Social Care Record: Minimum Operational Data Standard (MODS): Implementation Guidance

This use case does not follow the structure of the others, as there are multiple scenarios involved. Instead we have identified a range of user needs which combine to describe the benefits of a properly structured record.

MODS user needs and data source mapping across care, health, social work, and system roles

As a…	I need…	So that…	MODS data sources	Other data sources
Person receiving care	To tell people about my care and support needs (including any changes to what I need) once and once only	(a) I don't have to keep repeating myself to all the different professionals involved in my life (b) my care and support can adapt to meet my changing needs	About Me Observations including but not limited to Needs, Risks, Wishes, Preferences, Strengths
Person receiving care	Everyone involved in my care and support to have access to comprehensive and up-to-date information about my care and support needs	I get the right level and type of care and support at the right time	About Me Observations such as Needs, Risks, Wishes, Preferences, Strengths Problems Medication management Allergies and adverse reactions
Care actor	My involvement as a carer to be included in the Digital Social Care Record	Professionals are aware of the role I play in caring for/supporting the individual, and are able to involve me appropriately throughout the individual's care journey	Carers
Data SME	I need to understand the definitions, formats and processes used to collect data from various organisations and people and ensure that is consistent	I can provide aggregate data that is statistically valid, consistent over time, and fit for a wide range of purposes
Data SME	Client/person level data to align with existing data sources about individuals, eg PDS, GP Connect	To avoid duplication of records, so that aggregate data gives a more accurate picture across the whole population	MODS	PDS GP Connect
Operational SME (care provider)	My records to be populated with accurate, up-to-date data about health conditions, allergies and adverse reactions, prescriptions, etc from the GP's records; and this data to be updated in real time if it changes	(a) I can ensure the person receiving care’s day-to-day health needs are being met correctly (b) I don't need to re-create/re-enter data that is already held digitally	About Me Observations including but not limited to Needs, Risks, Wishes, Preferences, Strengths	GP Connect
Operational SME (care provider)	Confidence that I have a legitimate reason to hold/access all the data held within the DSCR/MODS	I am fully compliant with the GDPR
Operational SME (care provider)	New care and support packages arriving from the local authority to contain as much detail as possible about the individual's care and support needs, health conditions (including cognitive and sensory impairments) and desired outcomes	I don't need to repeat any aspects of the needs assessment process which others have already undertaken	Observations including but not limited to Needs, Risks, Wishes, Preferences, Strengths	Care Act eligibility assessment LA care and support plan GP Connect
Operational SME (care provider)	New care and support packages arriving from the local authority to include a clear statement of the care and support being commissioned, including time and cost	I can ensure the care and support I provide is in line with the funding available for it		LA care and support plan LA funding – time and budget
Operational SME (care provider)	To locate data sources about indicators/metrics	I can incorporate data collection needs into my internal working processes as efficiently as possible		NHS Digital CQC Skills for Care
Operational SME (care provider)	Confidence that the DSCR/MODS is fully aligned with statutory/regulatory requirements	I can be certain that by adopting MODS I am meeting all these requirements	MODS	Primary and secondary legislation CQC guidance NICE guidance
Operational SME (care provider)	To be consulted/informed about changes to statutory requirements, data standards, data gathering requirements, registration requirements etc	I can be fully prepared for changes which will impact on the way I provide care and support and/or capture data
Operational SME (care provider)	Access to standard national datasets and data standards	I can review/compare them against the data I capture in my own systems
Operational SME (care provider)	To be notified when someone I provide domiciliary care for is admitted to hospital	I do not have to make unnecessary visits		Hospital systems
Operational SME (health)	Clear and accurate information about the care and support needs of a person with sensory or cognitive impairment, learning disabilities and/or mental health needs when they are admitted to hospital	We can communicate with them effectively and take account of their needs in the way we care for them in hospital	About Me Observations including but not limited to Needs, Risks, Wishes, Preferences, Strengths Care and support plan Carers	About Me
Operational SME (health)	Clear and accurate information about the care and support arrangements available at home when someone is discharged from hospital	We know if it is safe and appropriate to discharge the individual back home	Care and support plan Carers
Operational SME (social work)	Data from care providers and TEC systems at an appropriate level of detail about the day-to-day care and support provided to an individual and the outcomes being achieved	(a) Contribute to the annual review of the individual's care and support plan (b) Flag any significant changes in care and support needs (c) Ensure commissioning meets current and future demand	Instructions Actions Alert Outcome	TEC data Day-to-day care record Hospital admissions/discharges Changes in care and support needs
Operational SME (social work) Operational SME (care provider)	To record data once in the system, ensure it is complete and accurate, and be confident that it will reach everyone else who needs to see it	To reduce the time pressure of constantly re-entering data and responding to requests for routine information	MODS
System SME (system administrator)	To be consulted/informed about changes to statutory requirements, data standards, data gathering requirements, registration requirements etc	I can be fully prepared for changes which will impact on the way I capture data
System SME (system supplier)	To locate data sources about indicators/metrics	I can ensure that data is captured correctly to auto-populate the statutory returns required of my clients	MODS
System SME (system supplier)	To locate person-specific data sources	I can create the functionality to import person-specific data from reliable and trustworthy sources to save double-entry and data quality issues		Data Catalogue PDS GP Connect

Page last updated: 13 July 2026