Technology changing lives: how technology can support the goals of the Care Act

Report from SCIE roundtable discussion held on 26 March 2015

SCIE Report 73

Published: June 2015

Eighty-four per cent of adults use the internet, but only two per cent of the population report any digitally enabled transaction with the NHS. That is an absolutely astonishing figure and one which we should be spending a lot of time looking at.

Lord Michael Bichard, Chair, SCIE

Twenty years ago the only piece of technology I carried was a beeper that I had to keep on me at all times. Things have changed dramatically in the intervening time. What we want to do today is look further into the future and the potential for technology to improve things for people who use services, for carers, providers and commissioners.

Technology can support individuals to make the right choices for the care that they have. It can help professionals to see that people are accessing the right care and those professionals can have quicker access to records and histories.

I worry that when we talk about technology in government we always want to talk about information, data and organisations when this has the potential to transform people’s lives, keep them independent for longer and give better value for money for the taxpayer.

The question is how do we turn all of that potential into a reality? We haven’t always been very good at capitalising on that potential. In fact, I think we have been quite slow on some of these issues though good practice increasingly exists. Some of the high-profile failures in large-scale technology have dented confidence but there are other barriers too so how are we going to overcome those barriers?

I recently discovered a quite shocking statistic: 84 per cent of adults use the internet, but only two per cent of the population report any digitally enabled transaction with the NHS. That is an absolutely astonishing figure and one which we should be spending a lot of time looking at.

So how do we overcome those barriers and turn the ambition into reality? The fact is health and social care has fallen behind but I worry that in trying to make up ground we fall into the trap of being seduced by ‘off-the-shelf’ solutions that may not actually meet the needs of individual users. We need to be more considered, informed and selective about the technology that we employ. My other concern is that the big providers think that they know best and then invest large amounts of scarce money in products which then don’t deliver the outcomes.

The potential of technology to transform how we deliver health and social care really is immense and also to provide the integrated, personalised and supported care that is envisaged in the Care Act.

Key messages

A number of key messages emerged from the roundtable presentations and table discussions.

Establishing a vision and case for change

1. We need a national and local vision for what we are trying to achieve with technological solutions – otherwise we risk being pulled in different directions by different policies.
2. We should seek to work with the Government Digital Service and the Department for Communities and Local Government to consider how to support the social care system in bringing together developers, designers and others working together as a driver for change.
3. There is need for us to develop a strong business case for investment in technology, and educate commissioners about technology through, for example, the use of independent technology advisors or a website of examples of technology in action.

Think ‘problem – solution’

4. Start by thinking about the problem you are trying to solve, not about a specific form of technology. Then think through logically how you are going to solve the problem, using an experimental process with technology to find the solution that works for you. Do not get caught up in thinking about the technology itself.
5. You do not need to invest in expensive, specialist technology. Simple equipment and technology can make a difference.

Personalisation

6. Technology can complement – not replace – personal care. It has the potential to transform people’s lives, keep them independent for longer and achieve better value for money.
7. Technology is cheaper, more accessible and easier to use than ever before (e.g. it is increasingly possible to access free wifi in many areas).
8. Everyday digital technology can bring communities of carers together (e.g. Jointly is an app that works as a central place for carers to store and share information about the person they are looking after).
9. Assisted technology could be built into new homes as a matter of course in order to support people to live independently in their homes for longer.

Co-production

10. Technological and digital solutions should be tested and co-produced with people who use services and carers, using an agile and experimental approach.
11. The sector should utilise the skills of people, users, their carers and families to build community capability and spread knowledge and skills. We need to build an army of ‘people with lived experience to ‘curate’ useful information.
12. Performance data could be used to bust the myths about the value of co-production and co-design by demonstrating the added value this approach takes.
13. We need to help build a powerful movement of people who use services and carers to demand demanding online services for health and care.
14. Frontline staff should be involved in identifying and developing solutions, including solutions to effective information-sharing.

Promoting innovation

15. We should support experimentation – test out and use technology more, which includes allowing experiments to fail.
16. We should encourage technology experts to work in and develop innovative solutions for the care and support sector.
17. We should recruit young people with technical and digital knowledge into social care and encourage them to train up and support existing staff.
18. We need to ensure that simple solutions are not overlooked, they often provide a cost-effective solution. Mass market technology can be as useful as specialist technology.
19. Leaders and commissioners need to articulate more clearly what is needed from the market – including the technology market.

Knowledge and skills

20. Local authorities need to work together to develop shared solutions – otherwise there will be duplication of effort. For example, they could work together to develop self-assessment packages that take a holistic approach beyond health and social care.
21. Establish digital curators to help people understand and access technology and to support the use of good quality information (e.g. information prescriptions).
22. There is a low level of awareness of the range of effective technology solutions available amongst people who commission and use services.
23. Too many policy-makers do not understand technology or the opportunities presented by digital technology.
24. Leaders within the sector need to understand technology and the benefits it can bring, in order to increase their confidence to experiment.
25. Commissioners need to understand the technology that they are commissioning. There is a risk that they are dependent on technology suppliers to explain the offer.
26. Managers and workforce development leads need to know how to decide when digital technology is the right approach to learning and development (e.g. it is difficult to explain moving and handling through e-learning).
27. Care staff are often confident about using digital technology but they do not know how to make decisions based on the wide range of options. A ‘curation’ service may help them to understand what they are looking at. A curation service could collect, manage and present information about digital technology in a way that helps to assess the potential relevance of different options to a range of audiences and situation.
28. Workforce training and engagement is critical if progress is to be made in using technology more widely.

Digital and social inclusion

29. Digital inclusion is essential in order to give access to information and to support training and skills development.
30. Technology can reduce loneliness and isolation by, for example, enabling people to engage online via online forums or Skype.
31. Use community facilities (e.g. libraries) – as hubs for groups and clubs where those isolated can meet and be supported to access technology.
32. Increased access to wifi in care homes would be a big leap forward.

Data-sharing and decision-making

33. Technology can support decision-making by people who use services, carers, providers and commissioners – for example, through providing access to records and histories.
34. Digital services can drive improvement by giving access to a range of data to compare services and performance.
35. There is huge sensitivity about information-sharing. There is a need for a single set of standards and principles by which information is shared. If information can be brought together, it will promote the integration of health and care, and ensure that we become better at identifying when someone has an increased need for support, which in turn could prevent an escalation in need.
36. Giving people access to their own care accounts – including the ability to update it themselves – would drive cultural change amongst professionals and within the system. It would support people’s ability to say want they want to achieve and what they want from the overall system of care and support.
37. Access to information can tackle deep cultural issues that the professional knows best. Professionals have to learn to relinquish power.
38. National government can take away the barriers to the effective use of technology – for example, through improving information governance and by disseminating what works in information-sharing.

Integration

39. Local authorities are ahead in terms of using digital information and technology. This learning could be used more effectively to drive the integration of health and social care.
40. The application of technology in the management of a long-term condition is important, not just for the health of the individual, but for health and care budgets as well.