Released On 31st Jul 2023
How social care actually is leading the way in digital
Big transformational changes in social care tend to occur over many decades. After all, this is a sector that constantly faces the choice of either allocating resources to improving itself or focusing on providing support to those in need.
However, the pace at which the sector has embraced digital transformation is truly astounding. Over the past five years alone, and looking solely at care planning software, more than 50% of the 39,000 registered care locations in the UK have adopted digital solutions, despite facing staff shortages and a global pandemic.
Comparatively, the digitisation of approximately 9,000 GPs took over a decade. Care homes and homecare agencies adopted digital care planning in over 19,000 locations within half the time.
From being considered a digital laggard, social care has wholeheartedly embraced technology. The rapid adoption of digital tools and solutions has had a profound impact on the sector, revolutionising the way care is delivered and improving the lives of both care providers and people they support.
The picture back then
In the late 2000s, I spent some time with care providers and founders of companies developing technology for the sector. I remember finding a wide chasm – technologies that had been designed for other sectors were being shoehorned into the way care teams worked. And care teams were too busy delivering care to sit through days of classroom training to learn how to use desktop applications which all seemed to have been designed for accountants.
From social care there was a sense that there were no good technologies for us; in the technology world there was a sense that care teams ‘didn’t get I.T’.
At a recent conference of a large domiciliary care provider, someone asked a room full of registered managers if anyone had heard of ChatGPT. Half the people in the room raised their hands – and when asked whether they had tried using it for work, about one in five were already exploring using it for creating care plans.
So, what changed? What made social care adopt digital technology at such a fast pace?
The not so lean start-up
In 2011, Eric Rees published The Lean Start-up, seen by many as the bible of distilled knowledge of how to efficiently launch a digital business. The entrenched beliefs of engineer entrepreneurs were that successful product businesses were built by understanding who the buyer is, what their problems are, and giving the buyer a product that presents a solution.
But in care, the buyer and the user are not the same. So companies developed with a simplistic engineering mindset continuously failed to understand that in order to have an impact on care teams, a product designer would have to get under the skin of how a care team works, of what makes for a good day in the life of each person who draws on care and support, how teams are managed and co-ordinated, who the people who deliver care are, and how care is managed and paid for.
Social care is very complex; understanding the dynamics of care teams, care services, commissioners, how the sector evolved and how it’s woven into healthcare and the role of regulators is not top of mind for entrepreneurs trying to develop the smallest product possible that will get care providers to part with their money.
This challenge is similar in healthcare, but healthcare technology is able to attract much larger budgets and healthcare organisations developed procurement organisations, which have shaped solutions. If a procurement framework classes 100 items of functionality as mandatory, but fails to establish how easy to use the solution is for a nurse on a hospital ward or walking out of an operating theatre, or how committed a supplier is to improving patient outcomes, then as a health system you will get what the product vendors see as the shortest path to sell into procurement.
In social care this was never going to work – there simply isn’t enough money. But a new generation of products in social care succeeded for taking a much longer road. Most products that succeeded over the last 20 years are deeply focused on the person receiving care, their life story, their wants, what makes a good day for them, what areas of their lives they need a hand with and what risks are involved.
These products are very well received by care teams, who immediately perceive the benefit.
The design of these products, and how care teams embraced them, is ultimately what led to the accelerated digital transformation of the sector.
Where in 2012 registered managers would resist the drive from owners to digitise, now we see registered managers demanding from owners that the right type of digital transformation takes place.
But the reality is that digital transformation in social care has very little to do with people buying products from a software vendor; digital in social care is less ‘lean start-up’, and more ‘it takes a village’. It’s a collaboration of everyone system-wide coming together to adopt and use systems that genuinely deliver an impact for people.
Impact on people
The impact of digital transformation on care delivery is significant. Care workers can now focus entirely on each person, continuously monitor their needs, and respond promptly to warnings or trends. Care becomes safer, with risk management integrated into the care process through information management, medication management, and improved handover processes. Digital solutions have enabled care providers to radically improve their operations, from handling inquiries and managing applicants for job roles, to engaging and managing care colleagues, creating efficient rosters, automating payroll and invoicing, and utilising auditing and incident management tools.
The improvements in care quality have caught the attention of regulators, leading to increasingly vocal support for digital transformation. Outdated paper-based systems are now seen as presenting numerous disadvantages, risks, and burdens. Regulators are even considering making digital care planning systems mandatory for care providers, such is the belief that they deliver improved outcomes for people.
To support the adoption of digital solutions, initiatives such as the Digital Social Care Records programme and the Technology-enabled Care programme have been established, funded by the NHS Transformation Directorate. In the absence of an equivalent to NHS Digital for social care, providers have formed services to give care providers support in digital transformation, such as Digital Social Care, to facilitate the sharing of best practice and provide guidance on technology adoption and cybersecurity.
What will the next 20 years bring?
Looking to the future, the anticipation and excitement surrounding the use of artificial intelligence (AI) in social care is palpable. Many care providers are already experimenting with AI-generated care plans. AI has the potential to enhance communication with individuals receiving care, particularly those who are neurodivergent or non-verbal. The combination of AI and voice-activated devices can increase their engagement and independence.
AI holds the promise of further reducing time spent on non-value-added work, allowing more time for meaningful interactions and people looking out for one another. As an eternal optimist, I believe that AI can make us more human.
But AI isn’t the only new technology that may deliver benefits. Albeit less exciting, widespread implementation of interoperability could enable a cocktail of benefits – both for people and their families, enabling them to self-manage by using a multitude of devices in combination with on-demand care, resulting in the optimisation of health and social care systems. The co-ordination of an empowered social care system that works alongside NHS acute and primary care in the management of long-term conditions in the community to deliver a more holistic version of virtual wards is the best shot we have as a country to provide adequate care for our population as it ages.
Social care has defied its reputation as a slow adopter of technology and achieved remarkable digital transformation in a relatively short period. The sector’s collaboration, focus on person-centred care, and adoption of digital tools across the board have led to significant improvements in safety, care delivery and outcomes.
The future looks promising, with the potential for AI to further enhance communication, accessibility, and personalised care in social care settings. But what’s exciting is that a digitally enabled social care sector is now ready to play a bigger role in the national context. And from my regular interactions with social care providers I get a sense we are ready to stand up, collaborate and help the NHS find the way to sustainability and large-scale delivery of person-centred, integrated care which the sector does so well every day.