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The health service’s digital unit, NHSX, should create a data strategy for social care as part of the basic foundations needed to support reform plans, according to a report by responsible technology think tank Doteveryone.
According to the Better care in the age of automation report, technology can play an important role in the wider reforms needed to address the crisis in the UK care system, where, according to Age UK, 1.2 million people are not getting the care they need.
The report noted that the situation would worsen as a result of growing budgetary constraints, along with other factors such as restrictions on labour due to Brexit. It argued that long-term investment in better data, more relevant skills and empowered communities needed to be in place to help tackle the issues.
Recommendations around what needs to be done for any technology to be effectively deployed in social care are also included in the report, with emphasis given to solutions that don’t require high levels of investment.
“The failings of our current system are too heartbreakingly apparent. Technology, used responsibly, can be part of a solution,” said Doteveryone’s executive chair and founder, Martha Lane Fox.
While technology can help to solve parts of the social care puzzle, the report argues that it “cannot perform magic”, especially if it is used unwisely or under the guise of short-term innovation projects.
Addressing data issues in care
On the topic of data, Doteveryone argued that the care sector already does a lot of measuring, which determines a lot of outcomes in the sector, but issues around data collection need to be addressed.
A lot of time and effort is spent by care staff filling out paperwork, the report noted. It added that providers using data successfully are having to build their own digital tools and processes from scratch and beyond national requirements, but council data on care is rarely aggregated to provide useful insight.
“The greatest data challenge in social care is the amount of basic information that is simply missing,” the report said.
The national data strategy that should be delivered by NHSX for care needs to include metrics for wellbeing and productivity of users, the report noted. This would sit within a new, well-funded social care division within the digital unit.
“Building and using technology responsibly requires data that measures what matters to people, reflects the interconnectedness of services, systems and communities, and promotes decision-making for the long term,” the report noted.
Research should be conducted on care by NHSX to understand user needs and deliver value. The digital unit should also collaborate with councils, the Care Quality Commission and the Office for National Statistics to include new metrics in surveys and evaluations.
Citing health secretary Matt Hancock’s ambitions to make the UK a “world leader in data-driven healthcare”, Doteveryone pointed out that vital care metrics had been cut in recent years.
Data gaps noted in the report include the lack of centrally collected information about the amount of care hours provided in local areas in England and no data on waiting times for council-provided care.
There is also no way of knowing the total level of funding in local areas in England as the boundaries of health and social care provision don’t match up. This situation makes it “impossible” to analyse the impact of investment and cuts on services, according to Doteveryone.
“Commissioners and providers are making critical decisions about the use of technology to support social care, armed with little more than marketing hype or political pressure,” the report noted.
“With so little information on the wellbeing of communities, there is little incentive for long-term, joined up thinking that can build capacity and reduce future needs,” it added.
Building tech skills for better care
Regarding the skills required to use tech to care, the report noted that tools and systems could not deliver the expected benefits if people don’t have the capacity or skills on the front line to implement and support them.
Recommendations to the Department of Health and Social Care included the founding of a Royal College for Carers to professionalise the care workforce and deliver technology training to augment their existing skills of empathy, creativity and social intelligence.
“Technology can never replace human care professionals and the complex, relationship-based and creative nature of their work,” the report noted. “But used well, technologies can assist in mundane tasks, augment the job of caring and improve people’s lives.”
Doteveryone also noted that technology on the front line would bring more tech support and more complex decision-making, and carers would need the knowledge to do this. “A better care system will depend on having people with the skills to work with technology,” it noted.
But the think tank also warned about the risks of “widgetisation” of the workforce, whereby care jobs are sliced into tasks without accounting for the whole picture of a person’s needs.
“[Widgetisation] has drawn parallels with other safety-critical industries, including aeronautic engineering. Taken to the point of absurdity in this way, technology doesn’t serve the interests of either the staff or the people they are caring for,” the report noted.
The report also stated a better culture must be in place to empower people to use technology according to their needs.
The suggestion given by Doteveryone is that NHSX should fund “enablement panels” showcasing new care technologies working on the ground. These would be run by disabled people, carers and families to tackle issues such as ageism and favouritism to able-bodied people.
“Technologists pride themselves on disruption, but to vulnerable people, disruption – in fact, any change at all – can be frightening,” the report argued. “People must feel empowered to engage with and shape how technology is used within a sustainable social care system.”