Even across such a broad group there was good agreement about both the challenges facing adult social care and the type of social care system people wanted to see.
There were also many examples of technology being effectively used to improve quality and ensure better choice and control, as well as generating efficiencies. These examples gave a glimpse of the potential for technology to benefit those that draw on services, carers, staff and organisations. We heard of electronic notification of people ready for discharge from hospital, digital social care records, remote monitoring and falls prevention technology, and consumer-facing technology, such as virtual assistant technology.
There was discussion of how technology had the potential to improve social care. However, it was noticeable that much of the discussion was about the potential for technology rather than its immediate usage.
What then needs to change for things to move forward more quickly? The challenges surfaced through our discussions broke down into four main areas: systems, resources and infrastructure, skills and culture, and co-production.
The key points made in relation to how systems can better use technology were the need for a more anticipatory, preventative model of care.
The mistake is to think about this as procuring pieces of technology when in fact it’s an exercise in designing the right service model in the first place.
To allow investment in a more preventative model, that encourages person centred care, participants also felt there was need for system-wide budgeting.
Sometimes, especially with tech enabled care solutions, the benefits may come elsewhere in the system.
Resources and infrastructure
In relation to resources and infrastructure, conversation focused on the need for funding, especially longer-term funding to encourage uptake of tools that show benefit.
We need to move from a mentality of piloting to a mentality of prototyping and then scaling.
An improvement in strategic management skills and expertise was also highlighted.
We are drowning in data but lacking in insight and foresight, and having the right capabilities to use the data that we have.
Local authorities struggle to make the investment in innovation working with different partners. They're not particularly trusting of the technology sector and struggle to invest the kind of capital and change management investment.
And others commented on the need to get the basic digital infrastructure on an equal footing nationally.
There are still many dark areas across the country where there’s not basic or strong wi-fi.
Skills and culture
Some participants thought skills and culture were holding back development.
Improvement in workforce skills and tackling concerns about technology are one of our biggest barriers within our services, our staff teams. There is resistance there.
As a sector we really struggle with the culture and conditions to drive this kind of innovation and change.
But others disagreed, arguing that uptake of digital social care records, for example, was related not to culture but to fee rates paid to care providers.
And there was recognition that workforce issues might stem from other deep-rooted problems.
When we have the workforce, that still hasn't been recognised for the skills it has outside of digital, how do we actually integrate digital even more.
There was also some nuance about whether the expectations and concerns of people drawing on services should be a key driver to the use of digital technologies.
We've got people now coming through into the system who've been growing up with technology. They are tech savvy, their parents are tech savvy and they're expecting that technology will be in place there.
In the main people are really enthusiastic about technology but there are real genuine concerns when it’s amplified at a system level… who owns the data, who has control.
A key issue was around co-production of solutions. This was expressed by people drawing on services.
I’d like to see co-production from beginning, from point of planning to commissioning, right to the support plan, with the personal being at the centre so you have a good life with choice and control.
And there was recognition that currently co-production was patchy.
Local authorities endeavour to work in a genuinely coproduced way, with people in receipt of support, but I think there's quite a bit of work to be done in that area.
But concern about the need to jointly developing solutions also extended to providers.
With digital social care records, providers sometimes think it has been forced upon them rather than done in a collaborative way.
And also to staff.
The most important thing is that care workers are supported by technology, not punished by it and it's developed with them as well as with people who draw on social care.
Together, this suggests that digital technologies within social care are in their infancy but have significant potential for those who draw on services, carers, staff, organisations and wider health and care systems, if they are co-developed in partnership. Adequate resourcing for digital involves not just basic infrastructure, such as wi-fi, to implement the technology but also the strategic capacity to capture and use data insights. If combined with sufficient system funding, digitally enabled social care has the potential to truly transform care around the person.
Many organisations like the King's Fund are voicing their concerns about the problems associated with IT systems and the vaste array of healthcare promoters and providers trying to establish workable solutions across ever expanding networks.
I would like to propose that my simple 6P Health Systems model could be developed into a workable framework which covers the main components of any healthcare system. Please let me know if you think this is achieveable. Thank you!