Digital, technology and care are three words that have become well acquainted over the past few years. We’ve watched the trio’s relationship blossom, develop and become part of our everyday lingo. The Government’s digital aspirations in People at the Heart of Care and Joined up Care: People, Places and Populations reinforce this relationship. The ambitions recognise the value that technology can bring to enhancing the quality of care through integration of health and social care systems, increased skills in the workforce, improved connectivity and the role of technology in prevention. The vision is built on the pandemic’s acceleration of digitisation in the sector and shows that technology will be integral to the future of care.
Some days we might feel part of this digital/technology/care relationship and on other days we feel like passive observers reading about them in a kiss-and-tell story. The journey to ‘be’ digital can feel a daunting voyage to embark on. Knowing where to start and how to navigate an ever-growing sea of new technology can feel overwhelming. Add to this a tide of wavering confidence that the solution is right for your organisation, staff and, at the heart, the people who you support. By taking a step back and boiling technology down to its very essence we can make the journey about three simple themes: people, problem solving and positive outcomes. Technology is anything that is an extension of the human body, it is just a ‘thing’ we use to do something or change something. Starting with people, understanding the problems and challenges they face will provide the solid foundation and direction to understand how technology can provide solutions to overcome them. This paves the way for a confident journey to digital transformation using technology that is fit-for-purpose and effective.
A Northstar guiding the way
Digital Social Care and the Care Software Provider Association (CASPA) have produced a northstar for digital transformation. The aim is to ensure that digital transformation leads to the joining up of health and care and, crucially, that this results in positive outcomes for those in receipt of care and their support teams. This is not only pertinent to Government ambition but instils confidence in a model of supplier and provider working towards the same outcomes. The northstar’s 5 principles provide a solid foundation for systems that are rolled out to the sector and emphasise that people should be at the centre of the design. My word count is not big enough to expand on all 5 principles (I recommend you head over to CASPA or Digital Social Care’s websites to see the full document) but I will be focusing on the northstar’s golden thread of people and co-design.
Principle one calls for people to be at the heart of systems and processes. It reinforces those systems that are designed around people in receipt of care and the staff teams result in decisions that lead to better outcomes. So, how does this look in practice?
Monumental changes are happening in the world of connected digital health and social care information. Person Centred Software and Nourish have recently announced the news that Registered Managers and non-clinical staff can use their GP Connect integration to access a filtered HTML view of information held on GP systems. Previously access to this information was only available to authorised clinical staff. This access opens up the sharing and viewing of appointment information, GP records, medical notes and data between systems in real-time. The journey to reach this point involved a number of key players including the Digitising Social Care programme (part of a joint Department of Health and Social Care and NHS England and Improvement unit within the NHS Transformation Directorate), the needs of providers andsoftware suppliers.
Woven into the journey to reach this point is the benefits to the person in receipt of care. Widening access to this information places it in the hands of the people who deliver that care. People who can now be more responsive, can avoid duplication and can provide safer care with up-to-date health information. This is a common goal for software providers on the Assured Provider List, hosted on Digital Social Care. Currently, 7 suppliers have met the requirements for assurance and, alongside the 2 aforementioned systems, CareVision, Eclipse by OLM, iPlanit by Aspirico, Care Control Systems and Pass by EveryLIFE strive to develop their solutions to meet the diverse needs of social care providers.
Following the golden thread
A closer look at examples across the sector provide us with a valuable source of lessons learned and best practice. The recent “Bringing people along with you” masterclass, delivered by Digital Social Care, showcased Making Space’s inclusive digital strategy titled Project Shine. Rachel Peacock, the CEO of Making Space, detailed how people are at the centre of this change. This elevates the strategy beyond staff and the people they support being informed of changes, creating instead a culture of designing together. This is framed around outcomes that are closely aligned with the person-centred values of the organisation. Technology is not handled by an inner circle of experts, opportunities are there for exploration, testing and reviewing with those who will use it and benefit from it most.
Flashback to the hazy days of 2020/21, the National Care Forum received funding from the NHS Digital Pathfinders Programme to demystify technology in care. The result was the Hubble Project: a dive into 3 different provider tech journeys. These were developed into a suite of resources including toolkits and service recipes that are aimed at supporting providers. The Hubble Project is a wealth of lessons learned from Parkhaven Trust, Johnnie Johnson Housing and Elizabeth Finn Homes. Resources can be accessed on the Digital Social Care website.
Parkhaven Trust’s tech-enabled care journey details the transformation at The Beeches, a residential and nursing service for 45 people with dementia in Merseyside. Parkhaven embedded the end user into their approach by including staff on the project team as they are integral to co-designing the right solution. Collectively they designed and integrated a holistic tech ‘ecosystem’ that makes a positive difference to residents and the staff team. The culture, again, is a shift away from technology being imposed.
One of Parkhaven’s aims was to remove night staff’s regular physical checks that disturbed residents’ sleep. The physical checks served the purpose of keeping residents safe but the method was detrimental. The method also limited the opportunity for preventing falls as the night staff could not be everywhere at once. The solution needed to be non-intrusive and alert staff to issues so that they could support residents when the person required it.
Acoustic Monitoring was the solution of choice. It uses sensors to monitor sound and when the sensor detects audio that suggests a person is having difficulty it sends an alert. The system, by CLB and supplied by Adaptive IT Solutions, gave the night team the alert they needed to respond appropriately. In addition to this a circadian lighting system from Whitecroft Lighting was installed. Circadian lighting helps people to regulate their sleep pattern by adjusting the colour and intensity of a light source to ‘mimic’ the natural cycle of day and night.
So, what difference has this made? Parkhaven Trust reported that by having a good night’s sleep the residents are more active during the day. This positively impacted on the motivation to participate in activities and residents had an increased appetite which in turn helps with absorption and effectiveness of medication.
Their ‘ecosystem’ was completed with a digital care management system supplied by Person Centred Software. The demand to reduce paperwork to free up time to provide quality support was balanced with the need for accurate and live care information. A digital care management system unlocks the power of data. This data can be used to make informed decisions, recognise signs of decline or illness and capture the evidence to prove the effectiveness of the ecosystem.
Shaping the future
The future of digital care must be shaped by the people who are directly impacted by it. As social care providers we should feel confident in co-design, it is engrained in the person-centred care we provide. Embedding real experience into digital design will only support a better developed solution that is embraced rather than imposed. Ultimately, this will improve our knowledge of how well current solutions meet the needs of the people at the heart of care. This knowledge will be the catalyst for more personalised and innovative technology into the future.