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The Role of Digital Social Care in Integration and Innovation

By Rafael Bengoa Chair of the ADASS TSA Commission and Co-Director of The Institute for Health & Strategy in Bilbao

Download the ADASS TSA Commission report on integrating technology into social care here.

In the next 25 years, the number of people aged 85 and over in the UK will almost double. This is great news – we are all living longer. But better life expectancy doesn’t necessarily mean better healthy life expectancy.

As our ageing population expands, the number of individuals who have co-morbidities also rises, as does the Old Age Dependency Ratio and the cost of healthcare.

With the best will in the world, the NHS can only influence a slim proportion of health and wellbeing outcomes. We know a broad mix of factors impact health and wellbeing, from lifestyles and behaviours to neighbourhood environment and social influences. That’s why strong, focused partnerships between local authorities, local communities and local health systems are more important than ever.

Having worked with health systems all over Europe, I’ve seen the UK lead the way in the development of these place-based care partnerships. Over the past five years, sustainability and transformation partnerships (STPs) have evolved, becoming integrated care systems (ICSs) and the recent health and social care white paper now seeks to formalise these collaborative arrangements within a legal framework, creating ICSs in every part of the country.

People often think that integration in health and social care is about pooling money and structures, but evidence shows this isn’t solely what makes place-based services succeed. Effective integration is also about galvanising local leaders, organisations, systems and their workforces around a common cause, focusing on improving key outcomes for the local population – and the individuals, families and carers within it.

I believe the UK’s drive to set up integrated care systems across England is a major opportunity for social care and technology. One of the defining features of our time is the volume of digital systems and data sets available that could help us better understand the health needs of populations and individuals.

Gathered and interpreted in the right way, this information can enable services to become more preventative, so people remain healthier for longer. Where people already have health and care needs, technology and data can mitigate some of the risks, giving individuals more control, choice and confidence so they can live the life they want, in the place they call home.

Despite these benefits, digital social care is not commonplace in England, nor in fact across the UK. Some forward-thinking care providers have woven technology and data into their day-to-day delivery, but most have not. Digital is still an add-on in many parts of the country, attached to a care service rather than central to its development and operation.

Since October 2020, I’ve been chairing a Commission to tackle this issue. I believe passionately that mainstreaming technology in social care can help to integrate it more successfully with health, housing and other support services, aligning practices and joining up services to better plan and distribute resources based on population health and care needs.

Our Commission, set up by the Association of Directors of Adult Social Services (ADASS) and the TEC Services Association (TSA) launched its final report in March. One of our recommendations is the creation of a ‘Personalised Care Innovation Programme’, with stage one of development involving work with people and care practitioners to capture the most effective proactive services and technologies. Running in parallel, stage two would pursue a ‘top-down’ approach, using regional data to confirm priority needs and determine how support organisations will embed digital technologies into their care practices.

An assessment of these local initiatives will help to develop a business case for stage three, the creation of a two-year programme of 10 social care innovation projects. Stage four will see national deployment of all learnings.

But it is only the work in those early stages - implementing and evaluating local services - that will enable proof of impact and cost-effectiveness to come through. This evidence and the business case it helps to form, will give technology suppliers strategic direction so they can develop digital solutions that add the most value to social services in the future.

Such a business case would be of real value in Europe where 20% of funds under the European Council’s Recovery and Resilience Facility have been made available for the transition from analogue to digital. My concern is that in Europe, development of the next generation of technologies may happen in a policy vacuum. Unlike England, many EU countries have no social care or health plan so manufacturers cannot position themselves strategically.

This all points to the value of the Government in England funding a programme that evidences the benefits of technology in social care. The resulting business case will not only inform technological developments but ensure the strategies of integrated care systems consider digital social care provision as well as digital health provision.

>> Download the ADASS TSA Commission report on integrating technology into social care here.

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