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Digitisation of social care moving slowly, says NAO

Digital folders
Image source: Kabakov

Social care providers in England have been taking up the use of digital records more slowly than the pace desired by the Department for Health and Social Care (DHSC), according to a new government auditor’s report.

The National Audit Office (NAO) has reported on the issue in a section of its newly published review of the broad issue, Reforming adult social care in England.

It points to the DHSC plan to accelerate the adoption of digital social care records among the providers registered by the Care Quality Commission (CQC), with the level having been raised from 40% in April 2021 to 57% in October of this year. But it says that, based on provider information, the level is expected to reach only 70% by March 2024 against a target of 80%.

This has been attributed partly to the DHSC spending less than a third of its budget to improve digital infrastructure over 2022-23, due to a deprioritising in autumn 2022 of the work to deliver fibre broadband to care homes.

The NAO says that it is instead developing a dashboard to detail the broadband capacity of care homes and future likely dates of full fibre implementation under government programmes.

In addition, a research project is taking place to understand the connectivity barriers faced by care homes.

More underspends

The report adds that in August of this year DHSC reported that it was spending as expected in the current financial year on digitising social care and the Adult Social Care Technology Fund, but that further underspends are expected on the digital infrastructure.

The department also said it spent around two-thirds of the budget on cyber resilience.

Looking at the broader reform of adult social care, the report notes that the Government has delayed its plans to cap lifetime care costs that a person pays and scaled back plans it set out in 2021 for reforming the system.

In addition, rising inflation has compounded long standing pressures on the sector and the widespread problem of delays to discharging people from hospital has persisted.

Subsequently, more than £1 billion of the £1.7 billion committed to the reform has now been diverted to other care priorities, and only £729 million may now be spend between 2022-25, the NAO says.

As things stand, there is no long term funded plan for transforming care, which makes it difficult to assess whether the DHSC is likely to meet its objectives.

Intractable challenge

Head of the NAO Gareth Davies said: “Adult social care reform has been an intractable political challenge for decades. Government has set out its ambition to meet this challenge and now needs to demonstrate how it is delivering on these plans.

“If government is to successfully reform adult social care, it will need to manage some significant risks, including its own capacity and that of local government to resume charging reform activity alongside system reform.

“To maximise its chances of succeeding, government will need to ensure it understands the impact of its ambitions on local authorities and other stakeholders and establish a costed plan which ensures delivery of its long term goals.”

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