Health and social care are taking a new direction with an effort to lighten the load on hospitals and transfer more care into communities. Much of it is about people caring for themselves better at home and preventing the conditions or accidents that lead them into hospital wards.
Officials in both sectors appear to be broadly in favour of the change. There was a general agreement on this at UKAuthority’s recent Digital Health and Social Care event, and an eagerness to explore the practicalities and possible solutions to the difficulties involved.
Some of the priorities reflect trends throughout the public sector: make more of mobile technology to ensure health and care workers can spend more time in communities; and step up data sharing between organisations to enable a closer integration of care. There are still anxieties over the latter due to worries about data protection, but any organisation that fully understands the relevant laws will know it is possible to do so with the right safeguards in place.
There is also a rising intent to increase the use of assistive technology. The development of the internet of things is increasing its potential as sensors, alarms and other devices are becoming more sophisticated and less expensive.
Assistive tech can take on new capabilities with emerging technologies such as augmented and virtual reality, robotics and artificial intelligence. The latter in particular is creating a stir, with a small but growing number of projects that use voice activated technology or robots to support people in their homes. There is a growing appreciation that the technologies can be used for some of the more mundane tasks currently handled by human carers and give them more scope for the complex and emotionally testing elements of their jobs.
But discussions at the conference also made clear there is a high awareness of the ethical challenges involved, and questions about how the public react to new technologies.
Organisations are understandably cautious about the use of patient data, with people quick to refer to the breakdown of the care data programme two years ago.
As the use of AI increases there are questions about limits of algorithms making decisions. It will be hard to overcome the perception of an AI system lacking emotional intelligence; and even though it would likely be used to augment rather than replace human decision-making, it could still tread into a minefield when applied to social care.
The prospect of robot carers is prompting organisations to ask if people will be comfortable with non-human companions. Some see positive signs in the rapid rise of Amazon Alexa and there have been reports of people reacting well to robots in trials, but it becomes more complex when there are issues of safeguards and the person’s mental capacity. Also, any sign of it undermining the care recipient’s sense of control could be a cause of alarm.
One argument that could overcome these concerns is that technology is most effective when it facilitates contact between people, and that organisations will have to find what works best for specific groups or individuals.
Nobody claims that dealing with these ethical issues will be a clear cut process, but there was a sense that they should not be an excuse for retreating from the potential.
Then comes the perception of risk. It was pointed out that officials often support the broad idea of progress with technology then stand in the way of individual changes because of fears of what could go wrong. Perhaps the strongest argument to overcome this is that, with changing demographics and financial pressures stretching services to the limit, there is a larger risk in not moving forward.
The future is full of complexities and potential pitfalls, but there was generally a positive mood at the event and a sense that it reflects the broader outlook in health and social care.
James Palmer, programme head of social care at NHS Digital, predicted that by 2021 there will be a step change within the care sector on attitudes to digitisation. Leaders and employees will have a much clearer understanding of the return on investment, in financial and societal terms, and an established framework of benefits.
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You can read the full briefing note here.
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