DigitalHealth.London NHS Navigator, Ruth Bradbury, shares her experience of working in social care as a Speech & Language Therapist and discusses how she believes digital technologies can transform the social care sector.
During my 20-year career as a Speech & Language Therapist, I have worked with the social care sector in many ways. I’ve worked with patients who were residents in care homes as well as those who received domiciliary care support in their own homes; with social workers in hospitals and in the community; with social enterprise organisations supporting older people and organisations providing training for the social care sector.
I saw and experienced systems and processes that were largely paper-based, and witnessed the resulting duplication of patient information and siloing of clinical records. Communication between health and social care teams was often poor with communication technologies used by health teams progressing quicker than those used by social care teams e.g. electronic health records, the move from fax to email, landline phones to mobiles. As a clinician, this led to working practices that were inefficient, frustrating and created patient safety risks.
The potential of digital
In contrast to my clinical experience, in my current role as an NHS Navigator for DigitalHealth.London I have been fortunate to be able to gain a deeper understanding of how digital technologies can transform the social care sector.
I have worked with innovative digital health entrepreneurs who have the vision and creativity to transform how social care providers deliver care. Two examples of this are Birdie, who enable domiciliary care providers to digitise their care management systems and use AI and home sensor data to model predictive care needs and facilitate a proactive approach to care. And Feebris, who have developed a remote monitoring platform using point of care devices and AI to enable care homes to provide remote monitoring data for GPs which enables more accurate clinical triage and diagnosis. With digital systems like these in use, care staff can be upskilled to work more closely with clinicians in Primary and Community care, providing a more coordinated approach to care with a focus on partnership which is especially critical when working with COVID-19 restrictions.
I have also seen how NHS Digital and their Digital Social Care initiative in partnership with the Care provider Alliance, has delivered a new sector-led service offering digital support for social care providers. Programmes enabling providers to complete the Data Security Protection Toolkit (DSPT) and use NHS Mail to connect to their local health teams, assess the digital readiness of teams and support with understanding software and hardware that enable digital care delivery, are testament to the commitment to create a better digital infrastructure for social care. Organisations like Healthy London Partnership and the Health Innovation Network AHSN are also supporting these programmes regionally and locally through initiatives such as the Enhanced Health in Care Homes project.
I have been able to explore opportunities for clinical social care data to be integrated with Local Care Records. For example, in Bristol, North Somerset and South Gloucestershire, the Connecting Care Programme, a digital record system for sharing information, is piloting how non-NHS data from hospices, charities, care homes etc, can integrate with the platform and what data is needed at an individual patient level vs a population health level. As a direct result of COVID-19 pandemic, I have heard from Social Care teams are now working in greater partnership with healthcare teams for example to complement community district nursing services where they are under pressure or unable to visit patients as often as usual. This means it is becoming increasingly vital that clinical data can be shared.
The drivers of change
For social care providers, a digital transformation journey is often a long and complex one, however the COVID-19 pandemic has spotlighted the benefits and accelerated the implementation of digital opportunities.
During the pandemic, I have seen digital care management technologies support the need to provide remote working solutions for management teams providing them with the immediate access they need to care records in order to respond to queries and concerns. I have also observed how the sharing of clinical records, either through proxy access or use of NHS Mail, enable care staff to monitor and deliver the care usually delivered by others, helping to limit clinical visits and social contact.
It’s clear that remote monitoring can reduce the burden on Primary and Secondary care, upskill care staff and promote better multidisciplinary working. All of these outcomes directly impact on improving the quality of care given to the patient.
There have also been developments in the regulatory compliance requirements for digital systems. In April 2020, in response to the emerging COVID-19 pandemic, NHSX released guidance supporting a relaxation of the DSPT compliance requirements and Information Governance rules for social care so that providers could set up and use digital systems like NHS Mail quicker. In September 2020, the CQC published guidance on what good standards for digital care look like in an effort to standardise future practice.
Looking to the future
The future of digital transformation in social care is full of promise and the enablers of the change are aligning from the perspectives of the regulators, the social care providers and the technology suppliers. Digital solutions are becoming more accessible and relevant in the wake of the COVID-19 pandemic, regulatory bodies are streamlining processes supporting digital uptake and health and care providers are working in more integrated ways.
However, we must not lose sight of the fact that there is still huge variation in the digital maturity and digital infrastructure for social care across the UK and within a regional and local area. There is variation in how well systems are joined together, in who takes the lead when working across integrated teams and in ensuring representation from social care providers who don’t sit under one single organisation as health care providers do a local NHS system.
Now is the time to learn from best practice and share case studies and evidence, to work innovatively with digital health suppliers who have solutions to the problems. It’s time to embrace new ideas and new ways of working and offer education and support to enable the social care workforce to be partners of health and care delivery.