The technology-led opportunity for fundamental change in care delivery
Linking back to the work Agilisys did with NHSX and some of the technology solutions that we looked at from providers across the UK, it’s clear technology can play a big part in the future of social care.
Here’s a selection of the tangible ideas that can make a big difference.
Data is central to success
The Agilisys Helping Hands solution fixes one part of the problem. Roughly 2 million of the most at risk people across the UK who needed to shield based on age and co-morbidities, who needed some special care and attention if they were to survive the pandemic. What was painfully obvious was how the existing data distributed across health and local authorities had significant quality issues and a lack of cohesive integration between health and social care services.
Helping Hands digitised the front door to care allowing services to cleanse the information to a point where it supports the demand for care delivery to the at-risk cohort.
Helping Hands Explained…
Helping Hands is a software solution initially designed to enable local government to contact and register the support needs of citizens shielding during Covid-19. It rapidly grew across seven Councils in Scotland and four in England to help authorities engage and maintain contact with approximately 300,000 citizens in just six-weeks from initial deployment.
Councils soon realised that the solution could also accommodate vulnerable and other citizens, where each individual authority had identified the possible need to provide rapid contact and intervention tracking (either inbound or outbound). Interventions such as pharmacy pick-up, food parcel delivery, emergency food requests, financial support needs and potential domestic abuse cases were all included in the questionnaire set by the councils.
Effectively, Helping Hands became a triage contact register, where after initial contact had been made, councils could quickly issue requests for a range of service interventions from appropriate internal specialists/SMEs and external providers, including from the third sector.
Management data could be monitored and reported in real-time, to aid in identifying resource needs promptly and effectively. The solution also accepted auto data-loading from NHS Shielding lists, which were provided on a regular basis.
Despite the cessation of NHS Shielding, several councils are seeking to continue with the solution and possibly expand its scope into a wider number of business and service lines.
Volunteers have a huge role play to – especially when connected by technology
The original request for 50,000 volunteers to come forward led to 750,000 people offering their time to complete well over half a million tasks in support of at-risk groups and those in need of care across the UK.
That was extremely useful, and while volunteer numbers will reduce as lockdown is relaxed and furlough schemes come to an end, it’s estimated that 500,000 people across the UK who are registered as volunteers, will be networked and connected via technology. That means tasks can be communicated to the right people with the right skills in a very short space of time and reduces the strain on traditional methods of social care delivery.
Video technology will remain at the fore
A lot of the technology we looked at with NHSX were remote care products, including the ability to have video calls with somebody to reduce the feelings of isolation.
Remote healthcare usage surged during Covid-19 – at the middle of July 2020, over 50% of medical consultations by GPs were performed via video, rather than face-to-face. This must be continued.
Every one of the 307 million GP appointments each year costs around £30 when you include all costs such as property, heating, lighting, security and so on. If clinical appointments are carried out by a GP remotely via video, the number of appointments can increase – you can conduct 10 or so video consultations an hour as opposed to four or maybe five physical ones. The cost of delivering primary care in the UK drops substantially, which is something that we must do if we’re going to find a way through the budgetary challenge.
Care at home will be increasingly displaced by technology
By deploying technology across people’s homes and linking it with the digitised front door, which is Helping Hands, we can displace a large proportion of attended care at home. The use of sensors like oximeters or door contact sensors that trigger an exception when dementia sufferers open doors at unexpected times, can reduce the number of home visits dramatically.
If we displace just 50% of attended care, a local authority with a cohort of 2,500 people in care would save roughly £10m a year. That’s a very conservative estimate. By using technology and our knowledge of the sector, there are some very large savings to be made, while improving the quality of service delivered.
‘Pseudo care plans’ will be adopted to ease the pressure on the creaking care system
Coming back to volunteers, within Helping Hands we can develop a pseudo care plan that can tag and register not only volunteers, but family members, third sector organisations and charitable groups, who can be brought in to help when an exception is triggered. Each of those can determine what type of care are they going to provide, which could be doing some shopping, calling in and simply making sure people are eating, collecting repeat prescriptions or providing transport.
Within Helping Hands we can detail how, Ann Smith, for example, needs to go to the shops on Thursday afternoon; cook dinner for that evening and take her regular prescribed pharma. Her sister, Jean has registered to provide the transport and the shopping assistance as part of the pseudo virtual care plan. A neighbour has volunteered to cook meals for Ann and a local third sector organisation has arranged a rota service for medicinal care. We’re creating a support bubble around Ann and all other at-risk individuals – but it’s a bubble that could consist of 10,000 volunteers or organisations that bring different skills to the table, in addition to any formal care that would still be required.
Key to delivering the bubble is the digitised front door and capturing all members of the bubble, the service they will deliver and how that service is scheduled, all of which is available today within Helping Hands.
Substantial amounts of central funding will be released for remote technology
Central and local government have invested heavily in care, but the current situation demands additional targeted investment in finally integrating health and social care across the UK. Even the Prime Minister has stated in interviews, more than once, that care integration is a priority and hence we fully expect funding to be released from the treasury to fix the fundamental enabling technology and data challenges which make integration impossible and can bring residential and domiciliary care into the 21st century.
As an example, in 2019, 25% of residential care homes had no connection to the Internet. As we look at enhanced technology and data solutions, in parallel there are basic technology issues that need urgent attention.
Figure 2- Integration Elements for an ICS
Integration of health and social care is more than co-locating people. If we are to see the benefits of the Care Act 2014 and make a difference in both the cost and quality of care across the UK, we need to integrate services across the full technology spectrum and also from a budgetary perspective, given that an investment with Adult Social Care within a local authority may give rise to a financial benefit elsewhere within the locality, e.g. within primary care. This, I believe was the intent of creating the locality-based integrated care organisations and integrated care systems (ICSs)
Contact centres will change forever
The well-documented changes to working habits will impact the delivery of social care. Local authority contact centres have typically been reactive, with the onus on the customer to share their challenges and instigate a response. In the post Covid-19 world, contact centre headcounts are reduced as home working takes over.
From a property perspective, we’re not going back to having consolidated groups of people in buildings. Instead, we’ll be looking at the technology offered by organisations such as 8X8 who are virtualising contact centres and delivering skills-based routing. That means you can virtually bring in people, such as mental health care workers, who are home-based. And if you want to raise an exception that’s associated with one part of provisioning or social care, you’re able to do that automatically and immediately by using the relevant technologies.
Traditional local authority contact centres who operate an ‘inbound’ contact model must now change to a proactive ‘outbound’ contact model, making video calls to citizens, verifying current situations and using the proactive support bubble and close integration with primary care (providing medical diagnosis via video consultation) in any exception event.
Early intervention using a proactive contact model will provide high levels of cost avoidance in preventing admission into acute care and better outcomes for the citizen.
Use of RPA and AI will accelerate
We are already seeing increased interest in chatbots to manage inbound demand – and we expect this to accelerate further and be supported by more complex Artificial Intelligence and Robotic Process Automation led solutions.
I think there’s a large amount of pent-up demand for council services – people have held off making requests but as the world returns to normal, they will do so. Therefore, the opportunities to signpost and manage that demand by automating it is an obvious example of how they can protect that service.
That’s vital because in ‘new’ care models as stated above, local authority resource will be required to manage more outbound contacts and hence reducing standard inbound demand will mitigate any potential resource challenge.
Case management systems will be replaced by solutions more suited to integrated care
The final piece that we have on the horizon is to do with case management systems for child and adult social care. Case management systems are complex, expensive to maintain and operate and tend not to support the integration and common access to information. The more we look at the information that is integrated into Helping Hands, the more we see how it will replace those care management systems and provide further incremental savings and benefits.