A “lack of clear responsibility” and leadership for digital technology in the NHS has led to a “social care gap” which risks the sector getting left behind, a report has found.

The King’s Fund report discovered there was a “clear deficit” of evidence on how digital technology is being used within social care compared to the wider healthcare system, and called for greater investment to close the gap.

It attributed the shortfall to “often reshuffled” national leadership with a “lack of clear responsibility in many aspects of implementation or strategy-setting”.

The ‘Shaping the future of digital technology in health and social care’ report provides a summary of evidence for technologies including artificial intelligence, wearables and internet of things. It drew from available evidence on the impact of these technologies and interviews with experts in applying them.

It revealed a clear divide between the digital maturity of NHS providers’ and social care systems.

While there have been several government initiatives focused on generating ideas and pilots within the social care sector, “explicit” investment and support would be necessary to ensure the adoption and scale of digital technology.

“The gap between NHS providers’ digital maturity and that of the social care system appears large, even accounting for the substantial difference in technology use between NHS providers,” it said.

“Social care is being left behind health care with regards to the quality and level of evidence available to support the spread and implementation of new digital tools within the sector. Without more support, it is likely to be left even further behind.”

The Kings Fund called for “dramatically” increased investment in digital social care solutions and research to support better outcomes using technology.

Who is responsible?

While there have been “eye-catching” commitments to improve health and care technology – the report notes the National Programme for IT and paperless NHS initiative – there is a “notable absence” of similar commitments in social care.

A similar issue was found more broadly, with inconsistent leadership resulting in confusion over who is responsible for driving the use of digital technologies.

Highlighting the secretary of state’s technology vision, the report found there were a number of initiatives to support more consistent implementation of technology such as open standards and the provision of high-quality infrastructure.

But the ambitions “have not been met by consistent leadership across the national NHS bodies”. Recent reports have suggested NHSX is set to merge with NHS England to form a new “transformation directorate” which would further disrupt the travel of digital leadership.

Through their interviews, Kings Fund researchers found national leaders were expected to make a wide range of decisions around the development of digital technology, but there was uncertainty around who was responsible for implementation and evaluation.

It also found a “confused picture” over who was responsible for distribution of funding and investment priorities but added the establishment of Integrated Care Systems (ICS) may “bridge organisational divides”.

“Priority messaging must be matched with investment of time, attention to detail and delivered funding commitments,” it recommended.

“Funding must be aligned with expectations set from the centre, must be sufficient, will need to address historic under-investment and once committed should be delivered to the front line with pace across all forms of care, not just the hospital sector.”