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.”
22 April 2021 @ 20:50
I’d like to ask what the problems are in this area to which ‘digital solutions’ are the solution. You cannot get a solution to any problem – digital or otherwise – unless you define the problem(s) involved. ‘Not enough digitalisation’ is NOT the problem.
I find the references to ‘digital’ must come from someone who does not understand the clinical problem(s) with the social care system; ‘digital leadership’, ‘transformation’ etc etc. are buzzwords, not solutions.
22 April 2021 @ 17:54
Social Care has problems with:
Levers and funding – progress is made in funded pilots, but it is not easy to lever change through standards and funding, when social care is massively distributed (especially its governance) and underfunded.
Business Case
Digital tends to be good at handling small, crucial information, better than large care information (more like Facebook than banks and data). So social care business cases can be bitty and non-existent. All too often social workers rightly complain at wasting time feeding a beast (where is voice input etc.)
It has been wonderful to see PRSB work on the About Me standard, which highlights the difference in type of information and seems to share philosophy with personalisation.
Levels
Social care, like health, works at many levels of expertise, but tends to concentrate where digital expertise is lower. Health and care information all requires the highest level of digital security and care.
It is noteworthy that NHS Digital has been moderately successful at tying private care homes into the NHS email network.
Interfaces
With People/carers themselves (at the heart of care) and sometimes less digitally able.
Between public and private; commissioner and provider; social and health.
Interfaces are frequently where things can go badly wrong for care.
These key interfaces rely on some commonality, which can be lacking – so the King’s Fund do well to indicate Integrated Care work as a driver. This work needs to be adept at dealing with the different levels – both of information and capability (and not just making big data assumptions).
17 April 2021 @ 20:50
resource i.e. people and money, need to be shifted out of our NHS Hospitals and into our community, some NHS hospital management may disgaree, I am happy to discuss anytime… the “time to change” is NOW !