Are health and social services benefiting from the Scottish Government’s digital plans?
The Scottish government recently announced an additional £ 384million to improve broadband access in rural areas. While this announcement is welcome, it raises the question of how this investment in digital infrastructure will be used to improve public services, the most urgent of which: the integration of health care and social services?
Access to high quality broadband offers citizens many benefits. But that does not directly support the Scottish Government’s longstanding goal of helping people stay in their own communities for as long as possible.
This requires much closer collaboration between the health and social services communities. And that requires additional investment, at the national level, to build on the underlying broadband infrastructure to facilitate better trust and collaboration.
The provision of social care covers all three sectors of the economy. Those involved range from minimum wage gig workers to CEOs of big companies that run a chain of care homes, and everything in between. It includes the 22% of the population who regularly volunteer as well as tens of thousands of individual caregivers.
Interestingly, Derek Feeley’s recent report on health care and social services cites data from the Inspectorate of Care which indicates that when it comes to community services, quality is usually the highest. high among third sector providers.
The links between these various people and organizations and the NHS often run through councils, which have a legal duty of care for certain services, and which usually fund local voluntary organizations.
A mechanism is needed to enable these various people and organizations to work together effectively to meet the needs of citizens in an efficient and cost-effective manner. Such collaboration requires the sharing of data which is often sensitive and must be properly protected.
Interlude: On Married…
Mary, 88, had her hip replaced earlier this week. Her surgeon was brilliant and everything was very smooth – NHS staff called it a ‘care journey’. She feels a little stiff, but a lot better. She is ready to go home and eagerly awaits a cup of tea and her own bed. But there seems to be a problem, the nurse keeps talking about her “care needs” when she gets home. She seems to have fallen off the path, and she’s not sure why.
Why is Mary’s release being delayed?
There is no formal, digital journey out of the hospital that “connects the dots” – connecting all the resources available to meet Mary’s needs. The reasons for this include:
- Different organizations using different systems, all protected by their own firewalls.
- Health and social care providers do not have a common vocabulary to describe Mary’s needs.
- There is no way available to keep Mary’s data confidential, securely providing only the minimum information required to allow Mary’s discharge.
- Huge, often confusing bodies of laws and regulations on how Mary’s information can be shared.
- When data is shared, it involves lengthy discussions, with months or years passed, to produce paper-based data sharing agreements.
Interlude: Following In regards to Married…
A young “gig” economy home care worker lives on Mary Street. She knows Mary very well and would love to work a few extra hours so close to her home to provide her with the legal care she needs – especially since she is not paid for all the trips she makes on a regular basis. through the city.
The Council contractor has time to make the necessary changes to Mary’s house, but needs her security code to do so. And, since Mary is malnourished, Food Train has a volunteer in the area who could help her eat well when she gets home and can continue to monitor and record her condition.
But the hospital discharge team don’t know. Finding out requires filling out paper forms and passing them to the Council, numerous phone calls and emails, and the net result is that Mary spends another week in the hospital. And when she does finally get home, not everything has necessarily been coordinated and set up for her.
She is fortunate enough to have a son to make her a cup of tea – and to spend an additional two weeks dealing with social and other services, to allow her mother to live as well and safely as possible at home. House.
How can this situation Be improved?
First, the situation must be recognized as an overall system failure in many organizations as they attempt to manage modern, legal, technical and ethical requirements in increasingly complex networks of organizations and people.
There is a collective failure to meet Mary’s needs, as they all try to use the tools that have worked in the past: relationships, meetings, pen and paper, spreadsheets, email, and siled data stores.
In the context of different technical and clinical languages, cultures, and funding obligations among providers, it is just too painful to effectively meet Mary’s needs.
Health and social: it takes two to dance
Focus on pan-agency trust frameworks where there are agreed rules, roles, eligibilities, standards and definitions.
This will help rebuild working relationships based on a shared record approach that protects privacy, verifiable, automatable and immutable to make it easier for all stakeholders to understand and trust each other.
Investing in broadband facilitates such trust frameworks, but falls short of providing all the necessary tools. Wouldn’t you like to organize the provision of social care through the commercial tools that were built on broadband infrastructure, such as Facebook or TikTok?
Governments should invest in their own tools that sit on top of broadband infrastructure, at the national level, to facilitate decentralized, confidentiality-preserving data registries that can be shared by organizations across all three sectors of the economy. .
It’s not a tango, it’s a strip-the-willow. A “caller” is required to agree to the rules to enable all dancers to express their personal personalities and to provide, collectively and effectively, the services necessary to meet Mary’s needs.
What would look like though?
Supporting alternative approaches to health and care service delivery such as:
Data sources are growing rapidly with the increase of IoT, wearable devices, activity detection, cameras, biometric and personal health monitoring devices, sensors for door opening or l occupancy of the room and environmental sensors. All of these provide valuable information on the health and well-being of people living independently with illness or support needs.
Provide GPs with a dashboard to easily access alternative approaches to support the mental and physical well-being of their patients, effectively tackling common issues such as mental health, obesity and diabetes with local “non-medicalized” solutions.
Addressing key pinch points in the NHS
For example, providing hospital discharge units with access to relevant services, from organizations across the three sectors, which can support a reduction in delayed discharge from hospital.
Intelligence and data analysis
These are increasingly important elements of future care and social protection systems. The ability to securely capture, store, manage and analyze data from multiple sources will improve standards of care, preventative actions, and automated communications when issues are detected. Patterns across a large population can be correlated, to give early warning of problems such as epidemics. This is much more difficult to achieve in “closed” and fragmented systems.
About the authors:
Experienced entrepreneur and founding president of SICCAR. Prior to that, he helped found CodeClan, Scotland’s award-winning Digital Skills Academy.
He led a project in 2020 on how to better involve the third sector to reduce delayed hospital discharges. Find out more on this subject: A national care service, equal to the NHS, free at the point of delivery?
Founder and CEO of The Safe Shores Group which integrates Communicare247 and Safe Shores Monitoring.
Tom is a qualified Electronics and Communications Engineer with a rich and varied career including as a Communications and Electronic Warfare Specialist in the Royal Navy, Ground Station Manager for the Defense Research Agency – Sector (on the European Space Agency project ERS-1) and as operations manager for a major BT service center during the analog-to-digital phase of the mobile phone industry.
In 1998, he founded Safe Shores Monitoring, providing location-based digital security systems for healthcare workers. It now supports employer due diligence for over 20,000 employees in 150 UK organizations. In 2016, Tom launched Communicare247 to support the community of telecare service providers in the analog-to-digital transition and to share telecare data and information with other health and social care services. He is currently engaged with consumer groups and key stakeholders in the public and private sectors.
Laura is responsible for delivery for BJSS in Scotland, where she has grown the team to over 120 people, and is responsible for delivery for several clients, from our offices in Glasgow, Edinburgh and Aberdeen. Laura has primarily worked in IT consulting firms for over 20 years, supporting change and digital transformation. She started her career as a software tester and has held various positions since, including Head of Testing, Head of Governance and Delivery Director, before joining BJSS in 2018, to lead the team in Scotland.
For over 25 years Julian has been fascinated by computers, and in particular information technology and how it can help anyone in society. This has led the public sector to face technical, managerial and leadership roles in very small and very large organizations, all providing enhanced services underpinned by technology. Today that passion is strongly focused on user-centric digital transformation in government services in Scotland in an efficient, ethical and innovative way in his role as Executive Account Manager for Sopra Steria.