Talking about a revolution: technology and social care

Recently I have been giving some thought to technology. This is not my natural state, as people who know me will testify, as I am a self-diagnosed ‘late adopter’.

But talk of technology in health and care is all around us at present, so it is becoming increasingly hard for me to ignore. For example, one of the Grand Challenges in the Government’s Industrial Strategy is focused on responding to the needs of an ageing society, which it is said, will create “new demands for technologies, products and services, including new care technologies”.

Jeremy Hunt, the long serving Secretary of State at the Department of Health and Social Care, when outlining his seven key principles for reforming social care ahead of the now delayed Green Paper heralded “the potentially transformative role of new technology”. His successor, Matt Hancock, appears even more of an enthusiast, coming as he does with prior experience of championing digital technology in other Government departments. He has announced that technology is his second priority for health and social care, coming only second to the workforce. In his words “let this be clear: tech transformation is coming.”

So what’s my problem I hear you ask? Well it goes something like this. The late head of Apple Corporation, Steve Jobs, is quoted as saying “"We think the Mac will sell zillions, but we didn't build the Mac for anybody else. We built it for ourselves. We were the group of people who were going to judge whether it was great or not. We weren't going to go out and do market research. We just wanted to build the best thing we could build.”  

At one basic level who can argue with this approach, given that Apple is the first trillion dollar company?  If you ‘build it they will come’ (to badly paraphrase Kevin Coster’s words in the film Field of Dreams) has clearly been a fantastically successful business model in the Apple world of mobile devices. So why should social care be any different?

Earlier this year, TLAP’s Care Markets and Quality Forum spent time hearing about how technology is being used to improve how services are delivered in different settings: home care, nursing home and in sheltered housing.  In the table discussions that followed a number of themes stood out to me, which I have subsequently reflected on. Firstly, it is undoubtedly the case that technology can and does improve the lives of people, whether through the use of generally available consumer products such as I-Pads and the like or through particular care technologies. However, technology in a care and support context is not it seems to me a panacea. It needs to be thought through, as it requires investment in time and money. I would pose the question is there a tendency for ‘optimism bias’? That is, the ease of implementation and benefits can often be overstated and insufficient attention paid to what I would term ‘intelligent application’, whether that is preparing the workforce for its use or understanding how a particular development fits with the overall service or setting. It is also important to be aware of the law of ‘unintended consequence’. For example, that technological innovation is seen primarily as a way of reducing cost. Above all, what stood out from the discussions to me was a clear and unequivocal view that technology must be used purposively to assist and not replace personalised care and support.  As we all know good care and support is founded on positive relationships. Technology can play a significant part in improving efficiency, safety and enable people to do things they want and need more easily, but it cannot replace the value of relationships intrinsic to the provision of good personalised care and support. People also need to know what is available so that they can make well informed choices on what technology can do for them, rather than what it can do for the ‘system’. It might also be a good idea to encourage designers and developers to involve the people they see as customers in the early stage of design. Co-production leading to co-design perhaps?  

TLAP is currently working on behalf of ADASS to collect stories from people with lived experience on how technology is making a positive difference to their lives. I anticipate that this will bring a welcome fresh and informed perspective to the current buzz around technology enabled care.