Community Care, Digital Implementation, News, Population Health, Social Care January 17, 2022

The digital journey of adult social care

By Louis Holmes

In the face of unprecedented challenge for the sector, many adult social care providers are demonstrating their ability to deliver impressive tech systems. Louis Holmes, Senior Policy Officer for Care England writes for ICJ.

Digital transformation in social care is often overlooked, particularly by those outside the health and care sector; the perception is that care providers are not as technologically mature as their healthcare colleagues. Despite funding issues, the inability to invest in tech, and not having access to the same level of resources as their healthcare counterparts; adult social care providers have demonstrated that they have the capabilities to deliver impressive tech systems, even when facing a crisis.

Outlined below are three case studies from Care England members that demonstrate innovation in the sector. For more innovation to happen however, resolving the funding of new tech must be addressed. Each study shows the benefits of the independent care sector, but the challenges faced when trying to invest in care tech.

At Care England, England’s largest and most diverse representative body for independent adult social care providers, we have seen countless case studies from our membership where there is strong evidence of digital maturity and innovation. Through our Digital Special Interest Group (DSIG), Care England members can ask digital questions or share their experiences with other group members. This space allows organisations to learn about new software, or avoid, when browsing for what is on offer. Members have found this group incredibly useful, thus demonstrating communication and engagement as necessary when discussing digital transformation.

Blackadder

Blackadder is a family-owned and operated group of nursing and residential homes in the Midlands and can brilliantly demonstrate the power of remote monitoring.

At a recent Care England event on the subject, Finance Director Michael Butcher explained that, in 2018, Blackadder set themselves the objective of being able to monitor their care data remotely. The aim of this was to reduce time and administration work when gathering paper audits, and ensure that the right data was available to the right people at the right time.

Through Nourish’s Electronic Care Management System and Power BI, Blackadder can produce hourly, daily, weekly and monthly reports, efficiently and rapidly analysing core care data points within their homes. The next stage of their digital transformation is linking their current system further remote monitoring systems and eMARs.

Integration and interoperability are essential factors care providers need to consider as they expand their digital systems. It can be the case that a provider buys several different software solutions/pieces without realising that they are not compatible with one another, resulting in barriers being created between the different systems. However, it can also be the case where a regional CCG is rolling out a programme that is not yet compatible with the provider’s current system. Thankfully, more is being done to resolve interoperability issues, but it will remain a pertinent problem as we see more technologies become available.

Hallmark Care Homes

To help avoid such instances, Care England member Hallmark Care Homes are creating a business intelligence system through Yellow Fin that collects data from several different systems used by Hallmark. Building a data lake allows Hallmark to mine important information which can then be analysed effectively by the relevant employee.

Programme Delivery Manager Saad Baig has developed a visual traffic light system through intuitive thinking, enabling head office to monitor each care home. Using a traffic light system, Hallmark can identify which homes needs immediate support and which homes are starting to edge towards becoming a concern.

Sophisticated systems such as the one being developed by Hallmark provide further freedom when it comes to choosing the right tech and enables quicker response times and delivery of care. It buys the gift of time leaving health and care workers to focus on their core role of delivering high-quality care.

Canford Healthcare

Through Microsoft 365, Amanda Rae, Quality & Compliance Manager, has created a user-friendly system that brings together several data and compliance sources, minimising burden and time spent on administration work. Amanda can link and share important tasks and documents using SharePoint, Forms, Teams, Planner, and Power Bi. It allows Canford to create the correct compliance documents that can then be shared with the Care Quality Commission (CQC).

Although it may seem daunting for providers to build a similar system from scratch, Amanda, who led the project at Canford, does not come from an IT background, demonstrating how easy it would be for any provider to build. This sort of innovation needs to be applauded and the huge innovation in ASC recognised, learned from and built on.

Adult social care: going forward

With Integrated Care Systems (ICSs) introductions scheduled for the summer, we must continue these digital discussions and connect care providers to the right people within each new system.

NHSX, with the help of Digital Social Care, has already begun working with some systems and helping develop their digital capabilities. Tools such as the ‘Digital Social Care Records – Assured Supplier List’ helps care providers choose a supplier who has been rigorously selected, ensuring that they can meet and deliver against the national specification.

The Adult Social Care White Paper demonstrated The Department of Health and Social Care’s (DHSC) eagerness to digitise the sector and outlined some bold ambitions. £150 million shall be invested into the sector over the next three years to help drive care providers’ digital journey with the commitment to ensure that at least 80 per cent of social care providers have a digitised care record in place. This is welcoming news, and Care England looks forward to working with the DHSC in achieving these goals.

Through workspaces such as DSIG, we can actively promote and share successful digital stories that help show the digital maturity of the sector and bring care providers to the forefront of digital discussions.

Louis Holmes is Senior Policy Officer for Care England.

If you are interested in becoming an ICJ contributor, please click here.

All news

Don’t waste the chance to finally reform NHS dentistry

By Martin Skipper

The concurrent challenges of Covid-19 and longstanding issues with regards to dental access provides a unique opportunity to provide desperately needed reform to NHS dentistry.

As Covid-19 continues to restrict the public’s ability to access routine health services, increased attention is being paid to the precarious state of NHS dental services in England. It is becoming increasingly clear that dentistry needs ambitious reform if it is to play its part in reducing inequalities and improving health outcomes – both throughout Covid-19 and beyond.

The pandemic is amplifying longstanding issues of access to dental care. According to official NHS statistics, the number of people in England seeing a dentist within the maximum two year recall period dropped from 49.3 to 43 per cent for adults, and from 58 to 23.3 per cent for children.

Pre-pandemic data from August 2019 shows that access in deprived wards in London was already shockingly low, however. In Stanmore Park in Harrow adult access was 36 per cent, child access 34.2 per cent. While in South London the wards of West Thornton in Croydon and Bellingham had adult access of 47.6 per cent and 52.6 per cent respectively with children’s access at 31 per cent and 37.1 per cent. The third most deprived ward in London, Lansbury in Tower Hamlets, recorded adult access at 40.3 per cent and children’s access at 31.9 per cent.

Rethinking the NHS dental contract

NHS dental services are in the small minority of NHS services that charge most patients at the point of care. The British Dental Association estimates that patient charges are making up more and more of the dental budget, increasing from accounting for about 22 per cent in 2010 to over 30 per cent now. Local healthwatch report a great deal of concern and confusion among the public about dental charges. There is frustration too among the profession. Dentists do not enjoy acting as tax collectors for the NHS, nor do they benefit from the dynamic this creates with patients. NHS charges for dentistry are an anachronism that cause more problems than they solve.

As Integrated Care Boards (ICBs) begin developing plans for local health improvement and health inequality reduction, dental contract reform continues to pose obstacles to progress.

Dental contract reform must not take place in isolation from wider NHS reforms. If, as proposed in the Bill, dental commissioning is devolved to ICB level then it is vital that ICBs are involved in discussions about dental contracts. Dentistry will only be able to play its part in ICB plans if there is a contract which supports the delivery of ICB priorities.

Major problems will arise if ICBs attempt to drive local health improvement initiatives without reforming the dental contract.

If the 64 per cent of adults in Stanmore currently without access will require more care than the 36 per cent who have been going to the dentist, then they will require lengthier and perhaps more complicated treatment. This will inevitably reduce available appointments for others, delivering nothing extra towards contracted targets and cost the practice more money. At the same time the NHS is deprived of its ability to recoup its dental spend if these people are exempt. In this scenario, and it is replicated across the country, the existing contract will not be able to support ICBs in any meaningful attempt to reduce health inequalities or improve health outcomes.

If the Care Quality Commission takes responsibility for assessing whether services are accessible then there is an added incentive to change the system to ensure adequate funding. The alternative would be to rely on a primary care dental system which encourages episodic attendance and penalises routine care based on prevention. The very opposite of what we should be aiming for if we want to improve health and reduce health inequalities.

If dentistry is to play a meaningful role in health inequality improvement, then a dramatic increase in the dental budget is required, along with a move away from an overreliance on patient charge revenue. Without reform, ICBs will struggle to boost dental access in deprived communities without depriving access to others or hemorrhaging money from their limited dental budgets.

Leaders in the NHS and across government must be brave and take this opportunity to invest properly in NHS dentistry. The costs for inaction are stark. The estimated costs of hospital admissions in 0 to 19-year-olds for all tooth extractions was £54.6 million and for extractions due to tooth decay was £33 million in the 2019/20 financial year.

An integrated future for NHS dentistry?

A joined-up primary care service with dentistry as a fully integrated component would transform NHS approaches to reducing health inequalities and improving health outcomes.

The comprehensive integration of oral health considerations into existing care pathways will bring huge health benefits. For instance, current guidance around eating disorders makes barely a passing reference to dentists despite the impact on oral health of conditions such as bulimia. Diabetes and its relationship with oral health is becoming ever better understood, but pathways remain poor and local initiatives to join up services are sporadic.

Oral health is at risk of rapid deterioration for those who have had a stroke, been diagnosed with Parkinson’s, Alzheimer’s and other dementias – yet there is no joined-up approach to ensure that oral health plans are in place to support patients with these conditions. This is not to mention the potential for improving the oral health of those over 65 by using dental practices to provide immunisations, blood sugar checks, and so on.

The above issues are just some of the approaches that ICBs may like to consider in their efforts to reduce health inequalities and improve health outcomes. But without ambition and increased budget dentistry will remain a service outside of the rest of the NHS. If dentistry is to truly be a part of the NHS and a key part of the integrated health agenda, then it needs to be like the rest of the NHS: free at the point of service and available to all.