Setting the scene
To me, it seemed important to begin by providing some background on the digital journey and what ‘digitising social care’ actually means. We set the scene and reflected on the pandemic, when there was a collective realisation that data was not available for adult social care because records were largely stored on paper. This created a major issue in demonstrating the number of people who were being supported and the prioritisation that was desperately needed in the sector.
This encouraged Government to support providers to begin transitioning from paper to digital social care records (DSCR). The DiSC programme was launched in 2021 and £150m of funding was made available for providers, on a £50m per year basis. The funding has now reached its final pot, so any providers who have not yet got a DSCR system should move quickly.
Funding will close in March 2025, which is the Department of Health and Social Care (DHSC) deadline for completion of the digitisation process. The DHSC’s target is for 80% of social care providers to be using a DSCR system and 80% of people being supported having an individual DSCR by this time.
Funding is provided as a contribution to year one costs, to cover software licensing, hardware and implementation, meaning providers must fund the remaining costs in the first year and full costs in subsequent years. It is crucial to understand that costs are ongoing and need to be factored into long-term budgets. Providers should talk to their local integrated care system’s (ICS’s) digital social care lead to find out more.
Here to stay
DSCR systems are here to stay and have become the foundation for lots of care providers’ digital journeys; the first building block, you could say, towards the sector’s full immersion into the digital world. Digital records can transform operations for providers. They offer a dashboard view of your workforce, the people you support and their changing needs, so your whole organisation can be kept aware of updates and all interactions with individuals receiving care.
Beyond what might be viewed as the ‘tasks’ associated with adult social care provision, what digitisation also creates is the opportunity to focus more on a person’s wellbeing and record a 360-degree view of how that person is feeling. It was important then, to get PCS’s perspective as a care management software provider whose products help providers gather more information about people and improve efficiencies, effectiveness and compliance in their care settings. We explained how DSCRs can help care managers and teams focus on outcomes for people.
In the old world, information would have had to have been pulled from many different locations, but within the DSCR, everything is in one place. The data subsequently created can provide incredibly useful insights into the needs and requirements of people, as well as how the provider’s business is performing in delivering care outcomes.
Unprecedented impact
As many readers will know, the NCF is a founding member of Digital Social Care, now the Digital Care Hub. At that time, we were involved in a digital pathfinder project, called the Hubble Project, and one of our members who we talked to as part of the project had been operating DSCRs as well as an electronic medication system (eMAR) during the early stages of COVID-19, before testing was available.
Thanks to the way these systems recorded information about people, the provider was able to identify symptoms that older people suffering with COVID-19 presented with that were different to the symptoms known at that time. The provider was able to feed this vital information into the wider health and care system. which no doubt went on to have an enormous impact on our understanding of how COVID-19 presented amongst other people.
Minimising risk
What we all need to be aware of when it comes to any digital transformation, is cyber security and data protection and what we can do to minimise risk. We outlined our recommendations, starting with the Better Security, Better Care programme and the Data Security Protection Toolkit (DSPT), both developed for adult social care.
The DSPT uses a self-assessment approach to help providers assess their data security (both digital and paper) and there are a wide range of resources to support providers throughout the assessment. For smaller organisations who do not have either an internal IT team or access to outsourced support, it can be scary. The sector is frequently under increased attack from sophisticated hackers as we carry a lot of valuable data, so we need to protect our organisations better and be more aware of the risks
The art of the possible
So, what is the ‘art of the possible’ when it comes to the adoption of technology and integration within social care? What is already happening and what does the future look like? We talked about integration between software products, within social care and the NHS, and the importance of having good relationships with your assured supplier.
It is key to determine what an assured supplier is offering you – check out its credentials, particularly in cyber security, and how many of the 14 NHS DSCR Standards it complies with. Also, how does it manage data migration, does it understand your way of working and are mutual expectations understood?
You’ll also want to know if it has considered future developments around shared care records and increased interoperability with other platforms. The same question can be asked of your ICS to understand where it is on the roadmap. There is a list of NHS England-approved assured suppliers that social care providers can access here.
Scope for interoperability
GPConnect is a national programme that allows social care providers to review the GP records of the people they care for at the click of a button, creating time savings and efficiencies. Providers can easily find out if they would be able to integrate with this system by checking with their DSCR provider. As the conversation moved into interoperability, we talked about the digital version of medication management or eMAR, which was briefly mentioned earlier and can have a huge impact on reducing medication errors.
If a provider’s DSCR and eMAR talk to each other through one device or app, data about each person is also joined up. We explained how this would create many more prevention opportunities as the combined information creates a better ‘story’ of a person. Interoperability could help plot changes, to medication for example, along a timeline, explain why these changes have been made and indicate the evolving needs and requirements of the individual.
Advancements in falls technology were also explored and the possibilities presented by technology in not only monitoring falls, but also recording a care note once a fall has happened, all in real time. In the event of a fall, it is also possible to show how long it was before the person was attended to, which is vital information for ambulance staff if they are required.
With the DSCR acting as the foundation, all this additional information could act as an ‘ecosystem’ around a person, enabling providers to enhance their care offering based on individual need. There is also the added ability of evidencing service improvements, which is important for ensuring compliance and reporting to the regulator.
Monitoring global trends
Ambient or sensor technology is an area where UK providers have fallen behind other nations. We talked about expanding our view of the art of the possible globally and this is something the NCF is exploring with more vigour via the Global Ageing Network. Ambient sensing is developing into laser detection of key wellbeing indicators, such as heart or breathing rate, and can be operated purely on a ‘plug and go’ basis.
The possibilities are endless, but how do providers make the most of these advancements and is there funding available? We explored one potential avenue that would see collective investment from the regulator, ICSs and providers, working together to invest in these types of technology. Speaking of the regulator, to any providers who feel that they could sit in the 20% without a DSCR by March 2025, a word of warning – the CQC has communicated that it won’t be awarding ‘Good’ or ‘Outstanding’ ratings to providers without a DSCR system.
Further support
For any providers left puzzled or concerned after listening to this episode, our advice is to talk to other local providers to learn about their progress towards digital. Equally, if you are a member of a regional trade association, or indeed a national membership body, like the NCF, reach out and visit providers with systems in place. This is the best way to know what system would suit your business. In addition, once it comes to implementation, involve members of your wider team to get their perspectives and input.
Most importantly, be bold and brave. The NCF can help with support and signposting to information covering all aspects of digital transformation. Contact [email protected].
What is your experience of digitisation and what benefits have you seen? Leave a comment on this article or join the conversation to share your thoughts.
Liz Jones is Policy Director the National Care Forum (NFC).
Email: [email protected] X: @NCFCareForum