PUBLIC hosted a roundtable with key figures across health and social care to ask how integrated health and social care can fully realise the potential of remote care technologies to improve health outcomes, and what can be done to address existing barriers. In this article Programme Associate Sophie Hubbard outlines the key lessons learned from the discussion.
The deployment of remote care technologies has been prioritised over the COVID-19 pandemic, particularly in the case of more vulnerable members of society receiving formal or social care. The health insights revealed in the use of these technologies have the potential to revolutionise patient-centred care, and NHSX is currently working in partnership with the seven NHS Regions to support the scaling of remote monitoring solutions. The emerging Integrated Care Systems (currently being rolled out nationally and tasked with synthesising health and social care services, though subject to ongoing legislative change) must do more to understand how to unlock the full potential of the data insights gathered in domiciliary and social care settings made possible by new technologies.
The event kicked off with an introduction from Lisa Hollins, Director of Innovation Delivery at NHSX. She emphasised the need for technology addressing the gaps between primary, secondary and social care and stressed the opportunity presented post-COVID to rethink healthcare pathways, with remote care being the key connector of health and social care. The role of these technologies was further outlined by Kate Walker, Digital Programme Director at Suffolk and North-East Essex ICS, highlighting the role of technology in proactively identifying early warning signs in patients and the ability this would give ICSs to stratify care as a result of these insights.
This was followed by two case studies from digital solution providers spanning both health and social care: Alcuris and Birdie. Both providers outlined the benefits of passing data gathered in social care settings to healthcare providers, so that health outcomes can also benefit from the insights gained by the people working most closely and most regularly with patients in social care settings. A key question posed by the digital providers was how some areas of social care can be incentivised through commissioning decisions in healthcare and how funding flows can drive more joined-up health-related benefits. Katherine Church, Chief Digital Officer at Surrey Heartlands ICS, emphasised the issue of different procurement criteria between domiciliary care, social care and healthcare, creating varying thresholds of access for companies looking to work across both areas.
This is a pattern PUBLIC often sees in our procurement work in health and social care, where the benefits of investing in upgrading social care systems do not accrue to social care’s operating model. Instead, most of the value of additional interventions on top of core functionality are reaped by primary or secondary care systems. In the area of remote social care, the mandated switch from analogue to digital panic alarms is a valuable opportunity to revolutionise the way we gain insights from data gathered in domiciliary settings. Yet Local Authorities’ overwhelming focus on price results in only the cheapest, most basic alarm services winning contracts, potentially depriving the ICS of valuable data to join up care, or creating further expenditure down the road to develop or access this data.
This short term focus on cost means that, as a system, health and social care are missing out on the long-term savings and improved patient experience remote monitoring solutions can provide. For example, solutions like Alcuris can reduce hospital admissions through early detection of UTIs by monitoring the number of bathroom visits a patient makes at home. A marginal cost increase within social care could be far outweighed by avoiding the cost of a hospital admission, yet currently health and social care systems are not set up to realise these benefits.
The panel went on to address the barriers in engagement between remote care technologies and ICSs and healthcare systems. Fay Sibley, Head of Healthy Ageing at Health Innovation Network, highlighted the challenges facing startups looking to demonstrate their impact, as funding cycles have historically led to small pilots, without the capacity to test solutions over a long period of time with a larger sample size. Here, integrated care initiatives can play a key role, with Local Health and Care Record Exemplars (LHCREs) presenting an opportunity to run larger pilots at scale.
Finally, PUBLIC was particularly excited to see the challenge of shared priorities and pathways addressed by Lisa Hollins’ suggestion of a health and social care digital playbook. This would be an important document to support clinical teams in redesigning care pathways by showcasing technologies that have successfully tested solutions in real-world settings. This would help ensure that remote care technologies’ valuable innovations can be fully capitalised on across health and social care settings nationally, to truly integrate the care services they provide and improve patient outcomes.