November 8, 2021 • 43 mins
Sustainable Care Co-Investigator, Dr Kate Hamblin is joined by special guests Mark Allen, Head of Technology Enabled Care, Hampshire County Council and Alyson Scurfield, Chief Executive, TEC Services Association (TSA).
In this episode, Kate explores how the pandemic has been a catalyst for change for the Technology Enabled Care sector. Mark Allen gives great insight on how Hampshire County Council used technology during a time of unprecedented change and demand, reflecting on what the sector might learn from the crisis. Alyson Scurfield provides an industry-wide perspective on the pandemic’s impact for TSA members, TEC’s support to vulnerable communities and how the TSA supported the TEC sector with an intense outreach programme and obtaining key worker status for its workforce.
Links mentioned in/relating to this episode
- The joint ADASS-TSA Commission Findings and Recommendations – “How Can Technology Be Truly Integrated into Adult Social Care - https://www.tsa-voice.org.uk/adass-tsa-comm/
- The TSA Sector Insight Report - https://www.tsa-voice.org.uk/campaigns/download-the-tsa-sector-insight-report-2020/
- The TSA Leadership Report – strategic priorities for the TEC sector to 2025 - https://www.tsa-voice.org.uk/campaigns/leadership-report/
Learn more about Sustainable Care on our website: http://circle.group.shef.ac.uk/
---Intro/outro music: Ambient Cool by Sunsearcher is licensed under CC BY-SA 3.0 Gain/fade effects applied
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:12):
The Sustainable Care
Team is exploring how care arrangementscurrently in crisis in parts of the UK
can be made sustainable and deliverwellbeing outcomes
in this sustainable careand COVID 19 podcast series.
Our researchers and special guests
(00:32):
discuss how the pandemic has impactedthe different parts of the care sector.
We are studying.
(00:53):
For our project achieving sustainabilityin care systems,
the potential of technology,part of the sustainable Care program.
We conducted stakeholder consultationsthat took place during
the COVID 19 pandemicstarting in early spring
and with the second round of consultationsin the winter.
What was evident from our findingswas that so much of the adult
social care sectorand the technology enabled care sector,
(01:16):
this pandemic has been a real catalystfor change.
This podcast will explore the impactsof the pandemic on the way
technology is being used throughoutthe adult social care sector.
My guest is Mark Allen, head of LGEnabled Care at Hampshire County Council,
and he's going to give us some insightinto how one local authority
use technology during what was and a timethis unprecedented change in demand.
(01:39):
So maybe we could startby talking about the context.
Can you tell the listenersabout how Hampshire County Council
was deploying technologyin adult social care pre-pandemic?
Hi, Kate.
Yeah, we can actually we've we've gota fairly well-established partnership
that we've developed since 201213 with a consortium called Argenti.
(02:01):
The focus of that
has been on delivering technologyin the care setting.
So enabling this to blend in with
today's more traditional forms of care.
And that's been very muchfocussed on social care.
So delivering to people that need
and that range from the sort of moretraditional sort of telecare approach,
(02:23):
but moved onto using great array of technology,
including sensors and things like that,as well as the Amazon Alexa.
We run a pretty good trial of thata number of years ago
and we've done some work aroundsocial isolation as well.
So we've got a fairly well-establishedtechnology platform that we were using
and that enabled us to actually respondfairly well to the pandemic.
(02:46):
Thank you.
Can you tell us a bit about how maybe thishas changed during the pandemic?
What you have to addall parts of what was already
a really well developed serviceyou were providing?
Yeah, absolutely.
I think there are a number of thingsthat really was was firstly
the challenge of delivering servicesto people living in the community
and the whole issue that it's a March 2020
(03:09):
sprang up about how do we start to carryon delivering these services
because most of it is inis in people's homes.
So we were having to copewith that sort of platform of
how do you do somethingthat sort of quite a personalised service
that requires a direct assessmentin someone's home and then installation
of equipment in support those people.
(03:30):
So that was the whole challenge around A
ensuringpeople were prepared to accept people
and coming into their homesto install handsets.
So we had to make some changes aroundhow that actually works
and make sure that the people working inthose arms were actually safe to do so.
So these were some of the guysalong with those sort of care providers
(03:53):
and advisors were still out theredelivering services.
So it was a number of challengesjust how to keep that service
running and maintain it and the qualityand the type of service that was there.
There were also other thingsthat sprang up for us
which were just purely COVID related.
So there were issues aroundhow do we actually support
(04:16):
the workforce to deliver servicesmore effectively.
But equally,we started to see new calls on our
on our resourcesto work in different ways.
So as a as a top tier authority,
we hadthe responsibility to sort of manage,
along with our public health colleaguesshielding population, for example.
(04:38):
And a number of those peoplewould be known to us,
lots more would be known as the NHS,
but there would be otherswhich who were peripherally known
to the NHS and not all to us,and the numbers were significantly higher
than the numbers of peoplewe would support in the ICC.
Equally, we had issues aroundhow do we manage people
(05:02):
that were being passed out of hospitaldischarge from hospital fairly quickly
with fairly low levels
of information about those individuals.
So these sorts of challengesreally sprang us.
The numbers were quite significantand the response times
or required response times I talked to.
(05:23):
So how did you manage thatshielding population?
It's really interesting question,and I think initially the response
was we set up a welfare teaminternally in the council,
which is headed up by a colleague of mine,
and that was very human based,which it obviously would be.
And we linked together with the
District and Borough Council.
(05:45):
But alongside thiswe were starting to consider how we could
get more information about those peoplethat were being discharged from hospital
so often being discharged within 4 hours.
And so, you know, the information flows
in those sort of timescalesreduced quite significantly.
So I started having discussionswith consulting about actually
(06:08):
how could we start to gather informationfrom individuals where we knew very little
and we needed to establish whether I hada need to know all these sorts of things.
And we started to look at how we couldpotentially do that on an automated basis.
So could we start to use technologyto gather information here?
Can So you're also a development partnerwith Amazon Web Services, of course,
(06:33):
and the happy coincidencethat some of the AI technology
that Amazon used waswas being looked at by AI.
And we started to think about thatin terms of the hospital discharge.
Happily,some other solutions came up around that.
But what did start to
spring to mindwas was actually this is a system
(06:54):
if we linked to the Amazon's
capabilityof making Amazon connect to the hospital
and their ability to sort of contactpeople through various, various means,
could we use that to actually startto ask some of the basic questions
our shielding population were being asked,
and that was often viaa team, or it's not just the team,
(07:18):
it was an army of peoplemaking phone calls.
I sat and did that for one dayover the Easter period,
and I think I got something like 20
calls in a day and give you some context.
The numbers that we were looking atat the height of the shielding
period, 53,000 people shielding.
(07:39):
So my contribution
to that day's work of making callswas slightly minuscule,
but it gives you an indicationof the size of the tasks
that we had about contactingall these individuals.
We needed to make sure that all of thoseindividuals and contacts in some way
to ensure that they were so welland their needs would be met.
And those needs could be very basicin terms of accessing shopping,
(08:03):
food and contact with other people.
So as part of that whole process,we started to think
we use the IWC connects in the backend of the II back end.
Could we start to use that to supportthat whole process
of making that first contactwith individuals?
It was really interesting because wewe actually came to the conclusion
(08:25):
that, yes, we did want to do that
and I
think we set the whole thingup within two weeks.
So developers
in Northern Ireland worked quite hardto actually put together
the sort of the workflowsthrough the contact
and used a human voice to deliver it.
(08:45):
So it was actually one of the partnersof the developers in Northern Ireland.
So we had this very nice NorthernIrish accent asking the questions.
And so it wasn't the computer generatedvoice, it's human voice controlled by
and that late nightenabled us to ask a range of questions,
which meant that depending on the answer,
(09:06):
flows would go through to various places.
So people needed to talk to a human beingbecause they've got their issues
a complex or they've actually just wantedto talk to him, find out
if they were reporting to us.
Everything was fine. Okay.
But we had records that we would come backand talk to them in the future.
What it gave uswas a significant capability
(09:28):
in terms of contacting people,and that's that.
It's that first contact pointthat was was the important thing
to establish what the baselineof those individuals were.
It also meant thatif people did require further services,
we could pass them onto our districtborough colleagues who were manning
(09:49):
the more volunteer based services things.
I think that's really important.
It wasn't about replacing people,it was about enabling you
to use the people you hadin the most effective way.
This is, as you say,53,000 people to contact
would have taken you an awful lot of timewith the staff and had and
(10:09):
ultimately those who did this
to a real persondid get to speak to a real person
probably quicker than they wouldif you'd left it
to, you know, the existing staff.
You had to make those first calls.
Absolutely.
I think the interesting thing is, isis because we had a fairly
well-established platform to go fromwe've had really good principles
that we've developed over the years interms of using technology in social care.
(10:33):
I think one of the really important thingsfor us was, was that
we needed to blend that intoto the care offer, the all the technology
we use and deploy in termsof what we do on a day to day basis.
It's never done, done as a standalonething that it's always done
as part of a complete approachto working with people
(10:54):
and that will be blended with home care.
So supportive that people get homesfor use of technologies
to enable themto live independently at home
and will supplement homecare like you see for other services.
They would say.
And those other services might be unpaidcarers that might be finding them
to think We took that approach into this,which was it won't be
(11:18):
the only thing, it is an enabler to us to,
to work with peopleand pass them on to the appropriate place.
So when designing this,the workflow is really clear
that it had to flow through to peopleif that's what people needed and wanted.
So there was always that pathwaythrough to that.
There was no they were never dead ends.
(11:40):
What we found in most
cases is people were just really pleasedto get the contact
and what we got was the people sayinglargely, No, we're fine, okay.
That's exactly what I found on the callsalignment where the vast majority
of people say, No, we're okay, okay, Nowwe know the number we need to call you.
We will for calling.
(12:00):
And we got the same sort of responsethat we did.
We did follow up surveys.
We asked some peopledidn't like it inevitably,
but was a quite a small minority, Very,very small.
The vast majority of people respondedto the questions that we were asking.
I just found it a really good
they felt, you know, positivethat it was a good, friendly voice
(12:21):
and actually that the councilwas making the effort
to actually even contact in this timebecause most of these people,
53,000 people,you know, be completely honest,
most people in their daily liveshave very little to do with the council.
And so when there was a periodof national pandemic and emergency,
(12:42):
in some senses it wasit was useful to be able to reassure them
that there was a structure therethat was there to provide support.
But we were able to do itin a very smart way.
That meant we couldvery effectively contact
and get theviews of a significant number of people.
I was going to ask actually, were you ableto capture people's feedback and change?
(13:04):
Because I think
when there is a time of crisisand you have to move quite quickly,
it is hard to build inthat sort of the secret to the evaluation.
So it's good to hear that you've managedto speak to people
and find out what they didn't like.
And based on that, what do you thinkyou're going to take forward from it?
I think there are some interesting thingsthis is the forms
(13:26):
of ideas are useful,but they've got to be open
and you've always got to have routesthrough to be able to talk to people.
If they want have a need.
I think one of the issues was, was that
these things that there werethere was a lot behind it.
They're incredibly useful.
They're just very, very good quality
(13:48):
tools to use to concern people
in terms of the sort of commercial,for example,
they work on a large scale,
on smaller scale,they become much more expensive
because they've got to be programmedand developed.
And so there's development on behindall of this.
But what we found is,
is if you do it in an appropriatewhile, people respond positively.
So, you know, there are the opportunitiesto look at these sorts of things,
(14:11):
for example, to undertake first stagereview of people's kit pitches,
be asking them, is everything okay?
Are there things you want to change?
Do you need to talk to somebody?
Those sorts of questions,but they're not useful
for highly complex conversations.
So I think thinking about it clearly
(14:33):
and blending it with more, more complexwork is a useful way of doing it.
Doing it just as an end in itself isprobably not the best way of doing this.
And I think that's what always worries mewhen when we start talking
about using technology,because there always
is the temptation to think it's a bitit's a stand alone thing
that that will deliver you.
(14:53):
The answer it never isyou have to have a system of being able
to integrate human actionand also learn from it and respond to it.
All of these things are importantin terms of developing
approaches to using technology,and certainly so in any way.
I think that's something that that reallycame through in our research as well.
This it can be a bit of a trend.
(15:16):
What we need to do to be innovative,and that is often being quite techno
centric and focusing on the technologyis the solution,
which if you say ignores all the important
things that it's embedded withinand the fact that you, you know,
it requires people to make it workneeds to be assessed
appropriatelyand needs to be installed appropriately.
You need to be supported to use it.
(15:37):
There needs to be routesthrough to take people ultimately,
because sometimes that'swhat people really need.
I just wanted if you couldif you were able to sort of reflect
on what the sector as a wholemight learn from the pandemic
with regard to technology.
Yeah,I think I think some of the learnings are
that there's a range of opportunitiesto develop and blending in technology
(16:00):
and into that divide crossover sales,
I don't think that's an areathat's actually been
exploited as much as it could.
That sort of crossover, I think there'sthere is an issue of actually the best
technologies that are actually reallysuccessful were addressing a challenge,
not the other way round,which didn't think about all.
(16:22):
That's a nice piece of technology.What can we do with it?
We actually have a lot of challengesand the things that really worked
well and what speedily got everybodythinking clearly were in response
to those challenges where we had to findresults, where we had to find a solution.
So we didn't come at itwith a predetermined logical answer.
(16:43):
It was actually we've got thismassive issue.
We had 53,000people that needed contacted.
We started doing it in a very traditionalbegin with, but we found that
actually we needed a solution to thisbecause, you know, those people,
some of them
will really, really depend on us,but we don't know who they are today.
So that then
(17:04):
enabled us to start thinking aboutwhen she went to sleep,
when when a potential solution came up,
we were able to think very clearlyin the context of the challenge.
I know about the capabilitiesof the technology, and for me
that was one of the really clear lessonsthat I need support.
The approach we've always taken,which was actually what is the problem
(17:26):
you're trying to addressabout the outcomes
you need to be seeing deliveredbefore you start to sink?
Think of the technological solution,and I think for me,
that's one of the big lessons of COVIDwas that
there are always these challengesthat faces
and that we actually needto be addressing them and that technology
(17:46):
can be part of the solution,not the other way around.
Thank you.
Those are all my questions
and it's great to speak to you and hearabout his experiences.
It's a pleasure.
I'd like to now turn to the technologyenabled care
sector and explore how it's been impactedby the COVID 19 pandemic.
The technology enabled care sector,of course, includes technology, designers,
(18:08):
manufacturers and providers,but also associated assessment,
installation, monitoring and responseservices.
The Technology Enabled Care ServicesAssociation is industry,
an advisory body for this sector.
And I'd like to welcome Alison's guestof the chief executive to this podcast.
Hello, Alison. Allocation.
I'm really pleased to be on this podcasttoday.
(18:29):
We've done a lot of learning. Fantastic.
And so we duringthe Sustainable Care Program
and the all work ended uphappening over the pandemic
and what we've sort of found is broadlythere is sometimes
an overly technical centricfocus on technology in adult social care.
You know, there's often a focuson the latest kits and gadgets
(18:51):
and illnesses in policy discourse.
But also,you know, academics can do this, too.
And it to me neglectsthe importance of services and systems
that ultimately make technologies,caring technologies.
Without these
services and systems in place, they justthey just kit aren't they really?
So, I mean, I'm strugglingto think of a standalone piece of kit
(19:12):
that doesn't involve some sort of service,either
install it, assess for it,or respond to it.
And I think the pandemicreally highlighted the importance
of these services and systemsand the people involved in them.
So I'd like to just ask you to tell usa bit about the impact of the pandemic on
some of those services who are TSA membersand how it made providing
(19:37):
that vital supporta little bit more challenging.
Yeah, no problem, Kate.
And I think this was a loudand clear message
that we've had in the sector for many,many years.
My background is not in technology
and serviceand delivering real outcomes for people.
So when the pandemic hit, it really shone
(19:57):
a light on technologyenabled care services out there
who are delivering services to 1.8million people in the communities now.
We all learnt different things, didn't we?
In our profession and on everyday lives
we had to all change new ways of working,
new things, of doinghow we lived day to day.
(20:18):
And I think the pandemic did shone
a light shine, a light on all of thosevulnerable people out there.
Those shielding people in our communitieswere needing support.
And I think we really should keepremembering when we used technology.
We did use technology and COVID,but we all need to live meaningful lives.
(20:39):
We need to do the things in communities
that we all live with,the people that we love surrounded.
And, you know, if we have a disabilityour age or we're getting older
or we've got mental health issueswithin exactly the same in the communities
and they had the same needs and called itand I think what we seen was incredible.
(21:00):
Like everyone else, as we clapped themand applauded them,
our health service,our care service on a Thursday evening,
there was the tech servicethat rallying the troops
there were quite incrediblein terms of the technology providers,
the service providers, 24 hoursa day there every day of the pandemic.
(21:20):
And yes, we've seen the 35% reductionin staffing, which was really difficult.
We had to repurpose, we had to retrain,
we had to look at other people who were
not necessarily notworking, but people in a local authority
that could come and supportthose frontline services.
(21:41):
So there was a need for immediate trainingresources digitally.
There was a need for new guidance,new core
trilogies,everything that they needed to keep
the organisation sustainable,delivering services from mind.
I think what we seein Department of Health
support across with an outreach programand we contacted
(22:03):
and were in contact,want to one with 92%, not members
but of the tech service providersacross the UK.
And I think what that was was we were ableto help them with their sustainability
plans, their business continuity plans,
although as certified members,quality members of service, we,
(22:25):
we you know, business continuity,that bit of the pandemic
hadn't really hit us so hardly.
So it was all new to everybodyand we had to react
really quicklyto keep all of those services going.
But I think what we seen wasthere was issues with the platforms.
Analogue to digitalhas been around for a long time,
(22:48):
but the non-digital platforms was reallydifficult for some of the organisations
to have home work and to be flexiblein their approach to the staffing.
But we did see some organisationssuch as battered housing,
they had digital solutionsand they were able to react
really quickly and 100% of their staffteams work from home
(23:11):
within weeks of the pandemic, hittingnot including their monitoring centre.
Everyone and a lot of themare still working from home and flexibly,
which is fabulous.
But I think what we learned
was the analogue to digital shiftin that tech connectivity.
We need to execute it really,
really quicklyand we talked about it for a lot of years,
(23:33):
but in reality, commissionersand people purchasing and services
didn't really get the impactand Corbett shone a light on that.
So what we did see in Corbett
is there was a massive increase of peoplepurchasing services for the next of kin.
So somebody down the farend of the country was a relative open
(23:53):
the Northeast
or even people in communitiesthat couldn't get out to see
their relatives was seen or a 25% uplift
of southlanders carers and individualsbuying new services,
which is quite incredible and thatsustained through the period of COVID.
And then we seen some fabulous exemplarswhere
(24:14):
in the initial stages of COVID,everybody had a problem.
The 24 hour services were bypassed
and then we createdall of these big call centres
when we had services in the community, 24seven able to access calls
now in Carmarthenshire and Wales,we used the example where down to well
(24:34):
being a front door to social carestarted to do all of the outreach.
They were part of their disaster planwith the health authority,
with the chief executive,the local authority and the MDA.
That Telecare provision
work collaboratively to servicesshielded in the communities.
And what was quite incrediblewas that often, you know, it was the
(24:57):
shielding services, the medicationlinking into community resources
and, you know, having a strengthbased approach to some of the
delivery, not the delivered
before COVID, that particular service
stopped about 7% at the front doorand avoided on to social care services
more, you know, and funded servicesin the social care setting.
(25:21):
But what was incredible in COVIDthat rose to 41%
and the reason for that iswe had communities working together.
We had collaborateand with the tech 24 hour services,
and they collaborated to deliver a onestop shop for the shielding people
in the communities.
Now, we had a conference from theirminister who invested in these services,
(25:43):
and that's now level claimed 33%.
So we're seeing people in communitiesself-manage
ageing their health and wellbeing,which is absolutely fantastic.
We've seen a brilliant example of usingthe AI and chat bots in Hampshire.
They have 53,000 people to serviceand immediately within weeks
(26:06):
they were servicing all of the 53,000 bookpeople that had done the pre work.
People in their communities
were used to using digital toolsand just seen it as a norm.
And what was incredible,the team were telling me
that only 2.1% of people needed escalationinto a person in social care.
(26:28):
Now we start to see the pictureof how we can use technology
and in really meaningful way,but focussed on that, on it,
on a person's outcomesand their needs in the community.
So lasting sample that I really foundcompelling
was telehealthin Liverpool and Mersey care.
In Mersey
(26:48):
care they had lots shielding nurses,
so they had a huge volumeof remote monitoring,
working with video conferencingoximetry at home and they were able,
I think within two weeksthat trained all of the shielding nurses
in Liverpool to then workvirtually on that telehealth service.
(27:10):
That's absolutely fantastic.
But because I think previously telehealthwas the unknown gem,
people didn't really embrace it
all GP's in Liverpoolprescribe for telehealth
and you just think these servicespre-COVID
had something different,not just technology.
(27:31):
They had really strong leadershipvision workforce.
They really looked at their workforcefrom leaders in, say, Hampshire
right through to the frontline staffwhere they embraced a digital first.
The key thing that makes theseall of these great things work
and deliver outcomes for the people inthe communities is those strong enablers,
(27:56):
interoperability of peopleand systems, community engagement,
leadership, workforce.
Let's not focus on the shiny kitwe've talked about before so many years
and it's so tempting and we've seen itso many times in Corbridge Systems
running out and buying a bunch of kit.
(28:19):
But then they didn'tput it into the system.
They didn't have the culture,
they didn't have the responder servicesto respond to the activity.
So it makes it really difficult to go.
This kid doesn't work.
It's really notSometimes the kit that doesn't work,
it's that whole enabling systemthat needs to come together.
(28:41):
And in 2019we did a lot of work with CQ CE,
with some of our commissioners,with some of our strategic leaders,
and we put a leadership report togetherthat said this key three key principles
of successful deployment of technology,
and the first is dating pre-COVID.
(29:02):
We had huge amounts of data.
We got data rich,but what we were was Intel, again, poor.
And I think the two of the elements thatwe really need to think about is people
across the system, peoplewhether it be in leadership
right through to frontline staff,right through to the volunteers
(29:23):
that are supporting youwith some of the work.
And I think the big thing that madeall those three examples
work and converge was that partnership.
And if we get those three elements right,you start to see that
we see system change and people's liveshave changed and communities.
Thank you.
That's right. Yeah.
I think those examples are really powerfuland something that reflecting on
(29:48):
the importance of people in these systemsand if you focus too strongly on the
you ignore these peopleand they become invisible.
And when people are invisible,then they're sort of underappreciated.
And I think perhaps that's an areaduring the pandemic where
maybe you can talkabout what the GSA did around key worker
status for some of these peopleworking in these services.
(30:11):
Yeah,it was really difficult when we first
only want to week sixand everybody was struggling for PPE
and part of the TELECARE serviceand the technology Enabled Care
Services is a responder service.
24 seven So they go into clients homes
and response to that emergency,that transaction,
(30:31):
somebody could be on the floorand they really struggled.
They weren't seen as a valuable workforcein the community.
So we have Paul Birstall is our chair
and we have Sir David Pearsonas the tech quality chair.
We lobbied government to make surethat the tech sector workforce,
their installation teams, which wereinvaluable in the responder services,
(30:56):
got key worker status.
That was just invaluablebecause immediately with that
they were able to get the PPEthat they needed.
The responder serviceswere suspended for weeks
because it was too muchrisk to the service user
and to the employee who didn't havethe protection that they needed.
(31:17):
But because of that,that workforce was applauded.
Every Thursday.
They were recognisedin the way that the Shield,
which we can thank the pandemic,if we can thank anything,
because it really gave ussome recognition.
But then when we startedto look at the vaccine programme,
we didn't then have to do that againbecause that workforce
(31:40):
was recognised as key workersand they got the vaccines really quickly
so they could continue their day to daydelivery.
And no matter how much technologyyou put into someone's home,
if there's no one there to respond to it,whether that be through a call
centre is a chalkboardor you need a physical response
(32:01):
because somebody has fallen on the floor,somebody is there
and they heard, Oh, they just needtriaged and put back to bed,
we just need to be recognised.
And those, those valuable services
that, that enablethat really wrap around care.
And I think that's one area of business.
(32:21):
The responder servicesthat you know, needs a bit more work.
It needs to be Zhong builtwith our emergency services,
it needs to be more youngand help with the other community assets
and in the communities.
And I think that'swhere and Delta will be.
And that's how they achievedthose remarkable things
(32:42):
because their responder serviceswere working with the community volunteers
as they were workingwith delivery services that were working
with lots of different medicationand delivery services.
And I think that's how they achievedsuch an increase, audible
and output to some of the workthat they did in the pandemic.
Thank you.
And I think that's as importantthat we can hope that
(33:04):
the pandemichas been incredibly difficult.
But there are things that we may keepand push
certain agendas forwardand hopefully the recognition of the wider
services around technology is somethingthat we can cling on to and take forward.
I just want to ask you to reflect maybe onwhat else do you think the sector
has learnt from the pandemicand will these hope to be taking forward
(33:27):
this looking at our findings, you know,the pandemic has been a huge accelerator
in terms of technologyacross the social care sector.
I think we all know
the word interoperabilityand I think when we had our conference in
in March, it came across loud and clear.
We need to escalate,
(33:48):
grow at scale,the analogue to digital shift
and not be frightened of thatand but not do like for like
we learned in the pandemicthat there was some fabulous new services.
Let's not just replace an analogue pieceof kit with a digital piece of kit.
Let's use the digital capabilitiesto change service of that.
(34:10):
And I think we learned that loud and clearbecause we have to change the service
of that.
And then the ones that the servicesthat we use in digital,
new Internet of Things,some great digital solutions
that then could dolots of different things to deliver
different outcomesfor the people that they serve.
And I think what we didlearn was personalisation,
(34:32):
that it's good to be thinkingabout proactive and preventative care.
But our recent work with the ADACommission
really taught us when we lookedunder the bonnet of social care.
What does personalise ization really mean?
And I think there's some key,key things in there
about owning your own care record
(34:57):
is reallyimportant, but what do you do with it?
I think there's an important proactiveand preventative care
that can be enabled by digital solutions,
and I think we need to really thinkabout how we start to think
in a personalised wayand deliver better outcomes to the people.
Always.
And digital just gives us a great platformto be able to do that.
(35:21):
So I think that's what I would recommendthat we learn from the pandemic
and take that forwardand continue the collaboration.
For the first timeever, we've been seeing the tech sector.
I've sat on all the national committeesas I spoke to Lord Bethell,
you know, the Under-Secretary of State,who said, Where is the sector being?
(35:43):
This is fantastic.
And so it's raised profile for technologyenabled care services.
But I think we need to be a little bit
more ambitious and continueour collaborations and continue the work
at the pace and scalethat we did within the pandemic.
I think
that's something that insome of our early consultations
(36:05):
there was a sort of hesitancyamong some commissioners around
sort of analogue to digital shiftthat there's almost too big a problem
to deal with all that weight.
And so the guidance, governmentand funding from government or a key
piece of kitthat's going to solve all the problems,
it's going to literally replacelike for like
(36:25):
and potentiallythe pandemic has forced that agenda.
So beyond those sort of discussions.
We've done a lot of workduring COVID around support commissioners,
support and service providers about whatwe mean about analogue to digital,
what they mean about different protocols
based by the country and on it goes.
(36:47):
And it's really, really confusingwhen you have a commissioner
preparing and services.
What does it all meanand does it give me longevity?
Is it is it going to be digital?
Will it work in the new world?
So we've done lots and lots.
There was about 39 pieces of differentrelevant
guidance,not just on an analogue to digital,
but everything the tech servicesneeded in terms of staff,
(37:10):
PPE, whateverthey was cause in itself was a problem.
We come back with some relevantguidance now,
ongoing work from now until Christmas,and it is to embed digital standards
into our quality standards framework,not just the services.
So they recognise that,but also to mandate
(37:31):
and regulate against that
the suppliers that are supplying the kit,the analogue tickets.
So we're also writingcommissioners guidance
so that they know exactly what to procureand why and what can be trusted.
And also we're writing specificationsto support the tech sector out there.
Is the move from the analogueto digital shift as they go
(37:54):
to new platforms, digital platforms,are they truly digital now?
We've seen a massive change from pre-COVIDto during COVID.
The ambition for some of our serviceproviders and commissioners
to move to digital and what whereout there in the communities
every day of the week, it's been superand is supporting that transition.
(38:15):
So does anyone listening to the podcastwere available
with all the resources thereto help you on that journey?
Because it's not an easy one to take,
but it's a well worth the journeyand if you get it right,
so GSA will be able to support any of all,
you know, service offersor any of the commissioners.
(38:35):
Commissioners get really, really
confused,
confused about what they needand needed to be doing.
And I think this is an area
the CSA are looking to create guidance on.
Something that came from the findingswas a real interest
in mainstream technologiesand the challenge then being
(38:58):
around the sort of standardsand regulation of those kit that all care
specific technologies are being deployedin caring contexts.
And how how can a commissioner navigatethat terrain which might open themselves
up to complexitiesthey perhaps hadn't foreseen?
We have some senior leadership people
(39:20):
who understand standards and understandinteroperability standards.
And you say everyday technologiesall are going to work.
And we've donea lot of work on standardisation
at the analogue to digital journey,but also the Internet of Things.
We were working really closelywith our colleagues in many respects
on their interoperability programs,on the data standards
(39:43):
and making sure that they're embeddedinto our quality standards framework.
So yes, that is of interest
and then it's turn it into plain English.
What does it mean when a commissioner,a good carer or service providers
looking at the shiny bit of kit and going,what will this do for me?
Is it compliant?
(40:04):
Will it work over a digital network?
All of that advice is there.
So the standards are one thing.
It's how you apply themin a consistent way.
And given our service providersthat knowledge and that ability to buy
and in a safe way,that's going to give the outcomes
that they need for their services.
(40:25):
And thank you.
That's really what I think that again,the outcomes thing, this is,
I think the thing to really againto come back to that.
So it should be at the forefrontof commissioning decisions, not all roles
within.
It's exciting
and I've heard about another authoritythat uses it well, why were they using it?
What were the outcomesthey were trying to achieve?
(40:46):
Is that, is that where you want to go?
And I think that's the real key thing.
I think it's abusiness I'm really strongly
advocating is that
outcomes and preventionand all those agendas.
And I think that's really importantto highlight.
And in a sector where perhaps
traditionally risk managementmight have been the focus around,
(41:07):
you know, things when they falland well, look, what can we can aspire to,
that's part of being a spiceit well being outcomes being in spots,
preventing peoplefrom getting to that point of emergency.
Where you see people, you know, continuing
to liberate your life as their illnesses,progress and communities.
If we only meet the needs
(41:29):
and don't meet the wants is an individual
that does not live in fulfilled,happy lives.
So one of our ethos is,and GSA is to deliver quality outcomes
for the individual,for the carers that serve
and supportand the families for the system.
(41:49):
It's got to be what's in it for me, for itto work across the whole system.
And I think if we all focus on qualityoutcomes in commissioning
for outcomes, we start to see the shift.
We didn't think about it in that wayin COVID, but that's what we did.
We had a problemand we all work together to solve this.
And if we use those principlesand don't leave them behind,
(42:12):
then we will always deliver.
We co-design will do things around peopleand how they want to live their lives.
And I think
technology should be the silent thingin the background, shouldn't it?
We're all used to using these zooms now.
We do it as a matter of course.
Let's see if we can deliver care services
enabled by technologyand nobody sees the technology any more.
(42:34):
It's just thereas part of the day to day lives.
Thank you, Alison.
That was that was really wonderful.
Brilliant.
And, you know, in the sector,if we all just focus back on those key
things of data, people in partnerships,what a wonderful world
they and it's great for the tech sectorand I just think it's so exciting.
(42:55):
We've got a bright, bright future.
The Sustainable Care
Team is exploring how care arrangementscurrently in crisis in parts of the UK
can be made sustainable and deliverwellbeing outcomes
in this sustainable careand COVID 19 podcast series.
Our researchers and special guests
(00:32):
discuss how the pandemic has impactedthe different parts of the care sector.
We are studying.
(00:53):
For our project achieving sustainabilityin care systems,
the potential of technology,part of the sustainable Care program.
We conducted stakeholder consultationsthat took place during
the COVID 19 pandemicstarting in early spring
and with the second round of consultationsin the winter.
What was evident from our findingswas that so much of the adult
social care sectorand the technology enabled care sector,
(01:16):
this pandemic has been a real catalystfor change.
This podcast will explore the impactsof the pandemic on the way
technology is being used throughoutthe adult social care sector.
My guest is Mark Allen, head of LGEnabled Care at Hampshire County Council,
and he's going to give us some insightinto how one local authority
use technology during what was and a timethis unprecedented change in demand.
(01:39):
So maybe we could startby talking about the context.
Can you tell the listenersabout how Hampshire County Council
was deploying technologyin adult social care pre-pandemic?
Hi, Kate.
Yeah, we can actually we've we've gota fairly well-established partnership
that we've developed since 201213 with a consortium called Argenti.
(02:01):
The focus of that
has been on delivering technologyin the care setting.
So enabling this to blend in with
today's more traditional forms of care.
And that's been very muchfocussed on social care.
So delivering to people that need
and that range from the sort of moretraditional sort of telecare approach,
(02:23):
but moved onto using great array of technology,
including sensors and things like that,as well as the Amazon Alexa.
We run a pretty good trial of thata number of years ago
and we've done some work aroundsocial isolation as well.
So we've got a fairly well-establishedtechnology platform that we were using
and that enabled us to actually respondfairly well to the pandemic.
(02:46):
Thank you.
Can you tell us a bit about how maybe thishas changed during the pandemic?
What you have to addall parts of what was already
a really well developed serviceyou were providing?
Yeah, absolutely.
I think there are a number of thingsthat really was was firstly
the challenge of delivering servicesto people living in the community
and the whole issue that it's a March 2020
(03:09):
sprang up about how do we start to carryon delivering these services
because most of it is inis in people's homes.
So we were having to copewith that sort of platform of
how do you do somethingthat sort of quite a personalised service
that requires a direct assessmentin someone's home and then installation
of equipment in support those people.
(03:30):
So that was the whole challenge around A
ensuringpeople were prepared to accept people
and coming into their homesto install handsets.
So we had to make some changes aroundhow that actually works
and make sure that the people working inthose arms were actually safe to do so.
So these were some of the guysalong with those sort of care providers
(03:53):
and advisors were still out theredelivering services.
So it was a number of challengesjust how to keep that service
running and maintain it and the qualityand the type of service that was there.
There were also other thingsthat sprang up for us
which were just purely COVID related.
So there were issues aroundhow do we actually support
(04:16):
the workforce to deliver servicesmore effectively.
But equally,we started to see new calls on our
on our resourcesto work in different ways.
So as a as a top tier authority,
we hadthe responsibility to sort of manage,
along with our public health colleaguesshielding population, for example.
(04:38):
And a number of those peoplewould be known to us,
lots more would be known as the NHS,
but there would be otherswhich who were peripherally known
to the NHS and not all to us,and the numbers were significantly higher
than the numbers of peoplewe would support in the ICC.
Equally, we had issues aroundhow do we manage people
(05:02):
that were being passed out of hospitaldischarge from hospital fairly quickly
with fairly low levels
of information about those individuals.
So these sorts of challengesreally sprang us.
The numbers were quite significantand the response times
or required response times I talked to.
(05:23):
So how did you manage thatshielding population?
It's really interesting question,and I think initially the response
was we set up a welfare teaminternally in the council,
which is headed up by a colleague of mine,
and that was very human based,which it obviously would be.
And we linked together with the
District and Borough Council.
(05:45):
But alongside thiswe were starting to consider how we could
get more information about those peoplethat were being discharged from hospital
so often being discharged within 4 hours.
And so, you know, the information flows
in those sort of timescalesreduced quite significantly.
So I started having discussionswith consulting about actually
(06:08):
how could we start to gather informationfrom individuals where we knew very little
and we needed to establish whether I hada need to know all these sorts of things.
And we started to look at how we couldpotentially do that on an automated basis.
So could we start to use technologyto gather information here?
Can So you're also a development partnerwith Amazon Web Services, of course,
(06:33):
and the happy coincidencethat some of the AI technology
that Amazon used waswas being looked at by AI.
And we started to think about thatin terms of the hospital discharge.
Happily,some other solutions came up around that.
But what did start to
spring to mindwas was actually this is a system
(06:54):
if we linked to the Amazon's
capabilityof making Amazon connect to the hospital
and their ability to sort of contactpeople through various, various means,
could we use that to actually startto ask some of the basic questions
our shielding population were being asked,
and that was often viaa team, or it's not just the team,
(07:18):
it was an army of peoplemaking phone calls.
I sat and did that for one dayover the Easter period,
and I think I got something like 20
calls in a day and give you some context.
The numbers that we were looking atat the height of the shielding
period, 53,000 people shielding.
(07:39):
So my contribution
to that day's work of making callswas slightly minuscule,
but it gives you an indicationof the size of the tasks
that we had about contactingall these individuals.
We needed to make sure that all of thoseindividuals and contacts in some way
to ensure that they were so welland their needs would be met.
And those needs could be very basicin terms of accessing shopping,
(08:03):
food and contact with other people.
So as part of that whole process,we started to think
we use the IWC connects in the backend of the II back end.
Could we start to use that to supportthat whole process
of making that first contactwith individuals?
It was really interesting because wewe actually came to the conclusion
(08:25):
that, yes, we did want to do that
and I
think we set the whole thingup within two weeks.
So developers
in Northern Ireland worked quite hardto actually put together
the sort of the workflowsthrough the contact
and used a human voice to deliver it.
(08:45):
So it was actually one of the partnersof the developers in Northern Ireland.
So we had this very nice NorthernIrish accent asking the questions.
And so it wasn't the computer generatedvoice, it's human voice controlled by
and that late nightenabled us to ask a range of questions,
which meant that depending on the answer,
(09:06):
flows would go through to various places.
So people needed to talk to a human beingbecause they've got their issues
a complex or they've actually just wantedto talk to him, find out
if they were reporting to us.
Everything was fine. Okay.
But we had records that we would come backand talk to them in the future.
What it gave uswas a significant capability
(09:28):
in terms of contacting people,and that's that.
It's that first contact pointthat was was the important thing
to establish what the baselineof those individuals were.
It also meant thatif people did require further services,
we could pass them onto our districtborough colleagues who were manning
(09:49):
the more volunteer based services things.
I think that's really important.
It wasn't about replacing people,it was about enabling you
to use the people you hadin the most effective way.
This is, as you say,53,000 people to contact
would have taken you an awful lot of timewith the staff and had and
(10:09):
ultimately those who did this
to a real persondid get to speak to a real person
probably quicker than they wouldif you'd left it
to, you know, the existing staff.
You had to make those first calls.
Absolutely.
I think the interesting thing is, isis because we had a fairly
well-established platform to go fromwe've had really good principles
that we've developed over the years interms of using technology in social care.
(10:33):
I think one of the really important thingsfor us was, was that
we needed to blend that intoto the care offer, the all the technology
we use and deploy in termsof what we do on a day to day basis.
It's never done, done as a standalonething that it's always done
as part of a complete approachto working with people
(10:54):
and that will be blended with home care.
So supportive that people get homesfor use of technologies
to enable themto live independently at home
and will supplement homecare like you see for other services.
They would say.
And those other services might be unpaidcarers that might be finding them
to think We took that approach into this,which was it won't be
(11:18):
the only thing, it is an enabler to us to,
to work with peopleand pass them on to the appropriate place.
So when designing this,the workflow is really clear
that it had to flow through to peopleif that's what people needed and wanted.
So there was always that pathwaythrough to that.
There was no they were never dead ends.
(11:40):
What we found in most
cases is people were just really pleasedto get the contact
and what we got was the people sayinglargely, No, we're fine, okay.
That's exactly what I found on the callsalignment where the vast majority
of people say, No, we're okay, okay, Nowwe know the number we need to call you.
We will for calling.
(12:00):
And we got the same sort of responsethat we did.
We did follow up surveys.
We asked some peopledidn't like it inevitably,
but was a quite a small minority, Very,very small.
The vast majority of people respondedto the questions that we were asking.
I just found it a really good
they felt, you know, positivethat it was a good, friendly voice
(12:21):
and actually that the councilwas making the effort
to actually even contact in this timebecause most of these people,
53,000 people,you know, be completely honest,
most people in their daily liveshave very little to do with the council.
And so when there was a periodof national pandemic and emergency,
(12:42):
in some senses it wasit was useful to be able to reassure them
that there was a structure therethat was there to provide support.
But we were able to do itin a very smart way.
That meant we couldvery effectively contact
and get theviews of a significant number of people.
I was going to ask actually, were you ableto capture people's feedback and change?
(13:04):
Because I think
when there is a time of crisisand you have to move quite quickly,
it is hard to build inthat sort of the secret to the evaluation.
So it's good to hear that you've managedto speak to people
and find out what they didn't like.
And based on that, what do you thinkyou're going to take forward from it?
I think there are some interesting thingsthis is the forms
(13:26):
of ideas are useful,but they've got to be open
and you've always got to have routesthrough to be able to talk to people.
If they want have a need.
I think one of the issues was, was that
these things that there werethere was a lot behind it.
They're incredibly useful.
They're just very, very good quality
(13:48):
tools to use to concern people
in terms of the sort of commercial,for example,
they work on a large scale,
on smaller scale,they become much more expensive
because they've got to be programmedand developed.
And so there's development on behindall of this.
But what we found is,
is if you do it in an appropriatewhile, people respond positively.
So, you know, there are the opportunitiesto look at these sorts of things,
(14:11):
for example, to undertake first stagereview of people's kit pitches,
be asking them, is everything okay?
Are there things you want to change?
Do you need to talk to somebody?
Those sorts of questions,but they're not useful
for highly complex conversations.
So I think thinking about it clearly
(14:33):
and blending it with more, more complexwork is a useful way of doing it.
Doing it just as an end in itself isprobably not the best way of doing this.
And I think that's what always worries mewhen when we start talking
about using technology,because there always
is the temptation to think it's a bitit's a stand alone thing
that that will deliver you.
(14:53):
The answer it never isyou have to have a system of being able
to integrate human actionand also learn from it and respond to it.
All of these things are importantin terms of developing
approaches to using technology,and certainly so in any way.
I think that's something that that reallycame through in our research as well.
This it can be a bit of a trend.
(15:16):
What we need to do to be innovative,and that is often being quite techno
centric and focusing on the technologyis the solution,
which if you say ignores all the important
things that it's embedded withinand the fact that you, you know,
it requires people to make it workneeds to be assessed
appropriatelyand needs to be installed appropriately.
You need to be supported to use it.
(15:37):
There needs to be routesthrough to take people ultimately,
because sometimes that'swhat people really need.
I just wanted if you couldif you were able to sort of reflect
on what the sector as a wholemight learn from the pandemic
with regard to technology.
Yeah,I think I think some of the learnings are
that there's a range of opportunitiesto develop and blending in technology
(16:00):
and into that divide crossover sales,
I don't think that's an areathat's actually been
exploited as much as it could.
That sort of crossover, I think there'sthere is an issue of actually the best
technologies that are actually reallysuccessful were addressing a challenge,
not the other way round,which didn't think about all.
(16:22):
That's a nice piece of technology.What can we do with it?
We actually have a lot of challengesand the things that really worked
well and what speedily got everybodythinking clearly were in response
to those challenges where we had to findresults, where we had to find a solution.
So we didn't come at itwith a predetermined logical answer.
(16:43):
It was actually we've got thismassive issue.
We had 53,000people that needed contacted.
We started doing it in a very traditionalbegin with, but we found that
actually we needed a solution to thisbecause, you know, those people,
some of them
will really, really depend on us,but we don't know who they are today.
So that then
(17:04):
enabled us to start thinking aboutwhen she went to sleep,
when when a potential solution came up,
we were able to think very clearlyin the context of the challenge.
I know about the capabilitiesof the technology, and for me
that was one of the really clear lessonsthat I need support.
The approach we've always taken,which was actually what is the problem
(17:26):
you're trying to addressabout the outcomes
you need to be seeing deliveredbefore you start to sink?
Think of the technological solution,and I think for me,
that's one of the big lessons of COVIDwas that
there are always these challengesthat faces
and that we actually needto be addressing them and that technology
(17:46):
can be part of the solution,not the other way around.
Thank you.
Those are all my questions
and it's great to speak to you and hearabout his experiences.
It's a pleasure.
I'd like to now turn to the technologyenabled care
sector and explore how it's been impactedby the COVID 19 pandemic.
The technology enabled care sector,of course, includes technology, designers,
(18:08):
manufacturers and providers,but also associated assessment,
installation, monitoring and responseservices.
The Technology Enabled Care ServicesAssociation is industry,
an advisory body for this sector.
And I'd like to welcome Alison's guestof the chief executive to this podcast.
Hello, Alison. Allocation.
I'm really pleased to be on this podcasttoday.
(18:29):
We've done a lot of learning. Fantastic.
And so we duringthe Sustainable Care Program
and the all work ended uphappening over the pandemic
and what we've sort of found is broadlythere is sometimes
an overly technical centricfocus on technology in adult social care.
You know, there's often a focuson the latest kits and gadgets
(18:51):
and illnesses in policy discourse.
But also,you know, academics can do this, too.
And it to me neglectsthe importance of services and systems
that ultimately make technologies,caring technologies.
Without these
services and systems in place, they justthey just kit aren't they really?
So, I mean, I'm strugglingto think of a standalone piece of kit
(19:12):
that doesn't involve some sort of service,either
install it, assess for it,or respond to it.
And I think the pandemicreally highlighted the importance
of these services and systemsand the people involved in them.
So I'd like to just ask you to tell usa bit about the impact of the pandemic on
some of those services who are TSA membersand how it made providing
(19:37):
that vital supporta little bit more challenging.
Yeah, no problem, Kate.
And I think this was a loudand clear message
that we've had in the sector for many,many years.
My background is not in technology
and serviceand delivering real outcomes for people.
So when the pandemic hit, it really shone
(19:57):
a light on technologyenabled care services out there
who are delivering services to 1.8million people in the communities now.
We all learnt different things, didn't we?
In our profession and on everyday lives
we had to all change new ways of working,
new things, of doinghow we lived day to day.
(20:18):
And I think the pandemic did shone
a light shine, a light on all of thosevulnerable people out there.
Those shielding people in our communitieswere needing support.
And I think we really should keepremembering when we used technology.
We did use technology and COVID,but we all need to live meaningful lives.
(20:39):
We need to do the things in communities
that we all live with,the people that we love surrounded.
And, you know, if we have a disabilityour age or we're getting older
or we've got mental health issueswithin exactly the same in the communities
and they had the same needs and called itand I think what we seen was incredible.
(21:00):
Like everyone else, as we clapped themand applauded them,
our health service,our care service on a Thursday evening,
there was the tech servicethat rallying the troops
there were quite incrediblein terms of the technology providers,
the service providers, 24 hoursa day there every day of the pandemic.
(21:20):
And yes, we've seen the 35% reductionin staffing, which was really difficult.
We had to repurpose, we had to retrain,
we had to look at other people who were
not necessarily notworking, but people in a local authority
that could come and supportthose frontline services.
(21:41):
So there was a need for immediate trainingresources digitally.
There was a need for new guidance,new core
trilogies,everything that they needed to keep
the organisation sustainable,delivering services from mind.
I think what we seein Department of Health
support across with an outreach programand we contacted
(22:03):
and were in contact,want to one with 92%, not members
but of the tech service providersacross the UK.
And I think what that was was we were ableto help them with their sustainability
plans, their business continuity plans,
although as certified members,quality members of service, we,
(22:25):
we you know, business continuity,that bit of the pandemic
hadn't really hit us so hardly.
So it was all new to everybodyand we had to react
really quicklyto keep all of those services going.
But I think what we seen wasthere was issues with the platforms.
Analogue to digitalhas been around for a long time,
(22:48):
but the non-digital platforms was reallydifficult for some of the organisations
to have home work and to be flexiblein their approach to the staffing.
But we did see some organisationssuch as battered housing,
they had digital solutionsand they were able to react
really quickly and 100% of their staffteams work from home
(23:11):
within weeks of the pandemic, hittingnot including their monitoring centre.
Everyone and a lot of themare still working from home and flexibly,
which is fabulous.
But I think what we learned
was the analogue to digital shiftin that tech connectivity.
We need to execute it really,
really quicklyand we talked about it for a lot of years,
(23:33):
but in reality, commissionersand people purchasing and services
didn't really get the impactand Corbett shone a light on that.
So what we did see in Corbett
is there was a massive increase of peoplepurchasing services for the next of kin.
So somebody down the farend of the country was a relative open
(23:53):
the Northeast
or even people in communitiesthat couldn't get out to see
their relatives was seen or a 25% uplift
of southlanders carers and individualsbuying new services,
which is quite incredible and thatsustained through the period of COVID.
And then we seen some fabulous exemplarswhere
(24:14):
in the initial stages of COVID,everybody had a problem.
The 24 hour services were bypassed
and then we createdall of these big call centres
when we had services in the community, 24seven able to access calls
now in Carmarthenshire and Wales,we used the example where down to well
(24:34):
being a front door to social carestarted to do all of the outreach.
They were part of their disaster planwith the health authority,
with the chief executive,the local authority and the MDA.
That Telecare provision
work collaboratively to servicesshielded in the communities.
And what was quite incrediblewas that often, you know, it was the
(24:57):
shielding services, the medicationlinking into community resources
and, you know, having a strengthbased approach to some of the
delivery, not the delivered
before COVID, that particular service
stopped about 7% at the front doorand avoided on to social care services
more, you know, and funded servicesin the social care setting.
(25:21):
But what was incredible in COVIDthat rose to 41%
and the reason for that iswe had communities working together.
We had collaborateand with the tech 24 hour services,
and they collaborated to deliver a onestop shop for the shielding people
in the communities.
Now, we had a conference from theirminister who invested in these services,
(25:43):
and that's now level claimed 33%.
So we're seeing people in communitiesself-manage
ageing their health and wellbeing,which is absolutely fantastic.
We've seen a brilliant example of usingthe AI and chat bots in Hampshire.
They have 53,000 people to serviceand immediately within weeks
(26:06):
they were servicing all of the 53,000 bookpeople that had done the pre work.
People in their communities
were used to using digital toolsand just seen it as a norm.
And what was incredible,the team were telling me
that only 2.1% of people needed escalationinto a person in social care.
(26:28):
Now we start to see the pictureof how we can use technology
and in really meaningful way,but focussed on that, on it,
on a person's outcomesand their needs in the community.
So lasting sample that I really foundcompelling
was telehealthin Liverpool and Mersey care.
In Mersey
(26:48):
care they had lots shielding nurses,
so they had a huge volumeof remote monitoring,
working with video conferencingoximetry at home and they were able,
I think within two weeksthat trained all of the shielding nurses
in Liverpool to then workvirtually on that telehealth service.
(27:10):
That's absolutely fantastic.
But because I think previously telehealthwas the unknown gem,
people didn't really embrace it
all GP's in Liverpoolprescribe for telehealth
and you just think these servicespre-COVID
had something different,not just technology.
(27:31):
They had really strong leadershipvision workforce.
They really looked at their workforcefrom leaders in, say, Hampshire
right through to the frontline staffwhere they embraced a digital first.
The key thing that makes theseall of these great things work
and deliver outcomes for the people inthe communities is those strong enablers,
(27:56):
interoperability of peopleand systems, community engagement,
leadership, workforce.
Let's not focus on the shiny kitwe've talked about before so many years
and it's so tempting and we've seen itso many times in Corbridge Systems
running out and buying a bunch of kit.
(28:19):
But then they didn'tput it into the system.
They didn't have the culture,
they didn't have the responder servicesto respond to the activity.
So it makes it really difficult to go.
This kid doesn't work.
It's really notSometimes the kit that doesn't work,
it's that whole enabling systemthat needs to come together.
(28:41):
And in 2019we did a lot of work with CQ CE,
with some of our commissioners,with some of our strategic leaders,
and we put a leadership report togetherthat said this key three key principles
of successful deployment of technology,
and the first is dating pre-COVID.
(29:02):
We had huge amounts of data.
We got data rich,but what we were was Intel, again, poor.
And I think the two of the elements thatwe really need to think about is people
across the system, peoplewhether it be in leadership
right through to frontline staff,right through to the volunteers
(29:23):
that are supporting youwith some of the work.
And I think the big thing that madeall those three examples
work and converge was that partnership.
And if we get those three elements right,you start to see that
we see system change and people's liveshave changed and communities.
Thank you.
That's right. Yeah.
I think those examples are really powerfuland something that reflecting on
(29:48):
the importance of people in these systemsand if you focus too strongly on the
you ignore these peopleand they become invisible.
And when people are invisible,then they're sort of underappreciated.
And I think perhaps that's an areaduring the pandemic where
maybe you can talkabout what the GSA did around key worker
status for some of these peopleworking in these services.
(30:11):
Yeah,it was really difficult when we first
only want to week sixand everybody was struggling for PPE
and part of the TELECARE serviceand the technology Enabled Care
Services is a responder service.
24 seven So they go into clients homes
and response to that emergency,that transaction,
(30:31):
somebody could be on the floorand they really struggled.
They weren't seen as a valuable workforcein the community.
So we have Paul Birstall is our chair
and we have Sir David Pearsonas the tech quality chair.
We lobbied government to make surethat the tech sector workforce,
their installation teams, which wereinvaluable in the responder services,
(30:56):
got key worker status.
That was just invaluablebecause immediately with that
they were able to get the PPEthat they needed.
The responder serviceswere suspended for weeks
because it was too muchrisk to the service user
and to the employee who didn't havethe protection that they needed.
(31:17):
But because of that,that workforce was applauded.
Every Thursday.
They were recognisedin the way that the Shield,
which we can thank the pandemic,if we can thank anything,
because it really gave ussome recognition.
But then when we startedto look at the vaccine programme,
we didn't then have to do that againbecause that workforce
(31:40):
was recognised as key workersand they got the vaccines really quickly
so they could continue their day to daydelivery.
And no matter how much technologyyou put into someone's home,
if there's no one there to respond to it,whether that be through a call
centre is a chalkboardor you need a physical response
(32:01):
because somebody has fallen on the floor,somebody is there
and they heard, Oh, they just needtriaged and put back to bed,
we just need to be recognised.
And those, those valuable services
that, that enablethat really wrap around care.
And I think that's one area of business.
(32:21):
The responder servicesthat you know, needs a bit more work.
It needs to be Zhong builtwith our emergency services,
it needs to be more youngand help with the other community assets
and in the communities.
And I think that'swhere and Delta will be.
And that's how they achievedthose remarkable things
(32:42):
because their responder serviceswere working with the community volunteers
as they were workingwith delivery services that were working
with lots of different medicationand delivery services.
And I think that's how they achievedsuch an increase, audible
and output to some of the workthat they did in the pandemic.
Thank you.
And I think that's as importantthat we can hope that
(33:04):
the pandemichas been incredibly difficult.
But there are things that we may keepand push
certain agendas forwardand hopefully the recognition of the wider
services around technology is somethingthat we can cling on to and take forward.
I just want to ask you to reflect maybe onwhat else do you think the sector
has learnt from the pandemicand will these hope to be taking forward
(33:27):
this looking at our findings, you know,the pandemic has been a huge accelerator
in terms of technologyacross the social care sector.
I think we all know
the word interoperabilityand I think when we had our conference in
in March, it came across loud and clear.
We need to escalate,
(33:48):
grow at scale,the analogue to digital shift
and not be frightened of thatand but not do like for like
we learned in the pandemicthat there was some fabulous new services.
Let's not just replace an analogue pieceof kit with a digital piece of kit.
Let's use the digital capabilitiesto change service of that.
(34:10):
And I think we learned that loud and clearbecause we have to change the service
of that.
And then the ones that the servicesthat we use in digital,
new Internet of Things,some great digital solutions
that then could dolots of different things to deliver
different outcomesfor the people that they serve.
And I think what we didlearn was personalisation,
(34:32):
that it's good to be thinkingabout proactive and preventative care.
But our recent work with the ADACommission
really taught us when we lookedunder the bonnet of social care.
What does personalise ization really mean?
And I think there's some key,key things in there
about owning your own care record
(34:57):
is reallyimportant, but what do you do with it?
I think there's an important proactiveand preventative care
that can be enabled by digital solutions,
and I think we need to really thinkabout how we start to think
in a personalised wayand deliver better outcomes to the people.
Always.
And digital just gives us a great platformto be able to do that.
(35:21):
So I think that's what I would recommendthat we learn from the pandemic
and take that forwardand continue the collaboration.
For the first timeever, we've been seeing the tech sector.
I've sat on all the national committeesas I spoke to Lord Bethell,
you know, the Under-Secretary of State,who said, Where is the sector being?
(35:43):
This is fantastic.
And so it's raised profile for technologyenabled care services.
But I think we need to be a little bit
more ambitious and continueour collaborations and continue the work
at the pace and scalethat we did within the pandemic.
I think
that's something that insome of our early consultations
(36:05):
there was a sort of hesitancyamong some commissioners around
sort of analogue to digital shiftthat there's almost too big a problem
to deal with all that weight.
And so the guidance, governmentand funding from government or a key
piece of kitthat's going to solve all the problems,
it's going to literally replacelike for like
(36:25):
and potentiallythe pandemic has forced that agenda.
So beyond those sort of discussions.
We've done a lot of workduring COVID around support commissioners,
support and service providers about whatwe mean about analogue to digital,
what they mean about different protocols
based by the country and on it goes.
(36:47):
And it's really, really confusingwhen you have a commissioner
preparing and services.
What does it all meanand does it give me longevity?
Is it is it going to be digital?
Will it work in the new world?
So we've done lots and lots.
There was about 39 pieces of differentrelevant
guidance,not just on an analogue to digital,
but everything the tech servicesneeded in terms of staff,
(37:10):
PPE, whateverthey was cause in itself was a problem.
We come back with some relevantguidance now,
ongoing work from now until Christmas,and it is to embed digital standards
into our quality standards framework,not just the services.
So they recognise that,but also to mandate
(37:31):
and regulate against that
the suppliers that are supplying the kit,the analogue tickets.
So we're also writingcommissioners guidance
so that they know exactly what to procureand why and what can be trusted.
And also we're writing specificationsto support the tech sector out there.
Is the move from the analogueto digital shift as they go
(37:54):
to new platforms, digital platforms,are they truly digital now?
We've seen a massive change from pre-COVIDto during COVID.
The ambition for some of our serviceproviders and commissioners
to move to digital and what whereout there in the communities
every day of the week, it's been superand is supporting that transition.
(38:15):
So does anyone listening to the podcastwere available
with all the resources thereto help you on that journey?
Because it's not an easy one to take,
but it's a well worth the journeyand if you get it right,
so GSA will be able to support any of all,
you know, service offersor any of the commissioners.
(38:35):
Commissioners get really, really
confused,
confused about what they needand needed to be doing.
And I think this is an area
the CSA are looking to create guidance on.
Something that came from the findingswas a real interest
in mainstream technologiesand the challenge then being
(38:58):
around the sort of standardsand regulation of those kit that all care
specific technologies are being deployedin caring contexts.
And how how can a commissioner navigatethat terrain which might open themselves
up to complexitiesthey perhaps hadn't foreseen?
We have some senior leadership people
(39:20):
who understand standards and understandinteroperability standards.
And you say everyday technologiesall are going to work.
And we've donea lot of work on standardisation
at the analogue to digital journey,but also the Internet of Things.
We were working really closelywith our colleagues in many respects
on their interoperability programs,on the data standards
(39:43):
and making sure that they're embeddedinto our quality standards framework.
So yes, that is of interest
and then it's turn it into plain English.
What does it mean when a commissioner,a good carer or service providers
looking at the shiny bit of kit and going,what will this do for me?
Is it compliant?
(40:04):
Will it work over a digital network?
All of that advice is there.
So the standards are one thing.
It's how you apply themin a consistent way.
And given our service providersthat knowledge and that ability to buy
and in a safe way,that's going to give the outcomes
that they need for their services.
(40:25):
And thank you.
That's really what I think that again,the outcomes thing, this is,
I think the thing to really againto come back to that.
So it should be at the forefrontof commissioning decisions, not all roles
within.
It's exciting
and I've heard about another authoritythat uses it well, why were they using it?
What were the outcomesthey were trying to achieve?
(40:46):
Is that, is that where you want to go?
And I think that's the real key thing.
I think it's abusiness I'm really strongly
advocating is that
outcomes and preventionand all those agendas.
And I think that's really importantto highlight.
And in a sector where perhaps
traditionally risk managementmight have been the focus around,
(41:07):
you know, things when they falland well, look, what can we can aspire to,
that's part of being a spiceit well being outcomes being in spots,
preventing peoplefrom getting to that point of emergency.
Where you see people, you know, continuing
to liberate your life as their illnesses,progress and communities.
If we only meet the needs
(41:29):
and don't meet the wants is an individual
that does not live in fulfilled,happy lives.
So one of our ethos is,and GSA is to deliver quality outcomes
for the individual,for the carers that serve
and supportand the families for the system.
(41:49):
It's got to be what's in it for me, for itto work across the whole system.
And I think if we all focus on qualityoutcomes in commissioning
for outcomes, we start to see the shift.
We didn't think about it in that wayin COVID, but that's what we did.
We had a problemand we all work together to solve this.
And if we use those principlesand don't leave them behind,
(42:12):
then we will always deliver.
We co-design will do things around peopleand how they want to live their lives.
And I think
technology should be the silent thingin the background, shouldn't it?
We're all used to using these zooms now.
We do it as a matter of course.
Let's see if we can deliver care services
enabled by technologyand nobody sees the technology any more.
(42:34):
It's just thereas part of the day to day lives.
Thank you, Alison.
That was that was really wonderful.
Brilliant.
And, you know, in the sector,if we all just focus back on those key
things of data, people in partnerships,what a wonderful world
they and it's great for the tech sectorand I just think it's so exciting.
(42:55):
We've got a bright, bright future.
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