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Rethinking health and social care post Covid-19

(Image credit: Image Credit: Lightpoet / Shutterstock)

As the new normal emerges and social care responds to the extraordinary situation we’re faced with, never has there been a greater need for technology-led transformation challenges. Covid-19 has turned the daily rhythms and routines of the world we knew upside down, reaching deep into our lives. The profound, lasting impact of the pandemic will be felt for many years to come.

Social care, weakened by years of declining real-terms public funding and rising demand, has been reeling from this impact of the virus. The social care sector in the UK is staring into an abyss of shrinking care capacity and exponentially rising demand, driven by factors such as chronic underfunding and a lack of joined-up thinking.

What will the new normal be for social care? How will this change the ways in which care is delivered and, crucially, what impact will this have on patients?

Video technology will remain at the fore

Remote healthcare usage surged during Covid-19 – at the middle of July 2020, over 50 percent of medical consultations by GPs were performed via video, rather than face-to-face. This must be continued.

Every one of the 307 million GP appointments each year costs around £30 when you include all costs such as property, heating, lighting, security and so on. If clinical appointments are carried out by a GP remotely via video, the number of appointments can increase – you can conduct 10 or so video consultations an hour as opposed to four or five physical ones. The cost of delivering primary care therefore drops substantially.

Care at home will be increasingly displaced by technology

By deploying technology across people's homes and linking it with the digitized front door, we can displace a large proportion of attended care at home. The use of sensors like oximeters or door contact sensors that trigger an exception when dementia sufferers open doors at unexpected times, can reduce the number of home visits dramatically.

By using technology, there are some very large savings to be made, while improving the quality of service delivered. If we displace just 50 percent of attended care, a local authority with a cohort of 2,500 people in care would save roughly £10m a year.

Virtual care plans will be adopted to ease the pressure on the creaking care system

Vulnerable people are alone now more than ever, and health care teams are struggling to keep up with the demand. Technology can help to create and connect support teams whether that be family members, third sector organizations or charitable groups.

Technology can detail how, Ann Smith, for example, needs to go to the shops on Thursday afternoon; cook dinner for that evening and take her regular prescribed pharma. Her sister, Jean has registered to provide the transport and the shopping assistance as part of a virtual care plan. A neighbor has volunteered to cook meals for Ann and a local third sector organization has arranged a rota service for medicinal care. This creates a support bubble around Ann and all other at-risk individuals – but it's a bubble that could consist of 10,000 volunteers or organizations that bring different skills to the table, in addition to any formal care that would still be required.

Key to delivering the bubble is the digitized front door and capturing all members of the bubble, the service they will deliver and how that service is scheduled.

Substantial amounts of central funding will be released for remote technology

Central and local government have invested heavily in care, but the current situation demands additional targeted investment in finally integrating health and social care across the UK. We fully expect funding to be released from the treasury to fix the fundamental enabling technology and data challenges which make integration impossible and can bring residential and domiciliary care into the 21st century. As an example, in 2019, 25 percent of residential care homes had no connection to the Internet. As we look at enhanced technology and data solutions, in parallel there are basic technology issues that need urgent attention.

Integration of health and social care is more than co-locating people. If we are to see the benefits of the Care Act 2014 and make a difference in both the cost and quality of care across the UK, we need to integrate services across the full technology spectrum and also from a budgetary perspective, given that an investment with Adult Social Care within a local authority may give rise to a financial benefit elsewhere within the locality, e.g. within primary care.

Contact centers will change forever

The well-documented changes to working habits will impact the delivery of social care. Local authority contact centers have typically been reactive, with the onus on the customer to share their challenges and instigate a response. In the post Covid-19 world, contact center headcounts are reduced as home working takes over.

From a property perspective, we're not going back to having consolidated groups of people in buildings. Instead, we'll be looking at the technology that can virtualize contact centers and deliver skills-based routing. That means you can virtually bring in people, such as mental health care workers, who are home-based. And if you want to raise an issue that's associated with one part of provisioning or social care, you're able to do that automatically and immediately by using the relevant technologies.

Traditional local authority contact centers who operate an ‘inbound’ contact model must now change to a proactive ‘outbound’ contact model, making video calls to citizens, verifying current situations and using the proactive support bubble and close integration with primary care (providing medical diagnosis via video consultation) in any exception event.

Use of RPA and AI will accelerate

We are already seeing increased interest in chatbots to manage inbound demand – and we expect this to accelerate further and be supported by more complex Artificial Intelligence and Robotic Process Automation led solutions.

I think there's a large amount of pent-up demand for council services – people have held off making requests but as the world returns to normal, they will do so. Therefore, the opportunities to signpost and manage that demand by automating it is an obvious example of how they can protect that service.

That's vital because in 'new' care models, local authority resource will be required to manage more outbound contacts and hence reducing standard inbound demand will mitigate any potential resource challenge.

Case management systems will be replaced by solutions more suited to integrated care

The final piece that we have on the horizon is to do with case management systems for child and adult social care. Case management systems are complex, expensive to maintain and operate and tend not to support the integration and common access to information. As with the virtual care plans, similar integrated processes will be applied for social care. Technology will replace antiquated care management systems and provide further incremental savings and benefits, providing a clear overall picture of the case, and secure access to those who need it.

Conclusion: The idea of locality will finally be embraced

What has been missing when looking at social care is for somebody to sit back and take the holistic view, as to how existing technologies come together to deliver the outcomes that we need to see for vulnerable and isolated people.

The past few months has been an eye opener for the health and social care sector. Get the technology angle right and you can deliver change from a locality perspective, not just with local government but with the involvement of acute and community trusts, CCGs, local authorities and the rest into that integrated care delivery model.

It’s clear that doing nothing is not an option. The pressures on the sector are severe – and have been seriously exacerbated by the pandemic – so now is the time to really bring technology to the fore.

Steve Morgan, Partnership Director, Agilisys

Steve Morgan, Partnership Director, Agilisys Experienced service delivery consultant with 30 years of experience across major private/public sector organisations with the last 10 years leading transformation of UK public sector customers.