The Government has committed to upgrading the UK’s current telephone network with digital infrastructure by 2025. Known as the Public Switched Telephone Network (PSTN), it consists of 75 million miles of copper cables and approximately 5,600 local exchanges. This will be replaced, and all landline calls will soon be routed over broadband.
This digital migration will affect over 1.8 million people who rely on Technology Enabled Care (TEC) services to help them stay safe and live independently. They include some of the most vulnerable people living in our communities who depend on the services commissioned or delivered by their local authority.
This creates a substantial challenge for all councils to ensure they minimise the known and unknown risks it creates for vulnerable service users. Additionally, the cost of migrating people from analogue to digital solutions will be significant.
The challenges, the risks and the costs are very real, but as the great Roman Emperor Marcus Aurelius wrote, the obstacle is the way.
Whilst the digital migration can be seen as an obstacle that must be overcome, it is also an opportunity. It offers a once-in-a-generation chance to dramatically change how TEC supports people to live better lives in their own homes through the novel use of digital care technology solutions.
The opportunity principally comes from:
• Removing barriers: Digital solutions today can potentially support people’s needs and outcomes in ways that were impossible yesterday. By removing barriers, more people will benefit from TEC than ever before.
• Rich, actionable insight: Digital solutions create data that can produce previously unobtainable insight into someone’s health and well-being. Answering meaningful questions from care and health practitioners will help them make more informed and better decisions. Enabling an insight-led approach to social care so that people then receive even more personalised care and support. This requires much more than just data dashboards, beautifully visualised.
• Proactive and preventative: New digital solutions enable an insight-led pro-active and preventative approach to social care, that was not possible with analogue solutions. Connecting smart devices so they can capture movement will provide insights into changes in lifestyle and help to identify when support is needed ahead of a crisis. The resulting proactive outreach and helping people to access support in the wider community will help to prevent and slow down the progression of health and care needs.
• Better quality services: There are a range of operational and service-delivered benefits that digital solutions promise to deliver. For example being able to remotely repair or re-configure digital solutions without the need of a physical visit creates a better experience for the service user. TEC services that embrace and integrate them into their service will support people who use them to improve their safety and independence and enjoy a better experience.
Seizing these opportunities will require a focus on the underpinning principles of successful TEC services.
Technology enables change...it is not change
TEC, on its own, does not deliver change or better service user outcomes. What is needed first is a focus on people, communities and outcomes. TEC should be the last thing you consider, not the first.
This approach allows new digital TEC pathways to be co-designed around desired outcomes and then ensures the technology solution supports it. The co-produced TEC service, as well as involving people who draw on care and support, should include care practitioners so that it fits their ways of working, aligns with a strength-based approach to adult social care, and is accompanied by a programme of culture change and engagement that explains to practitioners the value of new pathways.
Culture change is critical
Successfully mainstreaming digital TEC services requires councils to embed their approach to TEC, so it becomes a genuine part of the first offer in adult social care. Sustaining this cultural change is achieved when care practitioners confidently advocate for TEC within care packages because they believe it enables people to live the lives they want.
Running the odd optional training course and publicising a few examples where TEC has delivered positive outcomes is not enough to permanently change the behaviour of care practitioners. A coordinated and sustained change programme is required, ideally as part of a wider transformation programme that gives due weight to training and engagement and then actively supports care practitioners to work in the desired new ways.
Who benefits?
Against a backdrop of intensifying pressure on adult social care budgets, the need for councils to make decisions based on a clear, evidenced, and accurate financial case is growing. This is certainly the case for TEC services.
The digital migration is creating significant unplanned costs for councils. A recent Local Government Association study showed that over 50% of all councils neither understand the financial impact of digital migration nor have funding in place to deal with it. Investing in additional digital TEC pathways will add to that cost so councils need to be able to measure the financial benefits accurately.
Some councils, such as Hampshire County Council (HCC), have led the way in this work. By continually finding new, often digital, ways to support people to live better lives with TEC, HCC has realised a net financial benefit of over £19m in the last eight years, successfully using the technology to reduce, avoid and delay other traditional care and support.
This is just one example of how TEC services can achieve savings through better demand management and lower ongoing costs of care and support services.
The Local Government Information Unit recently reported that more than half of councils are planning to cut spending on services. The costs and risks created by the digital migration don’t need to be a further cost pressure. This obstacle is creating opportunities to ease pressure on strained budgets. The evidence of the impact of TEC has been building for years, and councils that get this right are seeing a return on their investment well within the first 12 months.
Robert Turnbull, Care Technology Specialist, PA Consulting and Alyson Scurfield, Chief Executive, TEC Services Association.
