Innovative approach to social care technology a win-win for residents and local authorities
By Michael Cleary, Consultant
Transformation Partners in Health and Care has supported social care innovation that will be key in benefiting residents and reducing pressures on local authorities’ budgets. By making the best use of the scale provided by integrated care systems (ICS), social care technology can be piloted and implemented without the risks for boroughs of going it alone.
Local authorities are experiencing ever-increasing financial pressures, with growing needs leading to increased demand for their services at the same time as inflation hits their budgets.
The past two years have seen an increased number of councils[1] issuing or at risk of issuing a section 114 notice, where expected expenditure exceeds the projected budget and councils are required to pass new budgets to bring their spending under control.
The 2023 Local Government Information Unit survey of councils showed that adult social care is considered one of the top short-term financial pressures and the greatest long-term financial pressure, with 40% of respondents stating it was the greatest long-term pressure on local authority budgets.[2]
Meanwhile, the 2023 Association of Directors of Adult Social Services spring survey found that, by the end of March 2023, 434,243 people were waiting for a Care Act assessment.[3] This waiting list, an ageing population, and the improvements in the treatment of long-term conditions mean further increases in the investment required for adult social care are likely.
There is no single answer to this, but there is something integrated care systems could do to help.
Issues with implementing technology-enabled care
Too often, councils are unable to find the resources to pilot, test and implement technology-enabled care (TEC) solutions in adult social care.
In recent years the number of solutions available to support social care has increased dramatically, with a renewed focus on proactive identification and early intervention, preventing crisis episodes and potential hospital admissions.
Capitalising on these opportunities could help residents stay as independent as possible, and ease some of the financial burden on adult social care.
But there are risks too.
Implementing a new solution or approach inevitably means a change to practice for front-line social workers, who are already stretched and whose buy-in is essential and can quickly be lost.
New ways of working require time and resource from commissioning and transformation teams to implement, oversee and evaluate – time and resource that may not be available.
Most challenging of all for finance leads, the implementation of new technology-enabled care not only has its own costs but also often means initially double-running existing services and the new solutions, as resident safety can’t be risked while a full evaluation is carried out.
How integrated care systems could help
Collaborative working within integrated care systems offers a potential solution to these issues. Working to develop and implement a prototype across a number of councils in an integrated care system could offer:
- lower initial investment per council, making it easier to identify potential funding and reducing the perceived risk of the prototype
- shared staffing resource to oversee the implementation of new solutions, change management programmes for social care staff, and proper evaluation to show the impact of the investment and inform future funding decisions
- opportunities to learn and build on strengths-based approaches to social care, based on a richer level of information about residents and their lives
- the opportunity to begin mitigating cost pressures through technology-enabled care solutions.
Councils have a strong track record of working across boundaries to identify and realise benefits in service delivery, for example for community equipment and care market commissioning.
It is arguably even more important to establish joint working in an area that features both unknowns and opportunities for the sector.
Integrated care systems have a unique opportunity to use their scale and relationships to begin these conversations, and to accelerate them where they are underway.
If integrated care systems are successful in this, they may see even wider benefits, such as frameworks for TEC that cover not just their local authorities, but primary care, acute trusts and community providers too.
North central London experience
At Transformation Partners in Health and Care, we recently supported North Central London Integrated Care Board (ICB) and the five north London borough councils to define and build on their ambitions as an ICS.
In supporting North Central London, we:
- provided project and programme management.
- facilitated system conversations for TEC, bringing key partners together and building on the existing work within the system and resulting in a strategy for TEC in the system.
- developed expressions of interest for the Adult Social Care Technology Fund, following the joint commitment from the ICB and the five councils to work together in partnership.
The funding offered by the Adult Social Care Technology Fund gives a unique chance to trial new solutions and ways of working without the need to identify local funding.
This opportunity is an exciting one and North Central London is now in the position to continue the conversation and identify areas of joint focus and delivery when future opportunities arise.
To have a conversation about how TPHC can support you, please contact our Consulting team at rf-tr.tphc-communication@nhs.net.
[1] Guardian article “Birmingham city council declares itself in financial distress”
[2] Local Government Information Unit statement: State of Local Government Finance 2023