The government has put forward proposals for social care funding. Of the £36bn promised from the Health and Social Care levy over the next three years, social care is due to receive £5.4bn or £1.8bn/annum. This recent announcement by the Prime Minister represents a missed opportunity, an opportunity to promote greater health and social care integration … and especially integration via digital transformation.
It is acknowledged that investing in social care will save the health and care system money. Investment in new technology to ensure people’s ongoing quality of life will help avoid the need for acute intervention to repair people’s health. The short-term funding fix proposed means that social care will not have the funding to invest in technology and digital transformation to make the crucial efficiencies to benefit the health and care system.
Let’s follow this line of thinking. NHS England reports that residents in care homes account for 185,000 emergency hospital admissions each year and 1.46 million emergency bed days, with 35-40% of emergency admissions deemed potentially avoidable. By improving the digital infrastructure and allowing appropriate access to people’s data in care home settings, care staff would be able to provide even better-informed, personalised care which in turn would help avoid emergency hospital admissions. If those 1.46 million days could be cut by 25% that would save the NHS over £0.5bn.
Let’s take another example. It is estimated that a hip replacement costs about £11,000 (https://www.privatehealth.co.uk/conditions-and-treatments/hip-replacement-total/costs/); the related costs to the NHS are difficult to ascertain accurately, however a figure of about £8,000 might cover it. There are about 40,000 hip replacements on the NHS annually (https://www.njrcentre.org.uk/njrcentre/Healthcare-providers/Accessing-the-data/StatsOnline/NJR-StatsOnline), so this equates to £760m. If falls could be reduced by half, the NHS could potentially safe almost £0.5bn which is the tip of the iceberg of what could be achieved. One company, Ally Labs, which promotes its acoustic monitoring solution, has evidence to show it can reduce falls by 55% in care homes. Doesn’t that make you dream of the potential efficiencies which can be created in the system?
The value created by care providers, employing technology to give even greater quality, generates value for the whole health and care system. The issue is that the value created in one part of the health and care system is then realised in another part of the system… which means that there is a clear case for place-based funding rather than siloed sector-based funding in health and social care.
There are many areas where implementation of technology in social care on a consistent basis could promote quality of life, create efficiencies for care and health organisations and save the system so much money. This requires some real forward planning, incentivisation, and there needs to be investment in technology to realise the savings.
The only way to make our healthcare system affordable in the future is by ensuring that people who require care and support, whether they be working age adults or older people, have as high a quality of life which will lead to system-wide savings. There needs to be money for social care organisations to invest in this sort of life quality improving technology. The recent publications by NHSX (What Good Looks Like and Who Pays for What) deal with health first, and the premise is that social care will be dealt with next, much as the Prime Minister has chosen to do in his recent funding proposals. Surely the time is right to turn this model on its head and invest in digital transformation in social care to realise the long-term efficiencies and value creation strategies that need to be promoted.
Daniel Casson is Care England’s Adviser on digital transformation.