Findings from the reviews
Findings and recommendations as summarised by Ipsos MORI, the Institute of Public Care and Skills for Care
Views on the benefits of digital technology.
There were high levels of agreement among the workforce and the sector more generally that digital technology is important in ASC. Participants associated digital technology with a range of benefits including better quality of care and outcomes for people who need care and support and unpaid carers, improved working practices and improved efficiency.
The main area where views differed was on the financial benefits of digital technologies. While participating technology suppliers explained that one aim of their products and services was to offer cost savings, care providers surveyed held mixed views about financial benefits. This included providers both with and without experience of implementing digital systems. Local authority staff thought the case for the non-financial benefits of technology, such as freeing up more time for person-centred care and improved quality of care, was more clear-cut.
The extent of digital technology use across the sector
The use of some, often basic, digital technology for care and support was widespread but mixed, suggesting its full potential is not currently being realised. Use of digital communication, including email and video calling, was common among all participants, the exception being people with care and support needs and unpaid carers aged 85 and over.
Access to and use of technology was lower among care workers than other groups in the workforce. Consumer digital technology was also increasingly being used to deliver care and support or by those with care and support needs. A range of digital technology was used to deliver care, but awareness and knowledge of care specific digital technology was variable among the workforce and care providers, and fairly low among people with care and support needs and unpaid carers.
Encouragingly, among the workforce there was openness to using digital technology more widely. On the whole, frontline staff taking part in the research wanted to develop their digital skills to be able to do so. There was also recognition among ASC staff that there will be an increasing need for digital skills in the future. Acquiring them was seen as an essential part of career progression. Similarly, there was agreement among the local authorities and care providers interviewed that digital technology would be part of their future way of working.
The reviews also found evidence that the COVID-19 pandemic had increased opportunities to develop digital skills in the face of difficulties. The pandemic has led to an increase in the use of digital technology, particularly communications technology. However, it may also have increased disparities in use of technology by staff in different roles, with less increase in use among care workers than, for instance, registered nurses.
Digital skills and confidence
There was consensus among registered managers and others with responsibility for developing the digital skills of staff that there were gaps in the digital skills of the frontline workforce. The types of skills thought to need improvement were predominantly basic digital skills.
The workforce’s self-assessment of their own skills and confidence was largely driven by familiarity and opportunity to use technology, with confidence being higher in organisations that had adopted digital systems. The digital skills and digital confidence of people with care and support needs and unpaid carers varied greatly. However, as would be expected, those who had been using technology for a long time, were using it for their work or had done in the past were more confident.
Age was an important factor concerning confidence. Among the workforce, younger groups exhibited higher levels of digital confidence, while older staff were more comfortable asking for support and were more interested in developing their digital skills. All participants with care and support needs who reported feeling not very or not at all confident in using digital technology were aged 65 and over.
Barriers to development of digital skills and adoption of technology
The review identified a range of barriers to developing digital skills and to the adoption and increased use of digital technology.
At an individual level, the main barriers were:
- variation in familiarity and opportunity to use digital technology - this affected people’s digital confidence
- awareness and knowledge about the range of digital technology available, and a perceived lack of need for digital technology felt by some people with care and support needs and unpaid carers
- anxiety and stress generated by the introduction of new technology felt by some of the frontline workforce, and by some people with care and support needs and unpaid carers
- a concern among some staff that digital technologies could replace face-to-face care and support, potentially impacting on quality, and a related reluctance to work digitally.
At organisation or sector level, the main barriers to the adoption of technology arose from:
- budget pressures making organisations less inclined to invest in technology, especially where financial benefits are not clear-cut or may be realised in another part of the health and social care system, or where organisations have competing priorities
- the lack of a digital vision for the sector to build on, with inconsistency in systems and a lack of interoperability
- the diverse nature of the demand for digital care technology (for example coming from SME care providers, local authorities, and people with care and support needs and their families), which was found to hinder the scaling and adoption of technology and limit purchasing confidence
- a need for stronger digital leadership in the ASC sector, and sufficient capacity and capability to introduce digital technologies into the sector and manage the related change.
Recommendations
Based on the above findings, the review research team proposed recommendations which were discussed with ASC representatives involved in the review expert reference group.
They are relevant not only to NHSX, but also to other organisations within adult social care and to those developing or supplying digital technology to the sector. Further discussion of the recommendations can be found in the main report.
Skills review recommendations
- Introducing digital technology to the workplace with appropriate support should be encouraged, irrespective of the current digital skills of staff. Access to digital technology can encourage the development of digital skills. Greater use of technology is associated with greater confidence in it and more positive views.
- A programme of myth busting, reassurance and culture change is needed, alongside changes to ways of working that focus on informing and raising awareness of digital technology, and communicating the benefits.
- Digital leadership skills should be developed further in the sector so that digital leadership becomes a ‘normal’ part of a leader’s role.
- Efforts should be made to raise knowledge and awareness of the role, availability and suitability of digital technology in the direct provision of care.
- There should be a continued focus on improving knowledge and confidence in data protection and information governance policies and procedures
- Greater collaboration and co-production of solutions would improve digital technology suppliers’ understanding of the needs of the ASC sector and assist in embedding digital solutions within ASC
- Digital skills support needs to be tailored - for example, through peers within and across organisations - and should aim to alleviate the anxieties felt by some of the workforce around greater use of technology
- Digital skills should be incorporated into ASC recruitment, qualifications and career progression
- There is a need to define and achieve a consistent baseline of transferable digital skills across the sector
- There is scope to improve consistency in the quality and availability of support for developing digital skills across the whole country and all workplaces, regardless of size of organisation or job role