by Carys Roberts, researcher at IPPR
Digital technology makes finding out about and purchasing services that suit us best infinitely easier than it used to be – and as it gets easier, so our expectations of digital services also change.
Public services, including social care, have been slow to catch-up. But as the sector comes under increasing pressure to provide universal, preventative and personalised advice and care, this may be about to change.
This week IPPR published a report showing that a quarter of councils are using Amazon-style e-marketplaces to enable people with care needs and their carers to review and organise care equipment and services. Many more are considering their implementation as one of many promising technologies to help deliver better care.
Success needs much more than a website
Digital technology can often be seen as a threat to jobs, as it changes the nature of work. But our research found that far from being a substitute for human interaction in care, at their best digital technologies place human relationships and frontline workers at the centre.
Success requires much more than a website because social care services are more complex and personal than, for example, applying for a parking permit. Frontline workers – from council social care workers to independent brokers – are the key to successful e-marketplaces.
Well designed e-marketplaces can help ensure service users have meaningful choice between diverse providers. They can help integrate formal with informal care, making better use of community assets. They can even place the user in direct control, by enabling user-led groups and commissioning of services by the user themselves.
For this vision to be achieved, local authority leaders as well as social services and digital managers must display strong leadership and commitment to personalised care. But our research also points to ways in which frontline workers can reflect on their practice to make sure e-marketplaces deliver radically different social care:
1. Reimagine your role as a frontline worker
E-marketplaces are one part of a much bigger drive towards personalisation and empowerment in care. This shift will see the role of the frontline worker shift from delivery to coordination of a more diverse system. For e-marketplaces to succeed, frontline workers must be willing to signpost services and providers they may be less familiar with, and have trust in users’ decisions over what is best for them. Otherwise, the same market of established providers will remain and users won’t have meaningful choice.
Of course the wider system, including pressures and targets delivered right down from central government, can make this difficult to achieve in practice. But it’s also up to frontline workers to use the freedom and responsibility they do have, to get the best outcomes for users. For example, frontline workers have a responsibility to evaluate risks posed to service users, which can mean unregulated, community services often aren’t recommended. But the most regulated service isn’t always the least risky.
As Community Catalysts, a social enterprise supporting micro-providers, told us: ‘Winterbourne View was inspected regularly and thoroughly; it’s amazing that people think regulation is safe and micro-providers aren’t. Ultimately, people are safe if they are connected to their communities.’
2. Don’t assume that people don’t want to access e-marketplaces
The latest statistics show that though 61% of people aged 75 or over have never used the internet, this falls to 24% among 65-74 year olds. Increasingly, older care users will not only be able to use digital services to access care, but will expect to. Most care users will also be able to use well-designed digital services such as e-marketplaces with support and guidance from carers or care workers.
Explanations can go a long way: Carers UK have found that though only 12% of the population would use telecare, when the term was explained to them this shot up to 79%. Equally, it is important to make sure those who cannot access the service have other ways to access choice over care services.
3. Collaborate to design empowering e-marketplaces
Design matters. Work with digital teams to make sure your expertise and insights from the frontline feed in to the design of the e-marketplace. Local authority social care teams are just as important as digital teams in creating an e-marketplace that are easy to use and designed around users’ needs and experiences.
Meet and get to know a range of providers – from the smallest to the largest – to make sure everyone understands what the e-marketplace means for them. Worcestershire County Council has found it particularly helpful to hold meetups between staff and external providers who want to advertise on the e-marketplace. Putting in place an active market facilitation programme will ensure that a range of providers, including user-led groups, can access the site.
4. Push for and take up training opportunities
Supporting users to exercise their choice through the e-marketplace may require new skills. Digital services at their best don’t just transfer the current service to the internet, they fundamentally transform services. That means everyone involved in delivery should understand how digital services work and what they could offer in the future. Similarly, training can help you learn about the principles and implications of personalisation and the 2014 Care Act, as well as the freedoms and responsibilities you are able to use.
There is a wealth of advice and guidance on offer. For example, RUILS offer advice on how users can find and best employ a personal assistant, Think Local Act Personal have lots of advice available around implementing choice and personalisation, and Community Catalysts work directly with local authorities to help make community care and choice a reality.
If you’re not offered training in these areas, you could collaborate with others to organise a shared learning group. LocalGov Digital do this on the tech side– bringing together digital officers from different LAs to share ideas and learning.
In the same way that digital technologies are reaching every other corner of our lives, social care will become increasingly digital. Now is the time to shape this ‘direction of travel’ to support more personalised care that empowers people as citizens rather than as service users.
Carys Roberts is a researcher at IPPR. She tweets at @carysroberts