4 Technology-enhanced care in Wales
The Welsh Government outlined an intention to use technology to enhance care in Wales in 2015 in its report, ‘Informed Health and Care: A digital health and social care strategy for Wales’. Figure 1 shows the ways in which digital technology is expected to transform care.
Some of the unique challenges for Wales include incorporating the use of the Welsh language in any IT or digital technologies and ensuring the languages are treated with equal parity. This means that if a particular service or app was to be offered to service users, there would have to be some consideration that some Welsh people can only or would prefer to receive this in Welsh (Welsh Government, 2015). Overall, in Wales there is the expectation that technology will enhance care by allowing service users to:
- see their own data and information to make better decisions about their care
- add information to their data and records (such as linking to their apps and wearable devices)
- access and use digital apps and wearable devices
- use the internet to connect to social care services and communicate with professionals via video conferencing, email and text
- use digitally-enabled services to support them to be able to live independently as long as possible.
For example, Powys, a region in Wales which is one of six locations in Europe that is taking part in a project on technology-enhanced care for older people who have chronic conditions. One hundred people in Powys are included in the project, CareWell. As part of the project, participants’ electronic data and records will be shared between community workers equipped with mobile devices and there will also be a shared record between GPs and hospital doctors. This project is about supporting the service user to remain safely and independently in their own home through all the health and social care professionals who are supporting the service user to all work from and input into the same electronic ‘patient record’ so that care is joined up. As part of the project, the community worker will also be able to communicate using the mobile device with the service user’s informal caregiver using text and picture messaging (Welsh Government, 2015; CareWell, n.d.). The CareWell project is a way to determine how and whether technology-enhanced care actually does work in practice and how it works.
In the next activity, you will learn about the some of the practical issues around incorporating technology into care in Wales.
Activity 3 Changing practice through technology in Wales
Watch the following video, concentrating particularly on the section from 2 minutes 39 seconds onwards, about incorporating technology into social care. The speakers include a social care professional from Wales, England, Scotland and Northern Ireland. They are all discussing both the opportunities and the challenges that this strategy will present for social care in incorporating assistive technologies in relation to their social care workforce in their own national setting. As you watch the video, make a list of all the advantages/opportunities that the speakers mention in the video in the left-hand column below, and all the disadvantages/challenges that are mentioned in the right-hand column below.
Download this video clip.Video player: Video 1
Transcript: Video 1
MARED LLWYD
I think there's been a recognition there's a gap in terms of knowledge and skills, learning and opportunities in terms of electronic assistive technology, and how the workforce utilises that, so is aware of, and has the right knowledge and skills to actually embed that in their day to day social care practice.
So the purpose of the work really is to help move that forward, to develop the workforce to have the confidence, the right skills, and knowledge to be able to enable people to live to support independence, choice, well being to increase really and add value to the sort of social care packages and support that is offered at the moment.
DIANE WEBB
I think that also that it's OK that staff do need support and training, and additional learning, because a lot of staff maybe came in to the social care fields. And there was no use of technology when they came in. Then all of a sudden, there's these new types of technology, which can be scary, because it changes your job. So staff do need support.
MARED LLWYD
And we are developing a set of knowledge and skillset, and a strategy, which is about how we will do that. And the knowledge and skillset provides more practical tools really.
REBECCA NANCARROW
I like the fact we've got the implementation plan as well, which helps people put it across. So you've got the high level strategy, which helps us look at it all as an overview. And then we've got the implementation plan, and the real good user friendly skill sets to really introduce the ideas through to the workforce.
TREVOR TAYLOR
Yeah. And I think as well, the skill sets that will be very useful for organisations, both at the local level, as well as regional. And for some organisations, national level, to ensure that their staff have the competency and skills to use the AT if it's required for specific tasks or jobs.
MARED LLWYD
Yeah. And it gives a baseline, doesn't it? That we all work to. Standard across the UK that people can apply.
Obviously, people can build on that. And hopefully, it’ll end in things like qualifications, development, future national occupational standards development possibly.
REBECCA NANCARROW
We've also looked at people like manufacturers, suppliers of equipment, hoping to get them on board. We've got good contacts with them from the work that we do. And it's really nice to have things in the plan and strategy that will include them as well. Yeah.
And there's so many people that have been involved in the workshops around the country. So many people involved. There's an awful lot of different viewpoints that work really well. That come to the same conclusions really.
MARED LLWYD
Yeah, I think it is good. We've had good representation from you four have come forward as champions in your regions, as well as many others. Because they're interested. And they want to see it succeed, and want to see something that will drive the development forward, as we're all trying to meet different challenges in all our countries with less resources.
TREVOR TAYLOR
The thing that we find in our flow and support service, which is community based so it's about our support workers going into people's homes, that we're now introducing things like support staff going out and using tablets. So we can develop, for example, maybe as a part of a support goal, menu planners, healthy eating. So we're able to pick through and flick through things, rather than bring out reams of paper.
And so it's a matter of the person. And if the person is lucky enough to have a printer. And it's also given them the confidence maybe to use if they have a smartphone, to actually start doing these things for themselves. So it’s also about the staff as well learning.
And it's a two way process about the staff learning, along with the service user. And sometimes the service user showing the staff maybe what they can do, which is another good thing as well.
REBECCA NANCARROW
They start off really nervous around the equipment. But now, they go on. They're creating artwork. They're using the drumming software, some people with their eyes, some by touch. They're getting involved in and included in all sorts of stuff.
And you can see the staff are visibly more confident and relaxed around it. And they all get so much out of it.
DIANE WEBB
And that makes such a big difference to the individual. Because if the staff are confident--
REBECCA NANCARROW
Absolutely.
DIANE WEBB
And feel comfortable in using the equipment, then that makes such a difference to them in how they use it, and even how they think about it, or think about getting other types of technology to support them in their life.
MARED LLWYD
I think it can reduce social isolation in some ways, as long as it's not the only thing that's happened. But also in terms of life, leisure, work opportunities, potentially, it opens up so much. But also relieves pressures on people like carers. Assistive technology, whether it's an alarm, or just a buzzer on a door sensor, warning them when their loved one gets up in the middle of the night and starts to go wandering, at least they can get to sleep.
DIANE WEBB
I think that's one of the great things about this strategy. It's not just about environmental aids. It's all about just every day technology.
REBECCA NANCARROW
It is. Yeah.
DIANE WEBB
And how some people that we're supporting are not able to access that every day technology, like mobile phones, like a laptop, internet. And it's about supporting them to access that as well.
REBECCA NANCARROW
And for people who live in remote places, the Tully Care, the Tully Health, it all provides the framework of how to ensure that your staff are comfortable to use all of this innovative stuff really.
TREVOR TAYLOR
Yeah. I think that's going to be a very important thing in the future, particularly for areas like Northern Ireland, which is quite rural. But it is about using assistive technology to bring people who are maybe living in rural areas. Making them feel much closer to their community, and not so much in terms of isolation. And it's about staff as well.
When they're learning the skills, helping people to develop up those skills so they don't feel socially excluded, or marginalised. Not necessarily because of their disability, but because maybe of where they actually live.
MARED LLWYD
Yeah. And to think that was recognised within this strategy, and the knowledge and skill sets, one of the key things is that basic awareness across the sector. Everybody needs some kind of awareness of what it is, what it does, a general understanding people will become more skilled than that. And that's built in too. So building it in into how we recruit and induct, and all of that in the future.
This strategy now has recommendations really just aimed at employers in the main. But it also has clear recommendations of how we can take this forward. So the specific recommendations.
But also, they're relevant for-- well, some of them are specifically relevant for suppliers.
DIANE WEBB
There's the week planner, our learning and training programme for next year. We will just take the knowledge and skill sets and work out what's relevant to us, who is responsible for which area, who needs training in what and more. And then we would just use that and map them across our training programme, and start to introduce those types of training, and also introduce it within inductions, and also across other types of training that we've already got running, like vulnerable adults, introducing some of the IT, introducing that into current courses that we have running.
From my own personal point of view, I was looking for further qualifications and training, and electronic assistive technology. I am actually managing a team and I have experience in using electronic assistive technology. I don't have a specific qualification in that field. And what I've found is there's hardly any training or qualifications out there. And I'm now having to go down to Coventry University to get a qualification, whereas I would rather achieve that in Scotland, and at Oakley.
TREVOR TAYLOR
I think it's important, certainly for the likes of organisations that provide social care services in Northern Ireland to get involved in the action strategy. It's that there's more and more development in this particular technology. And it's continuing to develop at a very rapid pace. And I think at the end of the day the important thing is to remember, if it's going to improve the quality of life for the individuals that we provide services for, that's the very soul of becoming involved, and in the strategy, and taking it on board, and developing up the knowledge and skill sets, and working to those. So I think that's very important certainly for any service provider.
MARED LLWYD
The main reason really is to improve the quality of life, the opportunities, independence for people, and enabling people to stay at home longer, have more choice and control.
REBECCA NANCARROW
I think for me it's to be proactive rather than reactive, because the technology is here. People are picking it up. They're seeing the opportunities. It's exciting. It's innovative, and it's a buzz. And rather than having to get the skills later, let's be proactive and get them now.
Video 1
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| Advantages and opportunities for technology-enhanced care | Disadvantages and challenges for technology-enhanced care |
|---|---|
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Discussion
Here is an example completed table:
| Advantages and opportunities for technology-enhanced care | Disadvantages and challenges for technology-enhanced care |
|---|---|
| People want to see the strategy succeed | Trying to meet needs with less resources |
| Relying less on paper and paperwork | Some people don’t have good access to technologies |
| Support staff can scaffold learning of service users to use internet and technology themselves (as they see it in action) | Need to build in digital skills or literacy into how social care employers recruit, induct and train |
| The staff themselves will learn and gain confidence using technology | Some managers/employers feel that they need more qualification or training in technologies themselves in order to manage their teams |
| People using the equipment gain digital confidence – staff and service users | There might not be many relevant training and qualifications to support technology in care in the early stages of adoption |
| Can reduce social isolation | |
| Relieves pressures on carers | |
| Reduces lack of access to technology | |
| Particularly useful for people who live in remote or rural areas | |
| Can be used to improve quality of life and independence for people, enabling them to stay at home for longer | |
| It’s exciting and innovative to include technology |