In 2024-5, IMPACT organised a Network on the topic of ‘technology for independence and prevention’. This blog shares the work that has been taken forward in Leeds, led by Involve Me Digital Health Ltd, to embed a principled approach to the use of technology in care that centres on human rights, relational care and choice.
What was the issue?
Technology has been part of adult social care since the 1960s, with approximately 1.8 million people in the UK currently using ‘technology-enabled care services’ (TECS) and devices. The types of technology used in care services have changed over time, from pendant alarm systems to more advanced systems using Broadband and Wi-Fi. Other emerging areas include:
Artificial Intelligence (AI): AI is being explored in adult social care as a way to enhance quality of life, improve working conditions for care workers, and streamline administrative functions. However, there are concerns about its effectiveness, the need for human intervention, accountability, privacy, and ethical considerations
Robotics: Robotics also has the potential to support care delivery through physically assistive, socially assistive, and cognitive assistance robots. While there is some evidence of positive effects on people in care settings, there are also concerns about the quality of evidence, implications for the care workforce and ethical issues, including deception and surveillance.
Smart Devices: Devices like smartphones, smart speakers, and wearable sensors are increasingly used in care due to their potential to improve health and wellbeing, provide emotional support and support carers. However, challenges include digital divides, the potential for social isolation, and concerns about data ownership and ethical issues.
There are however overarching challenges related to the use of technologies in care:
- Choosing the right technology: Selecting the appropriate technology from a complex marketplace is a significant challenge.
- Impact on the workforce: Integrating technology can create new roles and tasks for the care workforce and has implications for their jobs.
- Ethical considerations: Ethical issues such as privacy, benefit to wellbeing, fair distribution of resources, and trust need to be addressed.
- Digital exclusion and inequality: Digital poverty and exclusion can prevent some individuals from accessing and benefiting from digital services.
- Evidencing outcomes: It is difficult to capture evidence of technology’s outcomes in relation to care.
- Co-production: Co-production, involving people receiving care and support in the design and implementation of technologies and services, is proposed as a way to address these challenges and ensure that technology meets their needs and preferences.
The IMPACT Network in Leeds, England
In Leeds, the local Network coordinated by Involve Me Digital Health Ltd explored the evidence shared via discussion materials that combined research, practice knowledge and lived experience, including insights from Networks from across the four UK nations. The people in this local Network explored various issues related to the use of technology in care, including concerns about the replacement of people and human interaction with devices, and implications for privacy and trust. There was a shared agreement that human rights and responsible, ethical practices are needed to underpin approaches to technology use in care.
At the local meetings in Leeds, there was agreement that there needed to be principles that can support safe and effective adoption and use of technology in adult social care. One Network member noted “We need a consistent framework to compare products, like Go Compare.” The local Network looked at the NHSE@Home ‘5 Principles’ for inspiration in co-producing a set of principles to inform policy and strategy across Leeds City Council. There was agreement that the principles needed to be adopted at a system level, designed to be appealing/accessible without losing the detail and promoted in a wide range of media. The Leeds Network worked together to develop the ‘Leeds Technology Enabled Care Guiding Principles’, which are:
- Fundamentally simple– Products will be created using human centred design and tested on real world problems with people they are aimed at helping. The priority is doing what matters to a high standard.
- Personalised and condition specific– People will be able to personalise their technology to suit their needs, preferences and skills. Technology will have been shown to be safe and fit for use with people who need it most. It will enable everyone who needs it, more choice in how they manage their needs day to day, safely and effectively, to live the lives they wish.
- Clear purpose: users on both ends– The technology will work well for its intended purposes and have clear, easy to understand and use features for people and their health and care team members. The benefits to people the technology is aimed at, will be clear and deliver what it says it will.
- Supplement, not replace– Technology services will be used as a trusted, safe additional element to deepen care and support conversations. It will not be usedwithout human involvement/oversight day to day. Technology will provide enhanced opportunities for people regarding contact with others, as agreed with a health or social care professional, respecting the preferences of the individual, including understanding how their data may be used.
- Opt in or out choice– People exploring the use of technology in their care and daily lives will still be able to opt in or out of different products, services, and use of their data where they choose/need to. Transparency about the technology, its safety and how it might promote personal goals, autonomy and wellbeing are key to building trust.
Involve Me Digital Health is now undertaking discovery work to define a ‘Community of Collaborators’ who can build wider engagement, supported by members of the original local Network with lived experience, to embed these principles across all strategic priorities and collaborators in Leeds.