Technology thoughts for social care: positivity and threat.

It’s been a busy week in the world of technology, data and social care in Scotland. I managed that rare thing of attending the whole of a conference event and to listen to some insightful and interesting speakers. The event was the annual Holyrood Digital Health and Care Technology event. It brought together hundreds of delegates from the health, social care, technology, and data sectors to talk about the priorities of the moment, hear about some amazing innovations and be suitably challenged to think creatively and with imagination. It also combined an Awards evening which celebrated the cutting edge of excellence across Scotland in health and social care. I was honoured to have been one of the judges at an occasion where every nominee really was a winner.

Inevitably one leaves such an experience with a head full of thoughts and feelings, some of which were conflicting and contradictory. I want to share a few of them in this brief blog.

One of the key moments in the two days was the launch of the Scottish Government’s latest data strategy.  In many senses the title of this joint document with local government body COSLA says it all – ‘greater access, better insight, improved outcomes.’ The aims are clear and aspirational and are well articulated within a strategy which hopes to enable a better health and social care experience by the means of an ethical and human rights based use of data. The focus on autonomy and citizen ownership is laudable. The conference contained a lot of debate around data and how valuable our personal story through data was in our achievement of change and progress and yet along with many I was uncomfortable about the extent to which the disparity between the worlds of social care and health were highlighted in much of the debate around data and its use. My colleague Nicola Cooper who was also at the event articulated this in a succinct and prescient manner in a tweet yesterday where she said:

“‘Something has been troubling me. Data, data, data…….mentioned 10,564 times (felt like) at #digihealthcare2023 Conference… So are we saying that Social Care is less mature in its use of data, compared to health?’ The premise being it is…I’m not sure I agree. Here’s why.Social Care data is collected over & over, in different formats, to please different masters, and shared routinely for scrutiny & oversight, scrutiny & oversight (yes, I know I am repeating myself). It invokes negative + disempowering associations…Task driven, de-professionalising, risk averse, overwhelm – get it? Good data, often qualitative, helps with person-led high-quality care. It’s there but buried under the weight of reporting + regulation…. Data is the new gold at the end of the rainbow – always out of touch.

This is where maturity lies. In data driven innovation. Grass roots, by those closest to the challenge who are the most likely to know how to do better – improvement, service redesign, innovation… Will social care achieve data maturity is less of the question than IF social care in its current state is sustainable? (hint, the answer is NO).”

The social care sector has an abundance of rich often qualitative data, and this is immeasurably useful for the improvement of the individual experience of citizens and for the benefit of the whole health and care system but it is only useful if there is an adequacy of priority given to social care providers and staff to enable them to be the harvesters and users of such data in a way which is sustainable and beneficial to the rights and lives of the individual. It is only useful if the data tells the whole story and if social care is enabled to be autonomous and unique in its articulation and not be forced to utilise a data dialect which is not fit for context or purpose – thus the huge significance of the narrative as well as the number within data. Qualitative data matters as much to the outcome of a story as quantitative measures! Yet again the imbalance in strategic priorities between health and social care illustrates the failure of a whole system approach within Scotland.

My second observation of the conference was the extent to which there was a continual reference to the need to develop a digitally trained and competent workforce. At Scottish Care we are no strangers to the necessity of equipping our frontline carers with the tools to enable them to maximise the benefits of technology and digital in order to achieve the best possible outcomes and lives for the people who are supported in their own homes and in our care homes. The Care Technologist programme is an adventurous and innovative approach to ensuring that frontline social care is at the forefront in the challenge of championing that people are enabled to use technology to maximise their personal control and choice in their lives and in their care support. But if such innovation is to become mainstream, it demands an adequacy of resource priority to ensure our care workforce of the present and future is properly equipped, supported, and encouraged to undertake these progressive approaches. And all this at a time when social care providers are struggling to recruit and to retain frontline staff because of the embarrassingly shameful rates of pay which are predicated on inadequate Scottish Government pay awards. You cannot build and equip a technologically confident workforce on the deficit scale of reward and remuneration. There is a massive risk that the future of social care technology and digital usage in Scotland will be a shameful lost opportunity because of a lack of investment in and priority for the care workforce.

My next observation relates to the criticality of cyber and data security. After landing home after the event, I got an alert along with many parents at my local school around on-line security and threat. In this instance it was related to concerns which had been raised around the potential for cyberbullying, grooming or unwanted contact through the Roblox chat functions.  Roblox allows users to create and share their own games, as well as play other users’ games. As any user can create a game, an individual may create or invite a user to join a game that contains adult themes that will expose the child to content inappropriate for their age. No-one with a young child in their family will be unfamiliar with such warnings, and concerns – the world we inhabit is as full of technological threat as it is with digital promise and positivity. To ensure that those who work in and use social care are properly protected and aware both at an organisational and individual level is a massive challenge. This coming week (27th February to the 5th March) is Cyber Security Scotland Week which is an important initiative to make sure that we are all much more aware of the critical issues of cyber and online security. This is a fundamental element of ensuring our futures are one of positivity rather than abuse. The future promise of technology not least in the sensitive arena of health and social care will rise or fall on the extent that we prioritise both awareness of and investment in the protection of data and the development of our cyber security.

My last technology observation for the week relates to something which might seem antithetical to everything that has gone before and to a generally positivist approach to tech. It is simply that we must recognise that technology and digital are tools and not destinations. Like many people since the pandemic my world has become dominated by online meetings and Teams calls. In a very real sense attending a physical event is a rare treat and pleasure – it has become unusual for many of us to be out there with people in the way in which we used to be. This has had many benefits – we probably get more work done, we are more inclusive of those who live and work at a distance and we have managed to maximise participation and engagement in so many diverse ways. But – there is a cost. That cost is one I think we increasingly both individually and collectively need to challenge until we get to a point of healthier balance. The cost is personal interaction, dialogue, and honest communication. Online meetings allow those who organise and chair, those who lead and manage to control what happens, they drive out the directness of eye contact, the positivity of physical presence and the benefit of side exchange and networking. I am convinced in most meetings and group interactions they stunt innovative contribution and creativity. We have- not least in some governmental and statutory circles – reached a stage at which I am very worried about the way in which honest and healthy exchange and debate are being shut down by the dominance of virtual meetings and the absence of physical in-person interaction. It would be unfortunate in the extreme if the benefits of technology ended up leading to a situation of disingenuous exchange and the loss of freedom for speech and robust and honest contribution. I just wonder if that is the direction in so much of our working lives in which we are moving.

Enjoy your tech week.


Donald Macaskill