Agenda: Embracing innovation within Scotland’s National Care Service

THE Scottish Government recently held a consultation on its plans to improve the way social care is delivered in Scotland. The pandemic highlighted the urgent need for changes to the culture, planning and provision of social care in our country, and much of the consultation was positive.

In response to the paper, I chaired a working group which included Royal Society of Edinburgh Fellows and members of the Young Academy of Scotland. The group had significant and wide-ranging practitioner and research experience in the health and social care sector and in academia. Whilst we broadly welcome the proposals, some areas of the consultation raised concerns.

For example, the consultation focuses on organisational restructuring, rather than delivering a broader cultural shift which embraces innovation, and prioritises services matched to individuals’ specific needs. The provision of locally controlled, individually responsive, tailored care needs to be coupled with national standards and clearly defined career pathways and training for staff.

Innovation will be central to the implementation of a flexible National Care Strategy (NCS). While Covid-19 has significantly accelerated development of technological healthcare solutions, more must be done to develop a person-centred, human-rights model of care.

There are many examples of good practice to be built upon. For example, the Scottish Government’s Remote Health Monitoring approach utilises digital monitoring technology to enable patients to receive, record and relay information about their health and wellbeing in real time. This empowers patients to manage their own care, and provides flexible, wider access to services for everyone.

This kind of accessibility and innovation will be critical to moving beyond a purely outcomes-focused approach to care, which is based around the delivery of minimum standards, replacing it with a proactive, regulatory approach which harnesses the benefits of big data and AI.

However, a balance must be struck between harnessing the value of “big data” to revolutionise healthcare and taking more holistic approaches that value relationship-based care. Combining “big data” and soft information such as people’s values, feelings, and priorities will provide a clearer picture, allowing truly effective changes to take place.

Effective innovation will also depend on tackling wider issues, such as inequalities in digital literacy, financial hardship, and internet connectivity by building communities of practice that can develop local solutions. This must consider the impacts of socioeconomic deprivation, urban-rural geographic inequalities, and the needs of remote and island communities to overcome the “postcode lottery” that stymies access to service provision. As such, the NCS should build on ethnographic accounts of receiving care when designing solutions to issues such as the over-medicalisation of care and other associated barriers.

An urgent overhaul of our national care system is needed, and while the Government consultation is taking positive steps, more consideration is needed in how we can meet individuals’ specific needs.

Tailored care is no easy feat, but by harnessing the power of innovation and technology, we can support the urgent need for change, creating a better, fairer care system for everyone.

Caroline Gardner CBE FRSE is Chair of the RSE working group responding to the National Care Service consultation


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