At a recent, very well attended and incredibly informative event I was at, two things in particular struck me about the content of the programme: firstly, although headlined as ‘health and social care’, social care representation seemed to be largely missing from the agenda. Secondly, a lot of the innovations showcased and presentations delivered focused on condition (or symptom) management – important, sure; but there was very little (if any) reference to products that encourage the end user to change their behaviour and possibly therefore even mitigate against needing symptom management apps in the first place.
As a former local authority commissioner, it really is terrific to go to events and hear the public sector talking about embracing technological advances for the good of population health and wellbeing. It wasn’t always the case that I would hear such positive views expressed on how technology can support people and should therefore be utilised more frequently and better! However, it is concerning to see this largely remaining within the NHS thus far. Social care seems to be far behind. If not addressed soon, this gap in approaches taken by the health and social care sectors is going to widen and this, in turn, will negatively impact on the ability of the sectors to “integrate”.
Here in Greater Manchester, integration of health and social care is one of the cornerstones of the Devolution Programme, of which I am a huge supporter. The change in how the two sectors operate and the moves to bring them closer together are welcome ones. Real change is only going to happen though when things are done very differently and services are delivered differently.
Which brings me onto my second point; apps, platforms, websites, even wearables are invaluable for easily tracking and managing one’s own symptoms and conditions. There have been huge advances in the use of technology even from when I began my public sector career 10 years ago – for example, text reminders for appointments as standard.
Being able to manage one’s own health and/or specific condition using technology is fast catching on with members of the public and the fact that it is, is fantastic news to commissioners and policy makers, especially at times of national austerity. But what about taking things one step (or more) further? Why stop at commissioning and encouraging use of technology that assists with managing conditions, without thinking about how those conditions may be prevented in the first instance?
Apps, platforms and online programmes can all be targeted to ‘at risk’ individuals (or indeed everyone!) to help them make lifestyle or health changes before any ill effects may be felt. For example, by monitoring consumption and understanding their ‘peak’ drinking times, alongside being reminded about alternate pastimes, a person can be supported to reduce their alcohol intake and better understand the impact drinking at various levels has on them.
In this scenario, not only has the person changed their behaviour without having had any ‘professional intervention’, the choice to change their behaviour was theirs alone. They have taken responsibility for their own health and change management – thus becoming a change more likely to stick.
In this way we can say that self-help, online self-help available ‘at the touch of a button’, is a critical tool in demand reduction and will go a long way to alleviate some of the burden on public sector services. It is therefore a tool which commissioners of both health and social care services need to seriously consider in service design.