What could converged health and social care mean for all of us?

Discussing the future of health and social care provision often stirs passions and frequently underpins political tension. We need a conversation that is more inclusive whilst pushing the boundaries to achieve a shared vision. That’s why we recently kick-started a national conversation, and in the first part of our discussion series, introduced the idea of a Care Covenant as a means to frame this wide-ranging debate. In short, we believe that a Care Covenant could help to articulate peoples’ priorities in relation to a 21st century health and care system, and should be developed through co-creation, inviting the evolution of a new social movement to inform future policy decisions.

Our conversations have been facilitated by leading global thought leader, Jeremy Scrivens, and our Chief Executive, Greg Allen, along with colleagues who have shared their views. In this second conversation piece, we explore converged health and social care and, in particular, whether it could serve as the lightning rod for technological innovation which enables better outcomes for individuals. This is what contributors had to say…

Convergence from a health and social care perspective

The idea of converged health and care has been looked at in the US from a market perspective. In its purist form, convergence is a process by which emerging trends in health and social care are brought together to drive the development of innovation.

The US healthcare market has previously identified four key trends that are converging:

  • provision moving from hospital to community facilities;
  • disease management shifting from reactive to preventative;
  • personalised care becoming more customised and precise; and
  • a greater focus on more community-supported ageing.[1]

Health providers have then looked at the ways in which they can develop new, often technology-based, products to complement those emerging trends. A product of this type of thinking includes, for example, Care at Hand – technology developed to predict, through machine learning algorithms, the hospitalisation risk of an older person in order to help prevent unnecessary admissions.

Jeremy Scrivens challenged us to look at convergence and discuss if this concept, embraced across the pond, could be relevant in a UK setting.

“We’re well on our way to describing the building blocks of a Care Covenant. To make further progress, I think it is important to explore convergence as an interesting concept that will add value to the ongoing conversation.

“Our Care Covenant conversation is about looking at new opportunities. It could be argued that convergence has accelerated the development of new technology that aims to meet future health and care needs.  

 “The question for us to explore is how can convergence support the development of a Care Covenant and challenge existing assumptions about the path to innovation.”

Greg Allen challenged the relevance of convergence because it has been driven by market forces in the US. Our NHS is taxpayer-funded with a private healthcare footprint for those who want to pay for their healthcare, and certain adult social care provision includes a mix of private, non-profit and local authority funded care.

“We have always seen the Care Covenant as a vehicle to start a wider conversation about what health and social care provision should deliver in the future. I think convergence is an interesting concept, but can it be adapted to drive innovation in the UK strategically?

“It would be interesting to see whether the principles associated with convergence can be deployed to tackle some of the key health and care issues, dementia and the rise in diabetes, that are likely to place demand on future provision. More evidence is needed to understand its true potential to transform how we innovate to address future challenges.”

Sue Wixley considered the balance between higher level strategic ambitions and practical considerations. The Care Covenant will need to pay close attention to what the public actually want from future health and care provision.

“I think we run the risk of focusing too much on strategic thinking and not spending enough time on what individuals’ expectations are about accessing parts of the health and care system. For example, sometimes it feels like the ‘system’ says X is possible or the computer says Y is not possible, rather than there being real engagement with how people want to be treated and what options are available for them to choose from.

“Technological convergence seems to be a mechanism for churning out lots of new solutions to solve what clinicians and other care professionals need. The Care Covenant will need to be far more inclusive, ensuring innovation is user-led.”

Joel Charles discussed what convergence means at a local level as the quality of health and care provision can vary depending on where you live.

There remains a postcode lottery that has built inequality into the social care system. Experience of care can vary depending on where you live.

“The growing complexity of health and care needs means that we must be more willing to look at a targeted approach to resolve potential gaps in provision on the ground. If a converged approach to health and social care can help reduce the current inequality gap through technology, then it is worth affording it serious consideration.”

Here, we’ve briefly explored convergence and its potential to encourage innovation. Questions remain about how convergence can help complement the development of a Care Covenant, given that it’s associated with a market approach to health and social care delivery. We would be interested to learn if you think convergence is relevant and should form an element of our emerging future vision? As the conversation develops, we hope to push the boundaries further and encourage wider discussion about what needs to change. We welcome challenge and new ideas as our discussions continue to evolve.

Join our conversation and be part of a growing movement that aims to deliver a new vision that meets the health and social care needs of today, tomorrow and the decades to come.

If you’re interested to learn more about technological convergence, read this paper published by Insight.

[1] Deloitte (2015), The convergence of health care trends: Innovation strategies for emerging opportunities, page 1, available from: https://www2.deloitte.com/content/dam/Deloitte/us/Documents/life-sciences-health-care/us-lshc-dchs-convergence-of-trends.pdf