Coronavirus (COVID-19) digital health and care response: 2021 update

Inclusion and Participation

Digital Approaches in Care Homes

During the first phase of the response to COVID-19, it became clear that the impact on the residents, the staff and the care home providers was significant. An emerging need for the utilisation of digital technologies was identified. In the Summer of 2020, the work started to consult on and shape an Action Plan to support this significant new piece of work.

The subsequent Action Plan supported the Digital Health & Care Strategy and is aligned with national strategies, plans and programmes.

The collaborative approach involves partners from:

• The Convention of Scottish Local Authorities (COSLA).
• The Scottish Social Services Council.
• Scottish Care.
• Connecting Scotland.
• The Care Inspectorate .
• The Scottish Council of Voluntary Organisations.
• The Coalition of Care and Support Providers in Scotland.

The Action Plan is structured around three pillars of delivery: Digital Foundations, Digital Services and Digital Leadership & Skills.

Contributions to the COVID-19 response

• Consultation with key stakeholders.
• Consultation closed in October 2020.
• Action Plan for 2020-2021 developed.
• The final Plan was launched in November 2020.

Digital Inclusion in Care Homes

In collaboration with the Connecting Scotland Programme, the aim of this work has been to put in place the digital foundations in terms of devices and connectivity along with the skills for staff and residents. There are two strands to this work.

• Completed a deep dive in six care homes in Aberdeenshire to understand and support skills development for residents and staff. This was a collaboration with Care Inspectorate, Scottish Care, the Scottish Social Services Council (SSSC) and Connecting Scotland.
• A national programme, launched in November 2020, to offer devices to care homes, supported with funding from Scottish Government Digital Health & Care and the Connecting Scotland initiative as the Connecting Care Home Residents initiative; led by Scottish Government delivered with Connecting Scotland, in collaboration with COSLA, Care Inspectorate, Coalition of Care Providers Scotland, Scottish Social Services Council and Scottish Care.

This work was undertaken in tandem with the Adult social care – winter preparedness plan: 2020 to 2021 and the Digital Approaches in Care Homes Action Plan 2020-21. The Scottish Government committed funding to ensure, that all of Scotland's care homes would access to digital devices for use with or by residents, and, connectivity and support to help their residents. The digital package consists of a combination of the following:

• A tablet (iPad)/laptop. A mifi dongle and a data package for 4G connection.
  • staff skills development opportunities
• A mifi dongle enabled with a data package for care homes without wifi. Priority was initially given to registered care homes that have the necessary connectivity but lack sufficient devices for use by or with residents.

Sector uptake – 76% of all Scottish Care homes (1,056) = 91% of care home residents (ca. 31,500 people).

• Continued to deliver a £1.5 million programme of work, which to date has dispatched 1,961 iPad devices to 1,056 care homes (746 mifi devices).
• Developed and assessed options to address the connectivity challenges. The work has identified 132 homes with no devices (approx. 9% of all homes) which is impacting 3,500 residents (approx. 10% of resident population).
• The numbers of staff and residents using the devices has grown gradually. The team continue to raise awareness and establish a care home learning community for care home staff and enhanced the range of services available to staff and residents.
• Updated resources on the TEC website to share and promote the work.
• Established an approach to evaluating the digital inclusion initiative.
• Leveraging our in-team skills, the team have worked with the Near Me team to establish Near Me as a tool for undertaking care reviews.

Additional digital service developments

Practical steps to make connection and communication easier for those working in care homes were taken. For example, work to address connectivity problems, and the provision of NHS email (up to 3 addresses); and work to support skills development and knowledge exchange was undertaken. Other initiatives included:

• NHS Education for Scotland led a collaboration with Scottish Government and care providers, to develop the Care Home Safety Huddle tool, built by NHS Education for Scotland (NES Digital) teams working with stakeholders. It is a web-based, accessible-anywhere tool which allows staff to capture and collate data that can be used for multiple purposes to plan, manage resources, and provide a directed response. The initial focus was around outbreak management; the tool demonstrated that care homes could use the data to identify factors that may impact on the health, safety and wellbeing of residents.
• Work led by the Digital Health & Care Innovation Centre was undertaken to use the Care Homes Assessment Tool (CHAT): to improve local operational decision making in care homes.

Connecting Scotland

The subject of digital inclusion and the related challenges around digital literacy and digital health literacy has been the focus of a range of different initiatives in recent years. Many organisations have worked with individuals and within communities to help tackle these issues.

With the shift to providing services digitally, digital inclusion has been more important than ever. The recognition of this issue and the momentum to do something nationally as part of our response to COVID-19 resulted in the Connecting Scotland initiative.

The objective of the Scottish Government Digital Directorate initiative, which is managed by the Scottish Council for Voluntary Organisations and local authorities, is to increase the number of individuals and families who are digitally connected. The programme aims to get 60,000 digitally excluded households online by the end of 2021. This initiative has provided a very welcome opportunity to collaborate for the Digital Health and Care Directorate.

Since April 2020, Connecting Scotland has provided access to devices, connectivity and dedicated support to get people connected. The programme also works to develop individuals who become Digital Champions and support the objectives of the programme in their setting.

Building on learning from initiatives, the programme is a partnership with local authorities and local third sector organisations already working with the target groups to provide support. Applications to the Connecting Scotland programme for funding are via the organisations (who apply on behalf of the people they are working with).

The first phase of the programme focused on:

• People who were at identified as being clinically at high risk from COVID-19. These individuals were very likely to be in the shielding group and isolating at home.

The second phase of the programme focused on:

Households with children.

Care leavers up to the age of 26 (in line with eligibility for aftercare support).

Older and/or disabled people.

The most recent phase of the programme has focused on:

• A fast track – for organisations who have identified up to 10 people they are currently working with at risk of social isolation and loneliness.
• A social housing fast track – for housing associations and other social housing providers to rapidly distribute up to 100 devices to tenants at risk of social isolation and loneliness.

The support provided includes:

• Kit – internet-enabled devices.
• Connectivity.
• Training and support.

The Connecting Scotland initiative has also underpinned the Digital Inclusion – Connecting Residents in Scotland's Care Homes initiative outlined in the previous section of this report.

The Connecting Scotland programme has, to date, reached over 36,000 Scottish households.

For the work of the Digital Health and Care Directorate improving digital access and digital is and will continue to be an important factor in our success.

The Digital Citizen Delivery Plan (May 2021) has set out our aims to build upon the success achieved and to focus on digital inclusion and supporting some of the most vulnerable people in society, to create the conditions for sustainable change, and will be delivered with the public at the centre of its delivery.