Digital health and care strategy: enabling, connecting and empowering

Service Transformation

Domain C

Spread and adoption at scale of proven digital technologies within services across Scotland is critical to the success of this strategy. Most of what we are setting out to achieve requires local service change and redesign as part of pathways of care, supported by national approaches and models. Despite good progress in some aspects of using digital as a core part of service delivery, we need to go further.

'By collaborating with people and professionals, we can fully exploit the potential for digital to transform our health and care services and to support people in their self-management.'
– Ian Welsh OBE, Chief Executive, Health and Social Care Alliance Scotland (the ALLIANCE).

'Digital technology now needs to transform the way in which health, housing and social care services are provided, empowering people to self-manage and live more independently.'
– External Expert Panel report on digital technology in health and social care

The Health and Sport Committee agree that spread should be accelerated as a priority, and the Expert Panel called for broader implementation at scale across Scotland. Both reports set out a number of recommendations including the opportunity for co-designed person centred approaches, the need for a national 'once for Scotland' approach, requirement to support adoption of evidence-based technologies and rapid national scale-up, and a need to address cultural barriers to encourage widespread acceptance and uptake of technology and innovation. This, in turn, requires health and care organisations that put digital at the heart of their ways of working. We recognise that significant effort will also be required here: too often, digital initiatives fail to be adopted at scale due to insufficient focus on designing and implementing new 'ways of working' and the culture change that accompanies it.

Change happens at all levels – national, regional, and local, within an organisation and within individual services. Recognising the benefits of a structured, focused approach to delivery, the eight National Health Boards' new collaborative approach to offering improvement and transformational change support will – working with the Scottish Government, COSLA, the Local Government Digital Office, the Scottish Social Services Council and the Care Inspectorate – be key to delivering on our ambitions. Collectively we will design a consistent approach to supporting transformational change which brings together expertise and knowledge, incorporates technology as integral to all change programmes, and embraces and delivers significantly greater opportunities for self- management. We will also build on cross-sectoral work being taken forward by organisations such as the Scottish Federation of Housing Associations, Alzheimer Scotland, Coalition of Care and Support Providers and the Scottish Fire & Rescue Service, which is driving the uptake of digital in the delivery of care across different sectors.

We know that this can be accelerated with the right access to learning and knowledge mobilisation approaches via a combination of formal and informal networks, resources and toolkits.

'The housing sector can play its part in the digital revolution, developing and creating new services fit for the digital age.'
– Martin Polhammer, Chief Executive, East Lothian Housing Association

By end 2018, we will have in place a clear national approach to supporting local co-designed service transformation with clearly identified leads.

This will allow us to:

• Build the knowledge and skills within the system to support and deliver key digital transformation capabilities.
• Deliver remote monitoring of long term conditions by scaling-up our work on home and mobile health and care monitoring nationally to support prevention and supported self-care within priority care pathways.
• Support greater independent living and healthy ageing by delivering a step-change in how technology is used as a cost-effective support, including maximising the service redesign opportunities presented by the shift from analogue to digital telecare services, and embracing smart sensor technology and consumer devices.
• Expect all organisations involved in the delivery of care to sign up to the Digital Participation Charter ^[11] to ensure that they are working towards everyone having basic skills.
• Embed the Scottish approach to Service Design, with citizen engagement that enables the co-design of products and services that meet their needs and delivers sustainable, fit for purpose service models.
• Spread the use of video consultations direct from people's homes (including care homes) and mobile devices to allow greater and more convenient access to both routine care and specialist support from anywhere in the country and support resilient services.
• Facilitate the development and application of innovative approaches working with the Digital Health and Care Institute ( DHI) and other innovation centres, and continue to actively engage with Europe and more widely to collaborate and gain new funding opportunities.