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Are we ready for sci-fi social care?

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LGC’s analysis of two controversial social care innovations

The hit Channel 4 drama Humans presented a world in the not-too-distant future in which sophisticated, life-like androids known as “synths” were widely used in menial jobs and as household servants, as easy to purchase as a new iPad.

In one storyline viewers were introduced to an elderly man with dementia refusing to trade in his malfunctioning synth, which he used as a carer, for a newer model because his old robot had stored on its hard-drive all of his memories of his late wife.

It is said that science fiction influences real technology; if we can dream it up, we’ll eventually build it.

LGC is not suggesting the robot Southend-on-Sea BC has bought to use in social care services, named Pepper, will develop into a machine so sophisticated it will become better at being human than a human (nor that, as in the TV programme, Pepper will become sentient and start a violent robot revolution). However, Southend’s use of Pepper on an academic licence is a local authority first and makes real the prediction that AI and robotics will become part of easing the health and social care crisis.

Southend’s director of adult services and housing Sharon Houlden writes: “Pepper is… the first robot with the ability to recognise principal human emotions. He can also adapt his own behaviour and make independent decisions. Pepper is able to play videos, music, and sensory games that will be used to help dementia sufferers and children with complex disabilities.”

Ms Houlden emphasises that Pepper will not be used to deliver any personal one-to-one care. But the robot will “free up time for our social workers and carers to spend more time giving direct care” by, for instance, conducting “reminiscence sessions” with people with dementia, as a sort of high-tech elderly care equivalent of popping a toddler in front of CBeebies for 20 minutes.

Yet for some, the introduction of robotics into this most personal of services might ring alarm bells. First, there is the fear that elderly people or people with dementia, who are more likely than others to struggle with new technology, would find the robot confusing. Second, there is the implication that spending time simply talking to people in receipt of social care is a job we would rather outsource to a machine, which perhaps strikes some as callous.

Similarly, there was outrage at the news, first reported in Health Service Journal, that Southend University Hospital Trust and Essex local authorities were in talks with CareRooms, a company proposing to invite members of the public with no care experience to rent their spare rooms to people being discharged from hospital and provide basic assistance. The idea is to take pressure off both the acute and residential care sectors with an Airbnb model (which Twitter users immediately rebranded #Carebnb).

Concerns were raised over the safeguarding of the people being discharged, the quality of care they would receive, and against the general principle of this more laissez-faire approach to rehabilitation. Following attention from national newspapers, the hospital promptly issued a statement that it “has no intention… to support the pilot at this time”.

A spokesperson for Southend-on-Sea BC told LGC: “While we are supportive of innovation, ideas and working with our partners, we have not made any formal commitment to funding or supporting this project.”

It is right that councils and health partners experimenting with technology and new forms of delivery should face public scrutiny. The impersonality of technology will always raise fears. But in some senses the opprobrium aimed at local authorities is unfair. Endless funding cuts, coupled with this government’s failure to produce sufficient additional funding to ease the immediate care funding crisis or bring forward any long-term solutions have pushed councils into a corner.

Councils are under pressure to innovate to ease the pressure. Until now, the use of technology in this area has been mainly limited to better monitoring to help keep vulnerable people independent at home for longer, and to better coordinate health and care services for people leaving hospital. But this is not enough given the scale of the demand for services. In the absence of a large cash injection and a long-term overhaul of  funding, councils have few options but to try to fill the gaps with intelligent kit and untested solutions.

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