Social care needs a framework for innovation
From Spain to Canada, and everywhere in between, we have seen the devastation Covid-19 has brought to congregated care settings like nursing homes. Part of the issue is the nature of these settings; with so many vulnerable people in a confined space, it is fertile ground for infectious disease to spread.
This should act as a massive wake-up call for all of us. I hope it will have as far-reaching an effect on our care models as the 2008 financial crash had on banking practices. According to Irish figures, Home and Community Care Ireland (HCCI) recorded a peak Covid-19 infection rate of 0.45% (91 cases) among our members’ 20,000 clients.
Home care should be at the heart of our thinking as we redefine our thinking on how to deliver social care to vulnerable people.
The ASI’s report, Fixing Social Care, is a useful contribution to the debate and helps us to break down the problem. Making insurance costs more viable is important if we are to drive both value and innovation in the sector. Currently, technological advancement in healthcare is focused on either consumer facing wearables or high-tech equipment for hospitals. While there are some companies working on how to incorporate new technologies into social care, these efforts are relatively disparate.
If we are to change the game in social care – and this pandemic should leave us under no illusions that the status quo ante is acceptable – we need to create an innovation framework for the sector. We could start by looking at places like Germany. They take a broad approach, funding a €300 million annual Health Innovation Fund that encourages new models of care and more effective ways to deliver care across a range of healthcare settings, with the private sector closely involved. Although not every country can replicate the size of this funding, they should be able to design a national framework for healthcare innovation that carries with it an annual budget.
Looking to America, MobiHealthNews reported 82 health related funding deals worth $2.9 billion in Q1 2020. However, as you look through them, only one is focused on home care. They are almost all directed towards consumers or the acute hospital system. Talking to one home care entrepreneur in New York earlier this year, he was very discouraged about innovation in social care. His view was that American insurance companies are not yet serious about keeping people at home for longer – the money is in things like surgeries. It will take a considered investor, matched with some entrepreneurs with real vision, to turn the game on its head in the USA.
Another option for all countries to think about is for healthcare and hospital groups themselves to lead out on providing more care in the home, either themselves or with other provider organisations. For example, the Danes have trialled giving chemotherapy treatments in the home. If this sort of initiative is underpinned by the sort of innovation framework Germany has, we could see a much more integrated acute and community care system that provides continuity of care and the care where it is best for the patient to receive it.
Social care is the beginning and the end for so many people. Whether a sniffle treated by a relative, a healthcare assistant helping with the routines of daily living, to palliative care at the end of life – so much begins and ends at home. If we grasp the opportunity Covid-19 has given us to rethink healthcare delivery, and if we design a framework for innovation that seeks to integrate our care models, we have the chance to build a brighter future for millions of vulnerable people.
Joseph Musgrave is the CEO of Home and Community Care Ireland, the representative organisation for 80 companies that provides home care to 20,000 older and vulnerable people in Ireland. HCCI advocates for the highest standard of regulated home care services to be made available to all on a statutory basis, enabling as many people as possible to remain independent within their homes and community.