The government's 10 Year Health Plan released yesterday is the most ambitious I've read so far. It describes exactly what we’ve been advocating for and building at Birdie: more personalised and preventative care in the community, empowered by technology.
Healthcare is eating the economy: the NHS today accounts for 38% of day-to-day government spending and it will grow fast. It's unsustainable. 25%+ of the population have long-term health conditions, accounting for 65% of NHS spending. That's predominantly older adults. Our current episodic, reactive model is declining in productivity and not fit for purpose.
The way forward is a new preventative principle that care should happen as locally as it can: digital-by-default, in a patient's home where possible, in a neighbourhood health centre when needed, in a hospital if necessary.
Social care is at the heart of this plan, yet barely mentioned in it due to the ongoing work being done by the Casey Commission. This is a missed opportunity, but not a lost one. Below are the plan’s initiatives where social care can play an important role. My message to Baroness Casey and Secretary of State for Health and Social Care Streeting: lean on social care. They're ready to take on the job. Here's how.
- Care plans. Care plans and single patient records (SPRs) can improve care experience, while also achieving a ROI of £3 for every £1 spent on those who use healthcare most often, says the 10 Year Plan. Yet only about 20% of people with a long-term condition have one. The plan aims for 95% of people with complex needs to have an agreed care plan, with GenAI helping create the draft and support the discussion with the clinician. The SPR will make information visible across settings and capture non-clinical risk factors. Social care is ahead of the game: providers' comprehensive care plans (capturing social, nutrition and health data) are part of any new care package, are mostly digitised, enriched every day through visit notes and can be used today as a starting point.
- Delegation. The plan sees social care professionals deepening their involvement in rehabilitation, recovery and frailty prevention. The plan proposes working with social care organisations to enable care professionals to carry out more healthcare activities, such as blood pressure checks, to help people receive more proactive and timely care. This should go further to include more assessments, wound management, dermatology checks, concussion screening, measurement of vital signs and respiratory condition diagnosis. With technology and AI, care workers can become the eyes and ears of clinicians on the ground, freeing up doctors' and nurses' time. To start with, DHSC should develop delegation frameworks for three key acute conditions (UTI, pneumonia, cellulitis) and three key chronic conditions (diabetes, dementia, hypertension) responsible for unnecessary emergency admissions.
- Coordination. With poorly coordinated care, elderly patients have poor outcomes. The Plan wants to ‘call before convey’ to avoid unnecessary transfers to hospital thanks to neighbourhood health centres and monitoring technology. As private companies, social care providers have started their digital journey long before community health services, now equipped with the best technology to coordinate and deliver the right care by the right carer to the right patient. NHCs should leverage these existing platforms like Birdie and build on them.
- Prevention. Social care data is a key pillar for population health management and prevention. The plan targets that by 2035, all care providers should have technology and predictive tools to avoid falls, for instance. Social care providers already use technology to coordinate, monitor and prevent patients' health deterioration. Today, falls, infections or health deterioration can be averted and the relevant intervention taken in time. Social care providers have much more longitudinal data, with care workers visiting their patients usually at least once a day. At Birdie, we process 6 million clinical visits monthly for 110,000 patients supported at home by 1,200 providers using our technology. With the right financial incentives, social care providers are the best at ‘primary prevention care’. Across the country, initiatives by ICBs with social care providers have already shown significant savings. Listen to them and scale these initiatives nation-wide.
- CQC inspection. The plan acknowledges the need for the CQC to reform the inspection model, splitting it into two approaches: rapid response inspections, where concerns are identified, and inspectors are deployed to understand the nature and significance of problems; and routine planned inspections where services are independently inspected by experts. In social care, the former is already possible if the CQC reforms its assessment methodology, notably around a small number of core quality indicators, tracked digitally from each provider in real time. These would then form the basis of a new, shorter inspection, designed to validate and contextualise this quantitative data.
- Financing. The plan's aim is clear: 'bend the cost curve' through a relentless focus on delivering value-based healthcare. By including social care in the so-called ‘year of care payments’ (YCPs) which is a fixed budget for a patient's care over a year, incentives are aligned to optimise for health outcomes from the outset: when care providers, often the closest to the patients, take the right initiatives to improve the patient's health because they are rewarded for it.
Never has social care witnessed such momentum to join the effort and support the health system transformation that the government is initiating. The time is now.
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