The Local Government Association (LGA) estimates that, since 2010, councils have had to bridge a £6bn funding shortfall just to keep the adult social care system going. Those pressures will continue with both 1.8 million new requests for adult social care a year and a £3.5bn funding gap forecast for 2025.
Although alternative funding options (such as increases in income tax and National Insurance contributions for the over 40s) are being debated ahead of the eagerly anticipated Green Paper, some authorities are also exploring innovative ways to change how care is delivered.
The use of robotics is one of these innovations and its use in care has been increasing over the last four years. ‘Paro', a therapeutic baby harp seal robot, has been used by the NHS to help dementia patients since 2014, and a robot called ‘Robear' which can hoist people out of bed and into a chair was first used in Japan since 2015.
At the end of 2017, Southend-on-Sea BC became the first UK local authority to buy ‘Pepper' (a 120cm and 28kg humanoid robot) to deliver care services. It has initially been used for community engagement, awareness raising and to facilitate reminiscence activities (for example, through the development of a memory game for older people). Currently it is being used to support people living with dementia and Asperger's. Isle of Wight Council has recently secured LGA grant funding to test carer perceptions and explore what objections people may have to robotics being used for care.
Hampshire CC and one of its domiciliary care partners, have investigated the use of ‘cobots' (or collaborative robots), machines designed to enhance a human's abilities.
At the moment, lifting and moving people uses hoists and slings meaning that two carers are often required. A cobot could support a single carer to carry out that lifting activity and PA Consulting has been researching how they could be used to reduce double-handed carer visits. A key feature of the cobots is that they are worn by the carer and allow skin-to-skin contact between the individual and carer.
Hampshire's adoption of this technology could have a significant effect on costs as one third of its £42m domiciliary care budget (approximately £14.8m pa) goes on such visits, a proportion that is set to increase. At a national level, spending on double-handed care could be as much as £740m.
Cobots could also help providers tackle growing workforce shortages. Work by the National Audit Office found that the number of people working in care at a national level is already not meeting demand and a Skills for Care report found a vacancy rate of 9.2% in domiciliary care.
Hampshire's own estimates show its care workforce has an 8,000-person shortfall over the next five years
Later this year, Bristol City Council, working with the Robotics Laboratory at the University of the West of England and Designability (a co-production charity), is to embark on an initiative supporting older people living with early onset dementia. Using the robots Pepper and Nao (a smaller humanoid robot) the work will focus initially on assistance with daily tasks and memory problems. At a second stage, the partnership will explore additional areas, such as linkage with extra care housing and supporting individuals with a learning disability to live more independently. The emphasis will be on enhancing not replacing care input.
To ensure these solutions are deployed ethically and effectively, there are three key factors that need to be taken into account.
First, it needs to be recognised that robots are a supplement, not a replacement for traditional care services. Machines cannot soothe, cuddle and encourage a weak, upset and tearful person. Currently, they cannot clean them or feed them either.
Second, it is important to focus on the required outcomes and ensure that robots are adopted to support specific care needs and not seen as a panacea for all.
Finally, it is essential to view the introduction of robots as a change rather than a technology project where engagement with practitioners, partners and service users is critical.
While robots cannot address all the pressures on social care, if deployed carefully and with the right support in place, they can play a valuable role in managing scarce resources. This can only be good for the health and social care sectors.
David Rees is head of local government services at PA Consulting
