Technology and homecare in the UK: Policy, storylines and practice

Abstract

UK policy discourse presents technology as a solution to challenges facing care services, including issues of quality and the mismatch between care workforce supply and demand. This discourse characterises technology as ‘transformative’, homogenous and wholly positive for care delivery, eliding the diversity of digital devices and systems and their varied uses. Our paper draws on data gathered through 34 interviews with care sector stakeholders and four in-depth case studies of UK homecare providers to comparatively analyse ‘storylines’ of technological solutions expressed by policy (macro-level), sector stakeholders (meso-level) and homecare managers and care workers (micro-level) alongside enacted experiences of technology-in-use. The ‘storylines’ presented by care sector stakeholders and homecare managers converged with those of the policy discourse, emphasising technology’s capacity to enhance quality and efficiency. Our case studies however highlighted several implications for care work and organisational practice in homecare provision: the technologies we observed sometimes produced additional tasks and responsibilities, undermining the efficiency and quality storylines. The experiences of care providers and workers engaging with technologies in homecare warrant further investigation and greater prominence to challenge a discourse which is at times overly simplistic and optimistic.

UK homecare providers’ views about, and experiences of, digitalisation: A national survey

“… 22 As such, the study offers novel evidence relevant to informing and supporting the success of UK social care digital transformation programmes. More widely, it provides insight into the relatively neglected perspective of homecare company owners and senior directors/managers regarding planning for and implementing digital systems 5 , 17 with most existing work in this area focussing on the impacts of digitalisation on care workers or homecare clients and their families.…”

“…Such findings align with previous work on this topic. 5 Free-text responses conveyed the time investment required to research, select and move to (or switch) care management software: something which could be hard to protect given the pressing and unpredictable nature of many of the demands on senior managers’ time. Since the study was completed the government have published guidance for homecare providers on selecting a software system.…”

“…Here, digital systems are presented as both supporting the quality of care (e.g., outcomes, safety) and care efficiency, though this is relatively untested. 5 …”

Routine data collection in home care: A national survey of home care providers in England

“…In home care, people are more reliant on primary care to address their health needs, and lone workers may have a focus on discrete tasks rather than all aspects of care. Home care workers are also less likely than care home staff to have regular interactions with nursing and other allied health professionals (Hamblin, Burns, & Goodlad, 2023). The type of information that is routinely recorded in home care settings is indicative of the perceived scope and purpose of home care (Author’s own, In Review ) influenced by the tendency for tightly prescribed contracts in publicly funded home care (Davies et al, 2022) and, arguably, where care is self-funded, reflective of what people want to buy.…”

The gig economy, platform work, and social policy: food delivery workers’ occupational welfare dilemma in Hong Kong

“…While the digitisation for technological innovation and inclusive growth is internationally supported (Silva, 2022), new forms of inequality have appeared along with the policy agenda of marketisation (Considine et al, 2022;Schou & Pors, 2019) and the digitised transformation of work (Greve, 2022). The rise of online platforms as intermediaries between requesters and providers of labour services has received increasing attention and poses new challenges to welfare systems and homecare services (Hamblin et al, 2023;Schoukens, 2020;Sieker, 2022).…”