Rapid increase in health and social care innovation in the wake of COVID-19

Topics covered: COVID-19, CQC, CQC enforcement, CQC inspection, Gemma Nicholas

Over the past few years the health and social care sector has witnessed increasing innovation and use of new technologies.  This has skyrocketed in the recent months due to Providers finding new ways to continue to meet the demands of service users during the COVID-19 pandemic. Out of necessity and being in emergency mode, Providers appear to be fired-up to roll out electronic services wherever feasible.

The response from GP’s in particular, has been noteworthy. They embraced telehealth technologies in every domain of primary care, from patient triage to video consultations. Doctors are now better equipped to consult remotely than they were six months ago. Likewise patients are more accepting of remote consultations and have rapidly grown to expect this as an option.

Attend Anywhere, a secure NHS video call service for patients with pre-arranged appointment times has seen an increase from 200 consultations per day to over 6,000 by mid-May. Healthcare Markets quotes a survey of over 200 GPs – prior to the pandemic, only 28% performed more than ten telephone consultations per day compared to 97% now. Additionally, just 10% of GPs performed video consultations prior to lockdown, whereas now they nearly all do.

The use of digital health platforms is unlikely to slow down post COVID-19 given the backlog that the health and social care sector faces and the ever increasing demands in the sector. It will probably increase, especially as it has been proven, if done right, to improve the quality of care for patients.

Innovation and regulation

Dr Malte Gerhold, Executive Director of Strategy & Intelligence at the Care Quality Commission explains in a recent CQC Connect podcast that it can be difficult for regulators to accommodate new technologies into existing regulatory approaches and methodologies. That said, the CQC claim that they do not want regulation to be a barrier to innovation.

Dr Gerhold describes a process used by regulators called ‘sandboxing’, where the regulator proactively surveys the sector to identify new technologies that are being developed and applied, has conversations with developers and Providers and updates inspectors on emerging new technologies. As part of these conversations, in some cases lasting 12 weeks, the CQC aims to set out principles of what ‘Good’ looks like for the new technologies and solutions. They also consider what the risks and issues might be and how they can be addressed.

The CQC aspire to have in place innovation enabling regulation – an approach and methodology that encourages innovation in inspections (through the Well Led domain) and promotes a partnership of collaboration and transparency between the CQC and Providers who plan to introduce new technologies and digital platforms.

Challenges and Failure

There are of course challenges with digital tools.  The lack of physical examination has caused concern amongst GP’s. Furthermore the fact that the Attend Anywhere system was reported to have crashed multiple times in a week – causes scepticism of moving to virtual methods.

Failure and learning from failure is a part of innovation but the consequences of failure in health and social care, can be much more dire than in other sectors. Needless to say, the safety, health and wellbeing of service users could be affected by a failure in new technology. Furthermore, the Provider would be at risk of breaching regulations and as a result could face enforcement action. Before implementing new technology Providers need to engage with staff, staff need to know what the technology can and cannot do. Engagement with service users is worthwhile and so might be engagement with the wider public. Also, it is recommended that Providers get commissioners, partner organisations and patient representative bodies involved in the plans for innovation.  Testing is vital as is having an alternative system to fall back on should the new technology not work.

The CQC are encouraging Providers to talk to them about any plans to innovate and use of new technologies because it will allow them to know what to expect at inspection. According to Dr Gerhold, the CQC ultimately want the new technology to succeed and therefore want a transparent and collaborative relationship with Providers that are planning to innovate.

Whether a Provider is purchasing state of the art digital tools or simply contacting service users by video call, it is evident that the way health and social care is delivered is forever changed.  If regulation cannot keep up with the increase in innovation, Providers are likely to be on the receiving end of unfair judgments, inaccurate reports and unfounded enforcement action. Whilst, the CQC’s webpage Innovation and Inspiration makes for interesting reading, seeing the changes to service delivery that Providers have introduced during the pandemic, there will be cases of failure.

Ridouts can support Providers when implementation of new technologies has not gone so well, and when the CQC are no longer having collaborative conversations with the Provider. We frequently advise on factual accuracy, rating reviews warning notices and fixed penalty notices. For assistance and advice Providers can contact 0207 317 0340.



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