Virtual communication: does it have a future in adult social care?

The topic of virtual communication in social care has arguably been up for debate since the beginning of the pandemic. It replaced face-to-face interaction to comply with restrictions that the UK government implemented to protect the public. However, now these restrictions have eased, its begs the question of whether virtual communication is still necessary.

Although the majority of appointments have returned to in-person, the government continues to put a great deal of emphasis on increased digitisation of social care. This is largely seen in the People at the Heart of Care white paper which was published in 2021. The paper states its intention to ‘drive greater adoption of technology’, however, experts remain ambiguous about whether virtual communication should be a part of this. As a result, various questions such as what the benefits of remote communication with adults with social care needs are and, is there a way that we can embrace virtual communication and create more choices for users and improve engagement, have surfaced. 

This article is based upon the findings of a review of evidence conducted by Dr Christopher Dodd and Dr Olga Kozlowska of the Oxford Institute of Applied Health Research at Oxford Brookes University. For this piece they have teamed up with Jess Baker of Oxford Health, an occupational therapist who works on the frontline of adult social care, to ascertain how their findings relate to her first-hand experience and her view of how virtual communication was utilised and can be implemented going forward.

The research was conducted during the first half of 2023 and, involved identifying studies that could provide evidence of the experience of adults with social care needs and their carers engaging with social care professionals using virtual communication. Due to initial searches identifying a change in its use as a result of the pandemic, only studies that have taken place since the beginning of 2020 were used. Virtual communication in this instance was defined as non-face-to-face synchronous communication. The study utilised the PubMed, CINAHL, SCIE and Social Services Abstracts databases and identified 15 papers for inclusion in a systematic review that they hope to publish in the near future.

Let’s start with the good news  

People at the Heart of Care explains how technology became a ‘lifeline for millions of people’ in social care and shouldn’t be discontinued  in today’s reality. A report published by NHSX (now NHS Transformation Directorate) in conjunction with the Institute for Public Care [IPC] and Ipsos MORI has identified that those with social care needs often use such devices for shopping, banking and as a source of information. As far as communication is concerned, the report explained that digital technologies were also commonly used to keep in contact with friends and family, to take part in support groups and for making and attending medical appointments.

Studies have also shown that the use of technology is supported by carers. One particular example of this, is a study, which was published in 2022, recorded that over 70% of carers agreed or strongly agreed that they had an interest in using technology within their role.

The review itself is more concerned with identifying examples of individuals with social care needs contacting care professionals. It identified studies that have shown some groups benefited from remote services throughout Covid-19. In some cases this was related to individual preference, sometimes it was related to users’ conditions or comorbidities, in other cases it was dictated by an external constraint. For example, some adults with social care needs have anxiety about leaving the house and remote services made engagement easier for them. In other circumstances, users struggled to make the journey – held back by the financial or time constraints of attending an in-person appointment. It has also been noted in some studies that the younger generation prefer virtual communication and it eases their reticence about engaging with social care services.

First-hand experience tells us that some social care professionals benefited from remote delivery of services as it reduced travel time. This enabled social workers and occupational therapists to see more service users in a working day, which has a positive effect on waiting lists for adults with social care needs.  

This did not work for everyone  

Some social care users have reported feeling that the level or service dropped as a result of virtual appointments.

From the perspective of an occupational therapist, assessing an individual’s social care needs virtually was very challenging. In a practical sense it was hard to gather all the necessary information using apps like WhatsApp and Microsoft Teams. The inability to see the home environment first-hand also hindered assessments in this regard.

What causes this? 

Although its use is common across the piece in social care, significant numbers still find themselves digitally excluded. Age UK has reported 40% of people over 75 do not use the internet, and the Office of National Statistics has explained 14.9% of disabled people have never used the internet.

In addition, other research highlighted a lack of digital literacy among individuals with social care needs. This was associated more with older people who had not used technology before and was compounded by the pandemic restrictions as it was much harder to conduct training. For others, a lack of cognitive ability of anxiety regarding the use of information and communication technologies (ICTs) acts as a barrier. Some studies that are from the perspective of a specific cohort identified that an individual’s condition might contribute to difficulties engaging with virtual communication. For example, it was harder to maintain the concentration of some individuals living with dementia when using virtual communication than it would have been if appointments were still face-to-face.

Not to pile on the bad news but…

Some adults with social care needs lack the necessary equipment or the connectivity to engage with services. For example, those experiencing homelessness do not have the ability to purchase phones and when they are given them by organisations they can be easily lost or stolen.

In the field there was a need to distribute smartphones that had the capacity to run WhatsApp amongst staff, as many social care professionals had not been issued with phones that had the capability to run the app.

There is hope for the future

A seachange has been identified when it comes to the use of ICTs in social care. With the digital first initiative in the NHS and the push for more digitisation of social care contained in People at the Heart of Care white paper, it may be here to stay. Experience and research is telling us that we need to tread carefully when implementing such changes. Adults with social care needs and social care professionals that support them may be better placed than ever for digital services, but virtual communication is not right for everyone, nor is it necessarily the best solution for every situation.

Images: Pavan Trikutam and JD Mason

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