A co-design framework for empowering future care workforces

Categories: blog
Categories: blog

Cross-posted from: https://www.tas.ac.uk/a-co-design-framework-for-empowering-future-care-workforces/

Just before 8pm on the last Thursday of March 2020, millions of us in the UK picked up a pot and a wooden spoon. We headed for our front doors, our balconies and our windows. And when our clocks struck the hour we started banging. The covid clap for carers kept going for ten weeks. It was one of the more uplifting if slightly bizarre events in a year that turned our attitudes to health and social care professionals upside down. This research project is about making sure that the care workforces we celebrated two years ago stay centre-frame as digital health and care infrastructures are built back after the pandemic.

We aim to do this by scoping a framework for co-designing assistive robotics in health and social care that centres staff and service users.

This work is critical for evaluating the progress of post-covid Government plans for recovery. Many of these plans aim to accelerate digital transformation in areas such as healthy ageing, independent living, and wellbeing increases for everyone. But for these plans to work, digital transformations must be matched with investment in the workforces who use data and technology. For instance by providing training for staff who have been in the sector for years, and recruiting people with the kind of digital skills needed today and into the future.

Unfortunately, these workforces are often missing from research and innovation on emerging care technologies. Addressing this gap, our core idea is that care professionals benefit most from digital technologies when they are empowered to use them on their own terms. For instance, staff in a Bristol care home might prioritise being able to validate and verify the safety of assistive technologies anew as the conditions of use change as residents’ health deteriorates with age and illness. An occupational therapist in East London might value secure access to updated patient health records more than anything.

This means that evaluations of assistive technologies must take into account the diversity of the individuals’ goals, experiences and skills as well as the often-changing environments in which they work. In the English social care sector alone there are around 18,500 provider organisations delivering services across 39,000 establishments with a huge availability of patient needs, values and cultures. So our co-design framework first has to discover what dimensions of diversity matter to different stakeholders throughout the system.

The evaluation must also find out how ready for society the technology is. And just as importantly, it must establish how ready and willing society is to use the technology – in this case, care professionals and end-users. This brings us back to empowerment – in this case having the capabilities to control one’s working life. We think people are ready for technology only when they can benefit from it on the terms that matter most to them.

Practically then, the plan is to scope what human-digital capabilities will empower care professionals, and strengthen the well-being of people these professionals care for, while in turn making assistive robotics in care safer, more accountable, and more trustworthy. By understanding what kind of capabilities care professionals need to use physically assistive robotics on their own terms, and in ways that are safe, trustworthy, and meet the legal and ethical standards of their profession, we aim to produce valuable insights for future training and continued professional development.

Now for the hard part – specifying how assistive technologies can empower workforces in society in a robust and systematic way. Previous research by members of the team working with partner ACPIN has revealed four dimensions of empowerment that matter in care. These are the skills required to operate the systems in specific settings; ethical issues around understanding how to adapt and re-configure systems to maintain user autonomy; issues of responsibility, accountability and governance, including legal issues; and the technical functionality of the robotics systems.

To deepen our understanding, we’re going to use a capabilities approach. We’ll write more about this in a future post. In the meantime, the basic idea is we’ll bring together a group of participant health and social care professionals, end users, technology designers and colleagues from our partner organisations Bristol After Stroke and ACPIN and establish what we’re calling an empowerment lab. Together with our participants, we’ll work out what human-digital capabilities professionals need to feel empowered within complex care environments. We’ve started to detail the features of these environments and how they shape dimensions of empowerment in the accompanying figure.

A space for mapping human-digital capabilities

Here’s the thing. This work isn’t simply a nice-to-have exercise in academic research. Neglecting how technology can empower care professionals risks exacerbating the harms caused by digital exclusions if, for instance, workers cannot or are unwilling to operate assistive technologies effectively on the ground. Deploying assistive care technologies that cannot easily be adapted to their situation of use, or are not adaptable as those situations change, jeopardises the safety and wellbeing of professionals and others and increases the chance of expensive systems being underutilised. This is especially important in care settings because of their unstructured, dynamic and unpredictable nature, and because the conditions of care recipients are often in-flux.

We want to create insights for users of assistive technologies, and also for designers and funders of robotics and autonomous systems in care. So as we go, the project will be working with colleagues from professional bodies and patient groups, think tanks such as The King’s Fund and the NHS Race and Health Observatory and robotics networks like DIH Hero and the EPSRC EMERGENCE Network + as well as colleagues across the TAS Hub and Nodes.

We think that by working in this way we can help establish principles from which to seed future research on assistive technologies as well as some of the inter-and transdisciplinary relationships on which such research will depend. This project runs until the end of March 2023. With a bit of luck we’ll have something to bang our own pots and pans about then, and in the meantime, do get in touch if you’d like to be involved or simply want to know more.