Imagining the Future what's next for scotland's social services

Introduction

By 2025 the number of people requiring access to support and the strategies for responding to these needs are likely to change significantly. In 2012 IRISS embarked on a long term project with two aims:

  1. to anticipate and detail the major changes and challenges in the context and environment within which the workforce will be operating and support will be negotiated
  2. to explore a range of initiatives and potential developments which may facilitate responses to this future environment.

The outcome of the first phase of this work is three reports covering the workforce, citizenship and enabling technology. Together these reports offer a comprehensive survey of current trends as well as speculation about the future.

To make the content of the reports more digestible, stimulate discussion and encourage engagement in the processes that will shape the future, we have created Alex Chisholm.

a Alex in his army uniform

About Alex

Alex is in his 70s. He has lived alone since his wife left him in his mid 50s after a prolonged period of arguments.

a Alex with family

He has contact with his two daughters and their children. One daughter lives several hundred miles away but the other is local and he sees her frequently.

He smokes, has high alcohol consumption, poor diet and multiple long term conditions, including type 2 diabetes. He is becoming forgetful which could be vascular dementia.

Alex sitting up in a hospital bed

He survived a heart attack but with his lifestyle and medical conditions it is possible that in 2013 he might be assessed as not having the capacity to live alone.

By 2025 technical, medical and cultural changes may combine to offer someone like Alex a richer, less isolated life in which he is able to exercise more choice and control.

Alex is of course a particular individual and cannot represent the diversity of the Scotland’s population. The issues raised can however act as a trigger to consider what 2025 may be like for a range of individuals.

How to use this animation

Beside the animated snapshot of Alex’s life you will find a frame by frame breakdown of his story. At each frame you are invited to reflect on what is happening and follow links to the relevant parts of each report and to sources of more information. You can pause the video while you follow the links.

By the end you should understand more about the many forces, policies and technologies that might shape the future.

You may find this a useful tool for private study or for group discussions about the implications (social, legal, economic) for the workforce and people who receive care and support.

This short computer generated animation tells the story of Alex Chisholm.
Animation by Federico Fiore

0:36 Alex is an example of someone who will need care and support. Who else will need health care in the future?

0:42 The majority of long term conditions can't be cured but can be managed through medication and lifestyle changes.

0:53 How might the transition from hospital to home change in the coming years?

1:07 Do ethical problems arise from sharing personal information? Will health and care workers require to know about privacy, data security and data protection?

1:13 What is required to move from the medical model to the social model? What are the human rights implications?

1:17A shift from the expert professional to working with the strengths of the individual

1:24 How can we ensure the transition from hospital to home is seamless and puts the focus on the person? What are the implications for workforce skills?

1:38 Are people comfortable with a digital identity? Has been customised to his needs - not one size fits all

1:51 Isolation is serious problem for people living alone. Can digital communication compensate and reduce loneliness. How useful are prompts?

1:57 What is the scope for maintaining social networks using prompts?

2:16 Fire service believe they can predict house fires based on various factors including contact with social services

Knowing how one feels and how one lives in a way that can be measured and easily compared with other people can have both benefits and disadvantages. The benefits to society mainly stem from an ability to identify people who are unhealthy both with respect to acute needs and, from a predictive point of view, those who are likely to be unwell at some time in the future. In the mental health space, people who have bipolar disorder can be monitored and supported more efficiently perhaps leading to a reduction in self-harm and suicide.

2:26 Is it better to put control in the hands of the person or relay on remote telecare communication centre to remotely control entry?

2:35 How can we foster greater peer support for Alex?

2:42 To what extent can online communities and digital networks connect people and offer positive support to maintain health living?

Alex is reminded that he has missed a remote monitoring check. Rather than a helper appearing on the large screen, he is asked if he is OK and given a choice of person to speak to.

Does the presence of a large screen interactive screen raise questions about surveillance?

May raise questions of advocacy: in helping Alex understand privacy and what he is agreeing to in allowing this kind of communication.

Consider the question of privacy. People may give up some degree of privacy in return for the convenience of receiving help and support.

By choosing how he needs to talk to for support in specific instances the likelihood of emergency hospital admissions is reduced. Further, if a neighbour or friend is available and willing to offer low level intervention the degree of intrusion in Alex's life is reduced.

2:54 What is your particular role in shaping the future?