Written by By Siabhainn Russell with Praminda Caleb Solly, Praveen Kumar and Cian O’Donovan.

Empowering Future Care Workforces, UCL

Assistive robots promise to transform health and social care. However before robotic technologies can work in the real world, there will undoubtedly need to be significant adaptations at a systemic and process-level to fit them in. Take driverless cars: In the last few years we’ve seen calls by lawyers to update the rules of the road and electric charging docks are springing up all over cities in the UK and elsewhere.

 

So what kind of changes to our hospitals, homes and the people and practices and infrastructures within them will be needed ahead of future robot roll-outs? Recent research led by our co-investigator Praminda Caleb-Solly conducted as part of the Knowledge Transfer Partnership with Extracare Charitable Trust raised a set of critical questions for roboticists to ensure scale-up and sustainability as these technologies leave the lab. These were further developed by Praminda along with Linda Sumpter and Praveen Kumar, two more of our co-investigators, in subsequent work as part of the Assuring Autonomy International Programme, and formed the basis of this TAS project.

 

The project team have found these questions remain as important as ever. They closely match with issues and concerns that came up in a series of conversations with a specially convened co-design steering group of health and social care professionals, policy experts and service users as part of our Empowering Future Care Workforces project. We’ve used these discussions to further hone what we’re calling “precursors to deployment and integration” of robots and autonomous systems. In this project, we are using these questions to think about what might be useful for people designing and building assistive robots, and for people deciding whether to deploy them in care settings. These are:

 

1. Will the technology actually solve a problem faced by people working in care sectors today?
2. How do you show that the technology is cost-effective? This is an important question for two reasons. First, to make sure that technology provides value for money. And second, health and social care professionals told us that being able to make a budgetary case for technology investment is one way they can feel empowered to get involved in procurement discussions.
3. Who in the organization would be taking on the role for set-up and maintenance?
4. What skills are needed to set-up and maintain the technology? Who should have these skills?
5. How usable is the technology by the end-user? And who exactly is the end-user in care settings? Sometimes it might be a service user or patient, other times the member of staff, or the patient’s family is the person that best fits that role. It’s not always clear.
6. Where is the data from the system kept, who is responsible for it?
7. Is the infrastructure in place and capable of dealing with these additional interventions? How will existing care pathways change to accommodate any new systems, practices and processes?

 

These questions provide a valuable entry point into the main research phase of Empowering Future Care Workforces where we are investigating what human capabilities future health and care professionals will need to use assistive robotics as part of their jobs. In other words, we want to know what skills, attributes and knowledge carers, care organisations and institutions will need to develop in order to empower them to use assistive technologies on their terms.

 

Here is an example of why understanding the capabilities that empower staff is important. Most of us at some time or another have had a stay in hospital – or when we’re older might need some kind of support at home. During the stay in hospital, we will have contact with a large number of staff carrying out different tasks to provide care, such as assisting us to the bathroom, showering and ensuring that we have the correct medication at the correct time. For those people who cannot stand unaided, these staff may have to use hoists to move us to and from bed.

 

Assistive robots are being designed to expand and augment existing staff capabilities for these kinds of tasks. Robots may act as an adjunct, and support by reducing the number of staff needed for some tasks. For example, at the moment if a person is being hoisted from bed into a wheelchair to go to the bathroom, two members of staff are usually needed to operate and stabilise a hoist. If a robotic hoist could be used, then perhaps only one member of staff would be required for this task, freeing up time for other care practices. There are many similar examples of collaborative and socially assistive robot tasks in health and social care. In these kinds of situations where robots are designed to assist rather than replace human staff, staff need to gain understanding about how to use robotic systems. At the same time, it is critical that robotics engineers and designers understand what health and care professionals need a robot to assist them with.

 

The Empowering Future Care Workforces project is addressing this capability gap between robotics experts, health and social care professionals, and those with lived experience of care needs. As well as mapping the capabilities valued by professionals, we are planning to scope what a training curriculum that contributes to capability building would look like. This mapping and scoping is at the heart of ongoing workshops with care professionals, service users and family members.

 

 

So far, our workshops have produced a range of findings regarding stakeholder perceptions, opportunities and challenges for the deployment of these technologies. Some participants have said that the robots could provide a positive addition in many cases to the work that they do, for example allowing people to stay in their homes for longer, or be discharged from hospital sooner. However, people are concerned about how much such robotics would cost and whether commissioners and funding bodies would give funding to something that was expensive. People are also concerned about what happens to any data that the robot collects about them.

 

At the same time, participants have also said that in their experience service users are not at the forefront of developing assistive robots. This lack of user-centred design often leads to prioritising technical capability of the device, rather than considering effectiveness of functionality.

 

When it comes to designing interventions for expanding capabilities – a core aim of the project – participants have told us about the difficulty of running digital training schemes given the high levels of turnover in care sectors.

 

We’ll reflect on these emerging findings in greater depth in a future update here on the TAS Hub website. If you want to know more about the project, please do drop me a line at siabhainn.russell@ucl.ac.uk.

 

*Blog updated on November 21st to further elaborate the origin of the seven questions across two research and innovation projects that informed this ongoing work.