Britain's AI-care revolution isn't flashy—but it is the future
England may seem an unlikely pioneer in an AI-care revolution. Whereas Japan is deploying robots, a quarter of care providers in England still keep paper records. The country's care system is underfunded and overstretched. Yet necessity is spurring innovation, albeit not from cash-strapped local councils (over 40% of their spending on services already goes on adult social care). Young entrepreneurs are teaching carers to use tools more common to delivery services and dating apps.
One of them is Ben Maruthappu, Cera's founder. He launched Cera after failing to find reliable care for his mother (an origin story typical of aspiring age-tech entrepreneurs). If groceries could be tracked in real time to the doorstep, he reasoned, then why not medication? Today Cera claims to have created Europe's largest home-care data set—over 200bn data points—to train AI that predicts patients' needs.
A promising use of AI is to predict falls. Falls are among the gravest risks for the elderly: hip fractures are their most common cause of accidental death. They also cost the National Health Service (NHS), which is separate to social care, around £2bn ($2.7bn) a year. With its app, which uses algorithms to predict fall risk, Cera claims to have cut falls by a fifth. A peer-reviewed study from 2022 found that its app had reduced hospitalisations by 52%. In March the NHS said it would work with Cera to roll out its AI tool across the country.
Fifty kilometres south of Ms Westwood's patch is The Lawns, a nursing home. There, another tech adopter, Melanie Dawson, a former rugby player turned care manager, has overseen an NHS pilot using acoustic-monitoring devices. White boxes combine motion sensors and machine learning to detect unusual movements or noises in the residents' rooms, a kind of Shazam for ambient noise. Over a year-long trial, falls decreased by 66%, and staff made 61% fewer checks in person. With fewer disturbances, residents also slept better and, with less daytime-napping, ate more. When the pilot finished, the home chose to keep using them at its own cost.
At Cavendish Park, in Worcestershire, residents can play with robotic companion pets and try an interactive driving simulator. Most, though, stay in their rooms, chatting to smart speakers called Alexa (made by Amazon). Cavendish Park was the first home in Europe to build Alexas, adapted to care homes, into its infrastructure, integrating them with its alarm and communication systems. Residents can use them to ask for help, for a drink or to make an emergency call.
AI's adopters say the tech is meant to support staff, not replace them. At Cavendish Park, carers scan residents' faces using PainChek, a mobile app, which detects micro-expressions linked to pain. Within seconds, they can detect pain more quickly and accurately than a trained nurse.
Yet in other cases, AI appears to be filling gaps left by a shortage of carers. In Northamptonshire, Cera is testing robots to give routine prompts, like whether clients have eaten or taken their medication. Though fine for the most mundane tasks, they are no replacement for Ms Westwood's kind and competent team. At Cavendish Park, residents treat their chatbots as companions (one 99-year-old says she spends all her time playing 'Quick-fire Quiz"). Meryem Tom, who leads the Alexa division at Amazon, insists that the Alexas are 'complementary" to humans.
One risk is that care workers could become tethered to digital metrics, a grim prospect for such a human job. Consent is another concern. Many of the clients whom AI might best help have dementia, raising doubts about whether they can meaningfully opt in. Some homes already feel like prisons: the dementia wing at Cavendish Park, Chatsworth House, is locked with keypads. AI could worsen that controlling urge. With enough surveillance, warns Andrew Sixsmith, a gerontology professor at Simon Fraser University, they risk resembling Jeremy Bentham's Panopticon, a theoretical prison where a single guard can watch every cell.
Still, for those needing care, the benefits of safety and independence appear to outweigh the risks—at least for now. Brenda Adkin is a 101-year-old Cera client who recently suffered a fall. Still enjoying a sherry with her neighbour in the morning, she has no wish to go into a care home. 'I like my independence," she says. AI helps the carers she loves keep her at home. Solving the care crisis will take more of this kind of innovation, not less.
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