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Outcomes from Telecare and Advanced Assistive Technology Two Years of Progress

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Title: Outcomes from Telecare and Advanced Assistive Technology Two Years of Progress


1
Outcomes from Telecare and Advanced Assistive
Technology Two Years of Progress Welcome
2
Telecare Commissioning - Agenda
  • Building Telecare in England (July 2005) and PT
    Grant (from April 2006)
  • White Paper - Our health, our care, our say
    (January 2006) -demonstrators Cornwall, Newham,
    Kent
  • Putting People First Concordat (December 2007)
  • Prime Ministers Statement on the NHS (January
    2008)
  • Transforming Social Care LAC (2008)1 (January
    2008)
  • PT Grant carry over to 2008/9, Supporting People
    and other funding
  • Joint Strategic Needs Assessment, Local Area
    Agreements
  • Integrated and partnership working including
    pooled funds
  • Demographic factors and demand forecasting, use
    of predictive models
  • World class commissioning, whole systems
    approaches
  • Better procurement, performance management and
    value for money
  • Telecare and telehealth as mainstream service
    options
  • User choice and independence through direct
    payments, personal budgets, self care and self
    assessment, preventative services
  • Standards interoperability, connectivity,
    electronic health records
  • Workforce design, education and training

3
Section 3.3 Person centred planning and self
directed support to become mainstream and define
individually tailored support packages. Telecare
to be viewed as integral not marginal December
2007
4
  • Challenges for commissioners and providers
  • Whole population not solely those with identified
    needs (JSNA and LAA)
  • Embedding telecare in care pathways,
    commissioning documents, specifications and
    contracts
  • Choice, options and capacity in the marketplace
  • Independent advice, guidance and brokerage
  • Transforming community equipment/retail model
  • Added value eg enhanced home care
  • Marketing services directly to users and carers
  • Costing and charging, amounts transferred into
    personal budgets

5
.So over the next few years we will give
100,000 people with long-term conditions the
opportunity to manage their care in this way as
'expert patients'. And during 2008 we will bring
forward a patients' prospectus that sets out how
we will extend to all 15 million patients with a
chronic or long-term condition access to a choice
of 'active patient' or 'care at home' options --
clinically appropriate to them and supported by
the NHS. Real control and power for patients -
supported by clinicians and carers. More than
today's new choice of where and when you are
treated, a new choice tomorrow - in partnership
with your clinician - about your treatment
itself. Something made even more accessible by
using NHS direct, the internet and digital TV as
well as the telephone to improve support for
patients who want an active part in their
care.. Gordon Brown, Prime Minister, January
2008
6
Transforming Social Care LAC (2008)1 references
to telecare 11.Assistive technology such as
telecare and minor adaptations, like fitting a
handrail, can also enable people with support
needs to continue to live in their own
homes   17 With self-directed support, people
are able to design the support or care
arrangements that best suit their specific needs.
It puts people in the centre of the planning
process, and recognises that they are best placed
to understand their own needs and how to meet
them. They will be able to control or direct the
flexible use of resources (where they wish to),
building on the support of technology (eg
telecare), family, friends and the wider
community to enable them to enjoy their position
as citizens within their communities   10
..Person centred planning and self-directed
support to become mainstream, with individuals
having choice and control over how best to meet
their needs, including through routine access to
telecare..
7
Telecare Commissioning - Challenges
  • Human contact and technology, ethical and consent
    issues eg organisations are used to
    commissioning intensive home care but not linked
    with telecare, extra care or LTC management
  • Savings may accrue in health from a local
    authority investment
  • Local authorities and their partners fail to plan
    for telecare and telehealth beyond March 2008
    when the PT Grant funding ends (JSNA and LAA)
  • Poor engagement with users, carers, GPs, third
    sector and other key stakeholders decisions are
    made beyond the influence of main beneficiaries
  • Inconclusive benefits for investments made,
    charging, business case
  • Funding leakage and diversion with fragmented
    services and poor uptake
  • Focus on outcomes as well as inputs/outputs
  • Product and service innovation design
    improvements
  • Questions about the evidence base, problems with
    referrals
  • Lack of a culture of joint/integrated/strategic
    commissioning across service organisations leads
    to poor decisions made in isolation which are not
    linked to best outcomes

8
Telecare Commissioning Evidence of progress
  • CSCI survey information from 2006 and 2007 with
    further coverage in 2008
  • 150 Telecare profiles updated December 2007
  • NHS PASA framework further updates from April
    2008
  • Five events covering outcomes, achievements and
    challenges qualitative information about
    progress
  • Better understanding of the best care pathways
    and the importance of preventative as well as
    reactive approaches
  • White Paper LTC Demonstrator Sites commence
    Spring 2008
  • Assisted Living Innovation Platform (ALIP)
    commenced Nov 2007 - part of the work of the
    Technology Strategy Board
  • Headline issues on safer walking devices, home
    monitoring
  • References in key policy documents
  • Telecare on BBC Radio 4 You and Yours on 30
    January 2008, Ivan Lewis on 31 January 2008
  • Academic reports, evaluations, journals
  • Major conferences featuring telecare/telehealth
  • Wider initiatives on interoperability, standards,
    consumer products
  • Major global companies, expansion in Europe,
    North America etc

9
Achievements of the National Framework Agreement
since June 2006
  • Since the Telecare National Framework Agreement
    was launched in June 2006, it has
  • Helped support the implementation of telecare and
    telehealth across the UK. 32m worth of UK-wide
    spend (up to 30 Nov 07) has been channelled
    through the agreement
  • 80 of Local Authorities in England are actively
    using the NFA
  • Generated cash releasing savings of 7.4m (up to
    31 Oct 07)
  • Reduced the lead time and cost to the public
    sector bodies undertaking their own local
    tendering process to procure equipment and
    services (efficiency savings in the region of
    27m to the UK public sector)
  • Increased access to new technology and innovation
    offered by the wide range of suppliers
    participating in the agreement. NFA product
    offerings updated on an annual basis via review
    process with NFA participating suppliers
  • Won the Chartered Institute of Purchasing
    and Supply Best Public Procurement Project Award
    in September 2007

10
Telecare performance
The (Preventative Technology) grant should be
used to increase the numbers of people who
benefit from telecare, by at least 160,000 older
people nationally.   .Through the grant, the
Department expects councils to invest in telecare
to help support individuals in the community.
This aims to help an additional 160,000 older
people to live at home with safety and security
and reduce the number of avoidable admissions to
residential/nursing care and hospital. Building
Telecare in England, Department of Health, 2005
Additional users benefiting from telecare
11
Telecare performance
  • The first collection of local data was carried
    out by CSCI in April 2006
  • The aim was to
  • Identify baseline figures at March/April 2006
  • Identify projections of additional users and
    equipment/infrastructure expenditure for 2006/7
    and 2007/8
  • Obtain a summary of the proposed scope of the
    telecare service
  • A profile has been developed for each of the 150
    social care authorities based on the 2006
    information. These profiles, were updated in
    December 2007.

12
Telecare performance
13
Telecare performance
14
Telecare performance
15
Telecare performance
16
Telecare performance 2008 provisional
  • Outturns numbers/expenditure
  • Projections for 2008/9
  • Question outcomes
  • Question - mainstreaming and sustainability

17
Performance and support
HEALTH
Person centred planning and self directed
support to become mainstream and define
individually tailored support packages. Telecare
to be viewed as integral not marginal PPF
Section 3.3
Third sector and others
Social Care
Housing
18
In your area, how many people
Telecare Commissioning - Agenda
Have dementia?
Fell at home in the last week?
Have a long term neurological condition?
Have angina, heart failure, diabetes?
Live alone with poor housing at risk of crime?
Have intensive home care, COPD and depression?
Attend AE regularly?
Could be in a care home in the next year?
Could benefit from preventative support?
Could benefit from integrated telecare/telehealth
services?
19
LTC model, social care and housing
Health care (vulnerable)
More complex cases
Accessible Health social care Information/advice
20
LTC model, social care and housing
FACS
Critical
Substantial
Social care (vulnerable)
Moderate
Low
21
LTC model, social care and housing
FACS
Critical
Substantial
Social care (vulnerable)
Health care (vulnerable)
Moderate
More complex cases
Low
Accessible Health social care Information/advice
22
LTC model, social care and housing
FACS
Critical
Substantial
Social care (vulnerable)
Health care (vulnerable)
Data sharing/Degree of integration
Moderate
More complex cases
Low
Accessible Health social care Information/advice
23
LTC model, social care and housing
Extra Care
FACS
FACS
Hospital discharges
Critical
Heart failure/ECG
Dementia
COPD, diabetes
Substantial
Social care (vulnerable)
Health care (vulnerable)
Disease Mgmt
Moderate
LD
Falls, medication
More complex cases
Low
Supporting People
Accessible Health social care Information/advice
Examples of current telecare supported care
pathways
24
LTC model, social care and housing
FACS
Critical
Substantial
Single assessment Contact Overview Specialist Comp
rehensive
Social care (vulnerable)
Health care (vulnerable)
Moderate
More complex cases
Low
Accessible Health social care Information/advice
Commissioning Approach - reactive, responsive to
highest needs?
25
LTC model, social care and housing
FACS
Critical
Substantial
Single assessment Contact Overview Specialist Comp
rehensive
Social care (vulnerable)
Health care (vulnerable)
Moderate
More complex cases
Low
Accessible Health social care Information/advice
Commissioning approach preventative and self
care stops people moving into critical/substantial
and into hospital
26
LTC model, social care and housing
FACS
Critical
Substantial
Single assessment Contact Overview Specialist Comp
rehensive
Social care (vulnerable)
Health care (vulnerable)
Moderate
More complex cases
Low
Accessible Health social care Information/advice
Commissioning approach - all users where needs
could be met by telecare? Cost?
27
Two years of progress
28
Housing Telecare Networks Care Services
Improvement Partnership Department of
Health Wellington House 135-155 Waterloo
Road London SE1 8UG e-mail telecare_at_csip.org.uk
Website www.icn.csip.org.uk/telecare
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