Features: November 11th, 2005

Getting the Benefits from Telecare

By James Buckley

Telecare has the potential to make a significant difference to the lives of older people, while at the same time improving efficiency and reducing costs. Government support for telecare comes in the shape of a £80m Preventative Technologies Grant which is intended to transform the design and delivery of health and social care services for local authorities and their PCT partners.

The purpose of the grant is to develop long-term and sustainable service delivery improvements by using low-level support to prevent later crises, maintain well-being and independence and avoid more costly care. Community alarms and telecare can support older people and enable them to live safely and securely at home for longer, reducing avoidable admissions to residential care and hospital.

The Green Paper on reforming adult social care services, “Independence, Wellbeing and Choice” has placed the spotlight firmly on promoting preventative care that enables people to stay in their own homes. It has also highlighted the role that telecare can play in helping to deliver these services.

As the funding is not ring-fenced no bids are required, however councils with social services responsibility and relevant stakeholders need to have plans in place well before April 2006 to expand the uptake of these technologies in order to meet the target of 160,000 additional people benefiting from the technology.

So, how do these parties go about devising and putting their plans into action before the 2006 deadline? Here’s a series of practical steps that can help you through the process.

Setting aims and objectives

It is vital to plan well, setting out aims and objectives and a clear vision of how telecare can be integrated into an existing model of care or create a new methodology. Careful planning will help authorities to make the most of the Grant and telecare delivery, ensuring all stakeholders are engaged and clear about the goals and their responsibilities from the start.

A good place to start is to evaluate existing care provision and examine how this can be further developed and expanded using telecare technology. Knowledge and experience gained from other successful telecare projects can be applied to help this process. It’s also helpful to examine current provision for specific client groups, ie people with dementia or learning difficulties to establish what role telecare could have.

The Policy Context – Government Plans

The Government is convinced of the potential of telecare to deliver real and tangible benefits to vulnerable people, local authorities and healthcare providers, with Liam Byrne MP giving the unequivocal endorsement that: “Telecare gives people the confidence to live their lives in the way they want – independently, on their own terms, and with the peace of mind that comes from knowing that if something goes wrong, help is on its way.”

The Government also recognises that as the population ages, it is not feasible to continue to deliver care and support in the same way and that the commitment to offering independent living and choice to vulnerable people needs to be balanced with more efficient service delivery, given the financial burdens on the NHS. Telecare technology not only pays for itself but can also deliver savings that can be redeployed according to client need by providing cost-effective, low-level yet pro-active and preventative care

Financial modeling for your area — what’s needed?

There is no hard and fast financial model that can be applied unilaterally, but Section 31 of the Health Act 1999 provides flexibilities for local authorities and health trusts to pool funding to achieve agreed joint targets, and may provide an ideal framework for the financial management of PTG funding as well as support the kind of integrated working required for effective implementation.

Careful measurement and evaluation of telecare implementation is essential in order to allow local authorities and trusts to consider the charging options available on certain telecare services. This will highlight the cost benefits savings associated with introducing telecare into care provision. The model will depend on the finances and budget available to the local authority. Managers will need to examine existing revenue and look at all available grants and funding.

Local authorities and trusts also need to consider the charging options available on certain telecare services – whether to offer a fully managed telecare solution or purely the equipment. This will highlight the cost benefits savings associated with introducing telecare into care provision, and these in turn should be utilised to drive further system modernisation and improvement.

A Case in Point

Foyle Trust’s Going Home Staying Home project, has successfully introduced telecare into a pioneering a new approach to health and social care for older people. Telecare solutions from Tunstall have enabled the supported discharge of 335 people in the area to date, giving them the care they need in their own homes, thereby reducing instances of bed-blocking, alleviating some of the pressure on the NHS and saving over £250,000 in resources to date. As a result of impressive savings – 163 bed days and £550 per referral – the project has been extended to become part of the trust’s mainstream healthcare provision.

Southwest Staffordshire PCT’s innovative medication reminder initiative has harnessed telecare to help address the issue of medication non-compliance, an issue which is as costly and dangerous as many illnesses. Telecare is being used to reduce the costs and hospital admissions associated with not taking medicines as prescribed, benefiting the Trust and the people in its care.

Drawing up a telecare business plan

When drawing up a telecare business plan, one of the most important aspects to examine is how the service will be implemented by mapping the route to the service user in detail. Every aspect of deployment from who will assess and install, to who will manage the stock and who will monitor and respond to alerts needs to be considered. Resources can then be allocated accordingly as part of the plan, whether inhouse or outsourced and any training needs addressed.

Assessing telecare needs

Health and social care and support needs to be tailored to the individual, and not vice versa. The Single Assessment Process is being developed in order to drive efficiencies and in turn this should generate a specialist assessment for telecare. The specific requirements of the individual need to be assessed by the healthcare team and a telecare package supplied tailor-made to fulfill these needs.

It’s also important to remember that people’s needs and conditions change, and that assessment needs to be ongoing, to ensure that telecare continues to provide the reassurance and assistance required for independent living. All stakeholders in the process therefore need an understanding of telecare solutions and appropriate applications, along with clear criteria and the protocols which need to be applied for its use. Specialist software is now available which will identify possible telecare solutions for clients which can then be discussed and agreed with them.

Evaluation framework

It’s important to set out how the telecare programme will be evaluated in advance. What framework will be used to measure the success of the programme, and how will this success be measured?

Quantitative data will highlight the cost benefits and associated savings in NHS resources that telecare delivers, by reducing bed-blocking and the need for round-the-clock care and residential care home places.

Collecting qualitative data is equally as important, as this demonstrates how telecare can improve the quality of life for the individual, allowing them to remain in the familiar surroundings of their own home for longer. and giving them confidence and reassurance that help is on its way if and when they require it. Evaluation must be planned from the outset with future eventual outcomes in mind.

By following these guidelines, local authorities will be better prepared to benefit from the £80m Preventative Technologies Grant, develop telecare services to deliver advanced levels of care and give people the freedom and independence to remain in their own home.

James Buckley is CEO of telecare specialist Tunstall who offer advice and guidance on planning and implementing a telecare programme. Tunstall also supply an Implementation Toolkit and free of charge consultancy service – call 01977 660479 for more details.