Seamus Breen Impact Consultancy Making a Positive Impact

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Seamus Breen Impact ConsultancyMaking a
Positive Impact
Home Care and Telecare
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Policy Driver Shaping the Future

• The DH have agreed with ADASS and the LGA that
  there a 5 key priorities during this first phase
  of transformation of social Care (by April 2011)
• That the transformation of adult social care has
  been developed in partnership
• All those eligible for council funded adult
  social care support will receive a personal
  budget via a suitable assessment process.
• That partners are investing in cost effective
  preventative interventions, which reduce the
  demand for social care and health services.
• That citizens have access to information and
  advice regarding how meet their care and
  support needs.
• That service users are experiencing a broadening
  of choice and improvement in quality of care and
  support service supply ..

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Funding Drivers - Story 1 Public Sector Cuts

• Huge job cuts' for public sector
• The CIPD says public sector cuts will impact on
  service provision
• As many as 350,000 public sector jobs could be
  lost over the next five years, the Chartered
  Institute of Personnel and Development (CIPD) is
  warning.
• Chief economist John Philpott says the recession
  will bring "a bloodbath in the public finances"
  which will force employers to slash their
  workforce.

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On the cuts story

• A YouGov poll for the Sunday Times found 60 per
  cent of people wanted budgets cut to balance the
  books rather than more taxes
• A combination of interviews and briefings over
  the past week indicate that the Government is
  changing its position. The strategy seems to be
  to accept that there will have to be a
  significant spending reduction, but only once the
  economy returns to growth and that this will be
  across all public services including health and
  overseas aid.
• Within this spending reduction some key economic
  and social objectives will be identified such as
  skills, educations and poverty reduction, where
  spending will be prioritised.
• In the other areas of spending, the emphasis will
  be on a return to public service reform,
  productivity savings, efficiency, choice,
  competition and more co-production. By Ben
  Lucas,  2020 Public Service Trust

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What do we believe?

• An opinion poll conducted for the RSA by Ipsos
  MORI and published 21 Sept reveals voters still
  dont accept that they have to share in the pain.
• Even a few weeks ago, when the poll was
  conducted, by two to one, respondents rejected
  the assertion there is a real need to cut
  spending on public services to pay off the very
  high national debt. By the same proportion they
  also disagreed with the proposition too much
  money is spent on public services.
• All the talk of cuts will shift these figures,
  but politicians may be less able or willing to
  provide the other reality check demanded by our
  poll findings By Matthew Taylor, RSA Chief Exec
  2020 Commissioner

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Funding Drivers Story 2 is of spend!

• Free personal care will be introduced so the
  frailest can be cared for in their own homes,
  Prime Minister Gordon Brown has pledged.
• Under the National Care Service, some 350,000
  people with "the highest needs" would receive
  home care regardless of personal wealth.

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Questions

• Do we believe this will require the homecare
  sector to recruit additional care-workers?
• Is this workforce available?
• Will this have unintended consequences and so
  will we see more people wanting care?
• Is this affordable nationally?
• How will the country reduce the cuts elsewhere
  to make this affordable?
• Do we really believe the Local Authorities will
  have pots more money?

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Securing the future of Home Care

• Common Themes
• Some financial uncertainty in public funding but
  VFM will be increasingly important.
• The public themselves will want best value and
  only pay for what they have received.
• LAs will be forced to consider efficiencies and
  the evidence of what makes a positive impact on
  peoples lives
• LA performance will increasingly require them to
  put forward evidence on how they have made a
  difference.
• More people must be seen to be in control of
  their own care and have choice over that care
• Partnership approaches and integrated pathways
  will need to lean

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Most LA Budget Strategy.
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Telecare supports commissioning priorities-

• Being healthy - supports a range of issues for
  people with LD, epilepsy, LTC, early onset
  dementia, enuresis vulnerable older adults.
  etcBeing safe -  used in a range of ways,
  supporting people in managing inappropriate
  behaviour such as leaving the property during the
  night, nuisance activity (banging on doors),
  entering other peoples rooms in supported living
  environments.  By enabling professional
  assessment of situations re daily living
  activity, identifying frequency of seizures with
  info provided to GPs who have modified medication
  as a result to ameliorate the situation, calling
  of responders to assist when necessary.Quality
  of life - supporting people to live safely and
  with dignity as support  only provided when
  appropriate, can remove the need for frequent
  checks 'just in case something might have
  happened' which impacts upon choice of daily
  living activities.  Personal safety increased
  i.e. flood detectors, universal door sensors,
  fall detectors, epilepsy sensors.  Enables person
  needing support and family and friends feeling
  more in control of their situation.Positive
  contribution - assists people to live in society
  promoting social inclusion, supporting carers,
  promoting choice and control in own
  livesEconomic wellbeing - Reduces the need to
  put high levels of service into some situations
  which can lead to higher charges for services.
  supporting people to go to work,Access to high
  quality services - access to services and
  supporting outcomes in rural super sparse areas,
  ensuring services delivered close to home by use
  of assistive technology, support and activity.

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Mainstreaming Telecare
James Barlow, Imperial College London Business
School at a recent Kings Fund conference on
Sustaining innovations and new technologies for
managing long-term conditions
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Telecare delivers efficiencies and empowers

•  138 out of 297 new Telecare service users
  analysed .
• The comparison was made between what a
  traditional care package would have looked like
  and what actual packages of care were including
  a Telecare solution.
• In 64 out of 138 (46), the traditional package
  would have been residential, EMI or nursing.
• These have become home packages including
  Telecare, elements of home care and day care.
• In 74 out of 138, (54), traditional package
  would have been care in the home.
• In these cases, if existing homecare is 10 hours
  or above, then the trend is indicated for
  homecare to reduce but still be an element of the
  package.
• If the traditional package would have been 7
  hours or less, then trend is for home care hours
  to reduce or not have to be provided at all.

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• There are some specific examples of care packages
  reducing significantly e.g. permanent
  residential reducing to the provision of bed and
  chair sensors permanent EMI residential to
  property exit sensors and so on.
• Preliminary financial analysis is indicating
• a gross average efficiency per person on an
  annual basis of between 2,600 and 19,000 per
  area,
• averaging out at 7,000 countywide
• a 50 reduction in care package costs.
• The range is between a 90 reduction in package
  costs and in some cases an increase if Telecare
  added onto a residential package
• The evidence is increasing and more LAs are on
  the verge of driving hard on this agenda and
  mainstreaming telecare.

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Home Care Providers

• In terms of securing the future
• Consider how the use of telecare will enhance
  your business opportunities,
• Consider the financial pressures on commissioners
  and the challenges in increasing the capacity of
  your workforce. Explore how telecare will help
  you deliver outcomes more cost effectively.
• Talk to commissioners how you can help more
  people to be safe and independent at a price
  rather than how many home care hours you can
  deliver.
• Note the measure of success will be not on the
  numbers of Hrs delivered but how providers have
  made a difference.

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Telecare threat or opportunity?

• Make sure you avail of the opportunity!

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Thank You

• PostiveImpactConsultancy_at_googlemail.com