Developing a Telecare Strategy

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Developing a Telecare Strategy

• Greater Manchester
• November 2006

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Broad Directionsfor health and social care

• Personalisation of services
• Focus on outcomes for people
• Shift of focus from acute to community
• Shift from illness/exclusion/disability to
  health/independence and abilities
• Shift from dependency to empowerment
• Shift from professional knows best to user led
  approaches
• Shift from targets to outcomes
• From separate to integrated systems.

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• It can be as simple as the basic community alarm
  service, able to respond in an emergency and
  provide regular contact by telephone
• It may include detectors and monitors such as
  motion or falls detectors and warnings about fire
  and gas escape that can trigger a warning to a
  response centre

• Telecare is as much about the philosophy of
  dignity and independence as it is about equipment
  and services
• Equipment is provided to support the individual
  in their home and tailored to meet their needs

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What is telecare?

• Telemedicine - monitoring vital signs, such as
  blood pressure, and transmitting the data to a
  response centre or clinicians computer, where it
  is monitored against parameters set by the
  individuals clinician
• Evidence that vital signs are outside of normal
  parameters triggers a response
• Needs to be part of the local health and social
  care pathway for managing long term conditions

• As a preventative mode - services programmed to
  monitor an individuals health or well-being with
  early warning of deterioration, prompting a
  response from family or professionals
• Safety and
• security
• through
• bogus caller
• and burglar
• alarms

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Alerts, measurements in the home bells, sirens,
screen readout
Other AT devices
Home Sensors CO, PIR, pressure mat
Alerts to users, carers etc eg pagers
Alerts, info to mobile phones, home PCS etc
Integrated Telecare
Monitoring (including parameters), response/call
handling
Installation, maintenance
Autodiallers, phone line, 3g/GPRS transmission
modules, broadband
Home visits, users/carers, emergency services,
clinician response etc
Cameraphones
Community alarm handset/pendant
Standalone glucose monitors
Autodiallers, phone line, 3g/GPRS transmission
modules, broadband
Cameras
Autodiallers, phone line, 3g/GPRS transmission
modules, broadband
Housing systems, door entry, bogus caller
Sensors worn by users, falls, wristcare,
wandering etc
Telehealth units
Telehealth peripherals glucose, peak flow,
weight etc
Medication monitoring
Environmental controls
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PTG expected outcomes

• Support for
• hospital discharge and intermediate care
• those who wish to die at home with dignity
• reduced acute hospital admissions
• reduced need for residential/nursing home care
• reduce burden on carers more personal freedom
• reduction in accidents and falls in the home

• Contribute to
• the development of a range of preventative
  services
• wider health, housing and social care policy
  agendas
• care and support for people with long term health
  conditions
• an increased choice and independence for service
  users
• increased user re-assurance, less risk-averse
  policies, responsive to lifestyles

Help to unlock resources and redirect them
elsewhere
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Telecare offers choice and flexibility of service
provision from community alarms and sensors to
vital signs monitoring The potential of telecare
is gaining in recognition

• An estimated 90 of people want to live in their
  own home
• Approx 500,000 older people live in care homes
• As many as 35 of these people could be supported
  in their own homes or in extra care housing with
  telecare

• Over 1.6m emergency admissions were made in
  2003/4 telecare has the potential to reduce
  unnecessary admissions and improve quality of
  life

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The use of mobile telephones to send a text
message which will alert people when their
hospital/doctors appointments are due

. To send text messages about changes in the
weather, especially helpful for asthma sufferers
16-34 years olds were the most likely to
repeatedly miss appointments
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Identify some of the common pitfalls from your
own experience
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Common Pitfalls in developing a telecare strategy

• Poor preparation
• Inadequate resource
• Lack of awareness
• Working in isolation
• Poor communication pathways
• Unskilled staff and carers
• Trying to fit telecare into existing service
• No strategy

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Implementation issues

• Re-engineering services
• Response system
• Cross organisation support/Partnerships
• Prioritising need
• Evidence for supporting provision
• Engaging all parties/communication
• What intervention

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Implementation issues contd

• Eligibility
• Evaluation inc service user views
• Resources inc finance
• Risks how to monitor and manage
• Response protocols
• Training and awareness/skills
• What equipment to procure and how?

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Key components of a successful telecare strategy

• Vision
• Clear ownership and leadership
• Have a goal (and communicate it)
• Create awareness
• Training and Information
• Identify resources
• Identify your partners

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Key components contd

• Identify a project lead
• Identify suppliers
• Eligibility criteria
• Evaluation/evidence
• Use existing infrastructure
• Installation, maintenance, service, removal
• Charging
• Ethics

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Simple Messages

• Think, bold big and radical,
• Know the key outcomes being sought.
• Consider high levels of demand yet personalised
  approaches.
• Consider the implications of new major providers
  in the market place.
• Consider solutions for the most vulnerable- get
  it right for the older person with dementia and
  you will get it right for the many
• Think independence with dignity inc outside the
  home

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Telecare is a vital key to unlocking the future

• New demands will need to be managed
• Health and social care commissioners need
• to make decisions on investment in
  technology
• Services will take on new patterns to meet
• changing care and support needs and to give
  people a choice
• It is not realistic to plan to deliver care and
  support services in the way we do at present
• We must embrace new ways of working to meet the
  needs and aspirations of our service users and to
  take advantage of new and developing technologies

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The National Framework Agreement for Telecare

• The national framework agreement allows
  organisations involved in telecare implementation
  to simplify procurement arrangements and get best
  value from the Preventative Technology Grant.
• Organisations can continue to procure from
  outside the framework agreement but they will
  need to take into account EU tendering
  requirements and any local best value audit or
  scrutiny.
• There will be no charges for using the PASA
  framework. It covers installation, maintenance,
  monitoring and response as well as equipment.

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National Framework Agreement

• Organisations are able to mix and match - eg
  equipment may be procured using the framework and
  the response service arranged with a local
  provider under an existing service level
  agreement if that will meet the needs of the
  local community.
• Service commissioners are able to compare costs
  under the framework with any existing
  arrangements.
• Details of suppliers and products/services that
  are included within the National Framework
  Agreement are available via NHS E-cat (PASA's
  electronic catalogue).
• Details on how to access NHS E-cat or receive
  further information regarding the framework
  agreement are available on www.cat.csip.org.uk/tel
  ecare

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SOME USEFUL WEB SITE ADDRESSES

• Building Telecare in England, DH (July 2005) and
  Local Authority
• Circular LAC(2006)5
• http//www.dh.gov.uk/PublicationsAndStatistics/Pub
  lications/
• National Framework Agreement for procurement of
  telecare
• http/www.pasa.nhs.uk/eat/telecare
• CSIP Telecare implementation guide and
  factsheets/e-newsletter and telecare LINs
• www.cat.csip.org.uk/telecare
• CSIP DVD - Telecare living with independence
• www.changeagentteam.org.uk
• CSIP information telecare_at_csip.org.uk

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FURTHER INFORMATION

• Ian Salt ian.salt_at_cat.csip.org.uk
• Rachel Denton rachel.denton_at_csip.org.uk
• Tracey Bond tracey.bond_at_cat.csip.org.uk

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