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Welcome
The Victoria Park Plaza Hotel
Victoria
London
Chair’s Welcome
Richard Humphries
Chief Executive
Care Services Improvement Partnership
The Gift of Peace of Mind
Liam Byrne MPParliamentary Under Secretary of State for Care Services
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
Health & Social Care Change Agent Team
STRATEGIC STRATEGIC COMMISSIONING OF COMMISSIONING OF SERVICES AND THE SERVICES AND THE BENEFITS OF BENEFITS OF INVESTING IN INVESTING IN TELECARETELECARE LONDON Tuesday 19 July 2005LONDON Tuesday 19 July 2005
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
ARE YOU READY TO SPEND THE £80 MILLION?
Ian Salt Ian Salt
C.S.I.P. National Lead - TelecareC.S.I.P. National Lead - Telecare
1. Is there any evidence for telecare – is it cost-effective?
2. How do I deal with the ethical issues like consent?
3. How do I get Social Services, Health, Housing and the independent sector involved in improving services?
4. How does telecare fit in with other plans and priorities for promoting independence and dignity?
5. How does telecare become a mainstream service?
“In looking at the new funding, as a Director of Social Services I might be asking myself……..”
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
• Examples of good practice and innovation showing that telecare can help reduce care home and hospital admissions and support independence programmes
• Innovative housing schemes have led the way in providing telecare support
• Payment by Results and the National Tariff opportunities for PCTs to monitor long term conditions outside of hospital
• The CSIP Telecare Implementation Guide and factsheets provide information, checklists and contacts including local services and telecare experts
“Is there any evidence for telecare – is it cost effective?”
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
“How do I deal with the ethical issues like consent?”
• Users could benefit from telecare
• Care should be taken to obtain consent and agreement
• Follow-up, monitoring and review will ensure that telecare meets the needs of users and is not intrusive
• Complex situations will need special consideration
• Innovative work would need local ethics committee consideration – a factsheet is available
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
“How do I get Social Services, Health, Housing and the independent sector involved in improving services?”
• ICES Section 31 or other existing partnerships to bring people together – this could leverage in extra funding
• Users may have reduced hospital admissions and those supported by health services may need less care,– whole systems thinking is vital
• Telecare could provide considerable benefits for carers and families
• Fair Access to Care Services and Single Assessment will enable services to be focused on users and carers
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
“How does telecare fit in with other plans and priorities for promoting independence and dignity?”
• Audit Commission and the Health Select Committee reports
• The Green Paper on Adult Social Care includes telecare
• Standards in several of the NSF’s could be achieved using aspects of telecare ( long term conditions, falls strategies, intermediate care )
• Telecare could support people as part of palliative care programmes
• ‘Improving the Life Chances of Disabled People’ has many references to assistive technology
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
“How does telecare become a mainstream service?”
• Innovation and programme evaluation identifies the value of telecare services with a sound evidence base and demonstrates value for money
• Partnership working provides synergy and leveraging of additional, recurring funds to provide long term development
• A viable service option for health, housing and social services provision with clear links to their strategies, policies, commissioning plans and service priorities
• Involving users and carers through consultation and care planning focuses on independence, dignity and choice
• The CSIP Guide and factsheets support local plans
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
Project Mgr
Suppliers
Ethics
Pilot(s)
Charging
FACS, SAP
Awareness
Procurement
Contracts/SLAs
Protocols
Commence
Review
Implementation of telecare
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
Project Mgr
Ethics
Pilot(s)
Charging
FACS, SAP
Protocols
Commence
Review
Awareness, training
Funding >Procurement
Suppliers
Contracts/SLAs
Implementation of telecare
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
6 months6 months 6 months6 months 6 months6 months 6 months6 months 6 months6 months
Project Mgr
Ethics
Pilot(s)
Charging
FACS, SAP
Protocols
Commence
Review
Awareness, training
Funding >Procurement
Suppliers
Contracts/SLAs
Implementation of telecare – too long
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
July 2005July 2005 April 2006April 2006 Sept 2006Sept 2006
Telecare Champion
Ethics
FACS, SAP, fairer charging
Protocols
Commence
Review
Awareness, training
Funding and 2005/6 Plans
Evidence-base, suppliers, procurement
Contracts/SLAs
Implementation of telecare – telescoping the timeline using the Guide and Factsheets
Dec 2005Dec 2005
Partnership working
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
Health & Social Care Change Agent TeamHealth & Social Care Change Agent Team
SO - ARE YOU READY TO SPEND THE £80 MILLION?
Ian Salt Ian Salt
C.S.I.P. National Lead - TelecareC.S.I.P. National Lead - Telecare
We need to share information as it starts to emerge
We need to gather evidence so that we can move this telecare agenda forward together.
Health & Social Care Change Agent Team
FOR MORE HELP AND ACCESS FOR MORE HELP AND ACCESS TO THE CSIP TELECARE TO THE CSIP TELECARE IMPLEMENTATION GUIDE IMPLEMENTATION GUIDE
PLEASE VISIT OUR WEB SITE:PLEASE VISIT OUR WEB SITE:
www.icesdoh.org/telecare
www.changeagentteam.org.uk/telecare
Thank you
Ian Salt
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
20
Getting the Right Balance of Care in your Economy
Steve ArnoldDirector, Integrated CareNorth West London SHA
‘Strategic Commissioning of Services and the Benefits of Investing in Telecare’
Workshop 19 July 2005
Long Term Conditions:• are enduring• are not curable and require ongoing care• will get progressively worse
What’s included?:• arthritis, diabetes, heart failure, COPD• mental health• renal dialysis, cancer and HIV/AIDS• Sickle Cell and Thalassemia• NSF on Neurological Conditions
• 17.5m people with LTC, 8m with multiple LTCs
• Discomfort and stress an everyday reality
• Care has been reactive, unplanned and episodic, reliant on hospitals
• 5% LTC inpatients = 42% of all acute bed days
• LTCs account for 80% of GP attendances
• Only 50% medicines taken as prescribed
The challenge ….
• Embed a systematic approach across health and social care
• Reduce reliance on secondary care – increase primary, community and home support
• Deliver high quality personalised care
• Support for self-care – linking to ‘Choosing Health’ and healthier choices
Strategic Aims
National Targets
• April 2008 - reduce Emergency Occupied Bed Days by 5%
• April 2008 - identify the cohort of Very High Intensity Users - est. 240k nationally
• April 2008 – all VHIUs have care plans and are case managed
• April 2007 – complete appointment of Community Matrons - 3,000 nationally
Stratifying need and matching care
POPULATION WIDE PREVENTION
Level 3
Level 2
Level 1
Highly complexPatients (5%)
High riskPatients (15%)
Low riskPatients (80%)
DiseaseManagement
CaseManagement
Supported Self Care
‘Supporting People with Long Term Conditions – An NHS and Social Care Model’ (Jan 2005)
Albert’s story ….. present day•Albert is 72, lives alone - diagnosed with COPD 15 years ago
•30% of normal lung function at rest - severe breathlessness especially when he exerts himself, even in the most routine ways
•underweight; anxious, depressed, prone to panic; he feels hopeless and that he can’t cope
• regular exacerbations - admitted to hospital - 15 days LOS
•delay in notifying the GP and in getting support - re-admitted to hospital
•not able to attend the follow-up OPD appointments offered at the hospital
•GP does not normally visit
•treatment - oxygen therapy, steroids, antibiotics and regular use of inhalers, although he would often forget to take his medication
•meals delivered - carer support
Albert’s story ….. 2010•Co-ordinated by Primary Care Centre - Nurse Case Manager contacts him regularly both by telephone and in person
•Provides routine information daily through a hand held computer to the PCC - assessed daily
•Contact him by video link re possible exacerbation - advice about additional self-medication
•Other reports, inc weather conditions
•Urgent visits as appropriate
•Admissions to hospital reduced – and then:
– PCC stays in touch
– LOS reduced - usually 3 to 4 days
– Co-ordinated discharge
• ‘Direct payments’ funds gardener
•Calmer and spends lots of time admiring his newly reclaimed garden.
• Whole systems approach
• Links to the broader policy agenda
• Staff training inc decision support
• Awareness raising amongst users
• What can the industry contribute?
Lessons for the Telecare agenda
Be ambitious – this is about
transformation
Long Term Conditions – take home message
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
REFRESHMENTS
Newham Home Monitoring Newham Home Monitoring Project : Using Telecare to Project : Using Telecare to
Integrate Health and Integrate Health and Social Care Social Care
About Newham About Newham
About Newham About Newham
• Ranked 4Ranked 4thth in Jarman scores in Jarman scores
• 62% of population are from black and 62% of population are from black and ethnic minorities ethnic minorities
• High proportion of under 24sHigh proportion of under 24s
• Significant population growth Significant population growth forecastforecast
Health in NewhamHealth in Newham
• Major areas of health inequality Major areas of health inequality
• Significant burden of long term Significant burden of long term conditions particularly diabetes, conditions particularly diabetes, cardiovascular disease and cardiovascular disease and respiratory diseaserespiratory disease
• Age profile of LTCs different Age profile of LTCs different
• Huge potential for improvement Huge potential for improvement
Mortality trend for coronary heart disease, in people Mortality trend for coronary heart disease, in people aged under 65aged under 65
0.00
10.00
20.00
30.00
40.00
50.00
60.00
70.00
80.00
1993 1994 1995 1996 1997 1998 1999 2000 2001
rate
per
100
,000
England London Newham
Mortality trend for stroke, in people aged under 65Mortality trend for stroke, in people aged under 65
0.00
5.00
10.00
15.00
20.00
25.00
1993 1994 1995 1996 1997 1998 1999 2000 2001
rate
per
100,0
00
England London Newham
A Relatively Small Number of A Relatively Small Number of PatientsPatientsAccount for a Large Share CostsAccount for a Large Share CostsHospitalized Patients and % of Total Hospitalized Patients and % of Total Patient DaysPatient Days
3.0%
27.5%
7.0%
27.1%
10.0%
19.0%80.0%
26.4%
0%
20%
40%
60%
80%
100%
Pe
rce
nt
of
To
tal
3.0%
40.4%
7.0%
29.9%
10.0%
15.4%
80.0%
14.3%
0%
20%
40%
60%
80%
100%
Pe
rce
nt
of
To
tal
HospitalizedPatients
TotalPatient days
HospitalizedPatients
TotalPatient Days
All London Newham PCT
74%86%
What works in LTC management ?What works in LTC management ?
• Managing the whole package of needs Managing the whole package of needs
• Single point of contact, particularly to promote Single point of contact, particularly to promote good cross sectoral and multidisciplinary good cross sectoral and multidisciplinary working working
• Good quality, accessible information Good quality, accessible information
• Proactive managementProactive management
• Timely, effective and proportionate response in Timely, effective and proportionate response in and out of hours and out of hours
• Involved and informed patients and carers Involved and informed patients and carers
• Tailoring to individual needs, especially in Tailoring to individual needs, especially in complex cases complex cases
Aims of the Home Aims of the Home Monitoring Project Monitoring Project
• Increase patients’ knowledge of their Increase patients’ knowledge of their condition condition
• Identify risk factors/ deteriorating condition Identify risk factors/ deteriorating condition and intervene earlyand intervene early
• Increase access to information 24hrs a day Increase access to information 24hrs a day for health & social care professionals caring for health & social care professionals caring for the patientfor the patient
• Manage health & social care needs and Manage health & social care needs and patient anxietypatient anxiety
Target GroupTarget Group
• Older people living at home beginning to Older people living at home beginning to develop a pattern of regular admissions / develop a pattern of regular admissions / attendance at A&Eattendance at A&E
• At least one chronic condition At least one chronic condition
• Anxious / socially isolated and in need of Anxious / socially isolated and in need of supportsupport
• Those with language needs and early Those with language needs and early stage cognitive impairment actively stage cognitive impairment actively involvedinvolved
What the project consists of What the project consists of
Single Assessment Single Assessment
Risk Identification Risk Identification
Care Companion Care Companion
Web Record Web Record
Case Manager based in Local Authority Case Manager based in Local Authority Call Call
CentreCentre
Individual Escalation ProtocolIndividual Escalation Protocol
Assessment Unit Assessment Unit
+ wireless devicesAssessment Unit
+ wireless devices
+ videophone
AMD Care Companion AMD Care Companion SystemSystem
Potential Value of TelecarePotential Value of Telecare
• Extend care to home settingExtend care to home setting• Supports patient education and concordanceSupports patient education and concordance• Relieves pressure on carers Relieves pressure on carers • Integrates in and out of hours care Integrates in and out of hours care • Facilitates proactive care Facilitates proactive care • High quality reliable information for decision High quality reliable information for decision
makingmaking• Underpins information sharing and joint planningUnderpins information sharing and joint planning• Enables most effective use of health / social care Enables most effective use of health / social care
resources resources
Lessons Learned in NewhamLessons Learned in Newham
• Steep learning curve for NHS and Steep learning curve for NHS and independent sectorindependent sector
• Dedicated resources essentialDedicated resources essential
• Compatibility between systems Compatibility between systems neededneeded
• Risk issues (clinical, financial) Risk issues (clinical, financial)
• Enthusiasm from staff and patients Enthusiasm from staff and patients
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
Telecare
A Durham Perspective
Content
Part One (John Thornberry)We like telecare becauseThere are challengesOur strategic approach
Part Two (Dennis Scarr)Pathfinder programme3 examples
We like telecare because it….
Increases choice for people Helps to manage risks in community
care Achieves targets and performance Helps with CSEP/Gershon Changes cultures and practices
Some Challenges
Complex organisational arrangements Overlapping policy initiatives Tight budgets Silo working practices Development to mainstream
Durham Strategic Approach
Whole systems approach Partnership working as a key to success Countywide groups for older people, CEB,
Supporting People Locality Boards with SSD, DC and PCT At Home and in touch project to link IT with
practice
Pathfinder Programme
Three Examples
A case for improved integrated working in
local communities
We are sometimes
providing the wrong services at the wrong time to the
wrong people -we need to
review how and where we spend
our resourcesThe rate of changes in health care must link to changes in
social care and housing
provision-The key providers
must co-ordinate their
service changes more
effectively
We are still driving a reactive approach to
care and housing provision-
we need to develop enhanced preventative
services
Not developing the types of care services needed in the
future fast enough - we are too slow!
Low overall user
expectation -user
expectations will increase in both needs &
wants
33% increase in people
needing care services in
next 10 years- demand is increasing
more quickly than ever
before
Govt will no longer tolerate
poor performance
or slow progress- cash
rewards are available to those willing
to change
Assistive Technology and Extra Care Housing Sycamore Lodge – Hanover Extra
Care Remote Health Monitoring & CDM ‘Well Elderly Clinic’ Telemed / Community Alarms / GP’s /
Service User Making it happen Early learning
Assistive Technology and SCATS Sedgefield Community Assistive
Technology Service ‘helping someone with memory
related problems remain at home….’ Telecare sensors/ Community
Alarms/Warden Service Making it happen Early learning
Assistive Technology & Integrated Teams Integrated Teams for services to Vulnerable
Adults – Social Care & Health / Health / Housing Support services.
Assistive Technology / Community Alarms/Warden Services
Single Assessment Process Making it happen Early learning
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
19 April 2023
Helping people to stay at home - findings from an evaluation of
Northamptonshire's Safe at Home Project.
John WoolhamSenior Research Officer
Northamptonshire County CouncilCommunity Services Directorate
July 2005.
Safe at Home: background
Northamptonshire’s involvement in the EU funded ASTRID project
Putting principles into practice – the Safe at Home project
Safe at Home: project structure
Three full time project workers located in Care Management teams and responsible for assessing referrals, identifying and obtaining technology needed and arranging its installation
3 ‘Demonstration houses’ to show technology in action to professionals, carers, and service users.
Project depends on multi-agency partnership working and multi-disciplinary professional skills within its management groups
Safe at Home: what it does in practice:
The story of Mrs White and her gas cooker…..
The Problem: Forgets to light gas cooker
after turning it on. Risk of suffocation or
explosionHigh level of concern from
neighbours and relatives
The Solutions?Admission into care Disconnect cooker Substitute gas for electric or
microwave Use technology to manage
risks
Safe at Home: evaluation objectives
To assess the reliability of any technology used in the project
To assess the extent to which any technology used supported unpaid carers and relatives
To assess the success with which technology helps service users to maintain their independence
To examine the cost effectiveness of the project
Safe at Home: methods
Longitudinal design – 21 monthsCriteria for inclusion in evaluation:
Met criteria for referral to projectpermission given to use data for research purposes
Control group from Essex social services to collect some outcome and cost data
No sampling.
Safe at Home: methods
There was a fairly high drop out rate before a service was provided
Safe at Home service users and the control group were very well matched
Total no. referrals = 326
Total no. assessments = 291
Total no. people who received technology = 233
SAH User group (n= 233)
Comparator group (n= 173)
Mean age 80.2 (SD=7.97) 79.4 (SD=7.41)
Gender M = 62 (27%) M=48 (27%)
Ethnicity White = 97%Asian/Asian British =
1%Black or Black British =
1%Chinese = <1%
White = 100%
Living alone Y= 66% Y= 40%
Diagnosis of dementia
Y= 90% Y = 100%
Presence of unpaid carer
Y = 87% Y = 94%
Mean MMSE 19.9 (SD= 6.07) (n=87) 18.9 (SD= 5.05)(n=93)
Safe at Home: Objective 1. The reliability of the
technology
Over 50 different kinds of device were used
Some were simple ‘stand-alone’ devices that don’t need to be installed
Some were telecare devices which relayed messages to a local call centre so a ‘social response’ could be provided.
Reliability and effectiveness checked every three months by project workers
91% of devices worked perfectly over the course of six reviews.
Safe at Home: Objective 2: The impact of the project on
relatives and unpaid carers
123 relatives and carers were surveyed and 70% replied. A carer stress scale was used to measure the impact of the project. In all but one of the scored items the scale score was lower (i.e. the relative or carer was less stressed) after the project had provided technology. These changes in score were statistically significant in 9 of the 13 items on the scale (w=0.001)
4.7
4
4.44.1
4.8
4.4
3.6
4.3
3.6
4 3.9 3.9 3.9
4.3
3.94.1
3.8
4.7
4.1
3.5
4.1
3.53.8 3.8 3.9 3.8
0
1
2
3
4
5
Fear
of
acci
dent
s/da
nger
s
Inte
rrup
ted
slee
p
Diffi
cult
ies
copi
ng
Feel
ings
of
depr
essi
on
Wor
ries
abo
ut p
erso
n ca
red
for
Ups
et t
o ho
useh
old
rout
ine
Feel
ings
of
emba
rras
smen
t
Feel
ings
of
frus
trat
ion
Lack
of
plea
sure
Inab
ility
to
have
hol
iday
Sta
ndar
d of
livi
ng
Hea
lth
conc
erns
Dem
ands
for
att
enti
on
Bef ore
Af ter
Safe at HomeObjective 3: Extent to which project
supported independent living
Assessment score profiles for people at referral and 12 month later declined (i.e. showed evidence of slight improvement) in functioning on three of the eight sub-scales. All sub-scale scores were statistically significant (x2=<0.001)
7
2.4
8.8 9.2
7.3
5.4
3.32.5
7.1
2.3
11
9.2
6.8
5.5
2.9 2.5
0
2
4
6
8
10
12
Thi
nkin
g &
com
mun
icat
ion
Pers
onal
ity
& de
men
tia
pres
enta
tion
Phys
ical
hea
lth
Valu
es b
elie
fs a
nd f
eelin
gs
Cont
act
wit
h ot
hers
Abi
lity
to m
aint
ain
cont
rol
Prac
tica
l iss
ues
Beha
viou
rs d
ifficu
lt f
or o
ther
s
Agg
rega
te s
core
At ref erral
12 mths later
Safe at HomeObjective 3: Extent to which project
supported independent living
A control group was used to compare the rates at which people left the community. People from the control group left the community sooner and in greater numbers: they were four times more likely to leave the community than Safe at Home users.
0
10
20
30
40
50
60
70
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
months
% w
ho le
ft c
omm
unit
y
Saf e atHome
Essexcomparator
Safe at HomeObjective 3: Extent to which project
supported independent living
The study considered if other factors might be responsible for these outcomes
The composition of the two groups: no sampling occurred the two groups were large and well matched on a range of factors.
Provision of care: people from the control received more services, more hours of help more visits.
The possibility that the differences may be due to difference in use of ‘anti-dementia’ medication or some kind of ‘Hawthorne effect’ are unlikely but can not be entirely discounted.
Safe at HomeObjective 4: Cost effectiveness
The project was extremely cost effective as fewer people spent less time in hospital, residential or nursing care. The net equivalent saving over 21 months was £1,504,773.
477,270.30
15,911.36
568,440.18
1,020,054.00
127,356.96
1,705,837.50
0.00
500,000.00
1,000,000.00
1,500,000.00
2,000,000.00
Residential care Nursing care Hospital
expe
ndit
ure
Saf e at Home
Essex comparator
Safe at Home: conclusions
Operational teams need:Training, training, trainingAccess to information about what technology is available and what
it does & doesn’t doAbility to obtain relevant technology quickly as well as access to
people with the skills to install it safelyNeed for access to call centre staff who are trained and have the
resources to meet the demands of an expanded serviceTo include a social response service
If the infrastructure is in place technology can help deliver performance improvements in relation to several social care performance indicators
May need to think about re-engineering of services and the creation of new hybrid professional groups.
Safe at Home: conclusions
RisksUse of technology is
‘technology led’ not determined by need
Failure to understand or apply ethical protocols where informed consent to use is difficult or impossible
Used as a substitute for social care
Safe at Home: conclusions
Assistive & telecare technology a win-win situation?Consistent with what most service users would prefer
Supports carers
Very cost effective. Can be used to
Manage riskProvide support and reassurancePredict the occurrence of ‘risky’ activities
Limits to use areAvailability of technological solutionsInfrastructure and will to supportSkill and imagination of service providers
References
Barlow, J., et al. Flexible Homes, Flexible Care, Inflexible Attitudes? The Role of Telecare in Supporting Independence (2003) Housing Studies Journal.
Curry, R., et al. The use of Assistive Technology to Support Independent living for Older and Disabled People (2002) ICES/DH.
www.ICESDOH.org Telecare Implementation Guidance Pack. (2005)Marshall, M (ed) ASTRID: A Social and Technological Response to
meeting the needs of Individuals with Dementia (2000) Hawker, London.
Woolham, J. & Frisby, B. Building a Local Infrastructure that Supports the use of Assistive Technology in Dementia Care (2002) Research Policy & Planning Vol 20. No.2.
Woolham, J. Safe at Home – supporting the independence of people living with dementia by using assistive and telecare technology (2005) forthcoming)
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
LUNCH AND EXHIBITION
Making Your Investment
Decisions Work
Peter Gilroy
Chief Executive
Kent County Council
Kent Telehealth Evaluative Development Pilot
A Personal Perspective onthe future of
social work & social care services in the UK
(Kent Social Services & Pavillion Publishing, 2004)
“Services of the future must have at their core a ‘customer-care’ ethos and shift away from paternalistic cultures.
Attitudes are changing and judgements made by the general public on the quality of public, social-care services will not be determined by what we say but what they taste, see and feel.
They will be the ultimate arbiters as to whether we are serious about modernising public services.”
Why Local Government?
Family of Services
Modern and more effective service to the public
Opportunity of a fundamental step change in front end services
Better use of public resources:
Compliments objectives of our ‘well-being’ powers and provides choice and independence
Competence/procurement
Capacity/strategic/infrastructure.
A Modernising ForceFinancial Savings
Kent’s TeleHealth Evaluative Development Pilot
Kent Telehealth: Self-management of chronic disease using Telehealth technology.
KCC Social Services are the lead agency in this multi- agency arrangement
Exploiting emerging technology The largest UK pilot to date with up to 300 people.
Improve the life outcomes of a pilot group of people in Kent with chronic disease management requirements.
Deliver a range of efficiencies across the Health and Social Care spectrum.
Links to PSA2
Partner organisations
Five PCT’s across Kent.
Viterion Telehealthcare LLC are a Bayer-Panasonic Company: Offer comprehensive, affordable, quality healthcare,
particularly for people with chronic diseases. Committed to developing with Social Services a UK/Kent
version of the US model. Expertise and technology capabilities.
Veterans Health Administration (VHA), an agency of the US Department of Veterans Affairs: One of the largest independent health and social care
providers in the US. Serving 4.9m patients from a registered client base of 6.9m VHA is affiliated with 107 academic health and social care
systems within the US and across the world.
For the Kent TeleHealth Evaluative Development Pilot we will be working with VISN 20 – VA Puget
Sound Health Care System, Seattle.
Kent TeleHealth Evaluative Development Pilot
VHA targeted their high cost, high health and social care supporting US veterans with a range of related morbidities
Outcomes of the US programme :-
Hospital admissions reduced by 46%
No. hospital bed days reduced by 61%
Number of admissions to nursing facilities or similar reduced by 47%.
Number of Nursing home or similar bed days reduced by 81%.
Reduced (high) hypertensives (blood pressure) by approximately 15% over 4 years.
Reduced (mild) hypertensives (blood pressure) by approximately 8% over four Years.
After twelve months near perfect score on the cognitive status of the patient.
Kent TeleHealth Evaluative Development Pilot
Opportunity to reduce admissions and costs in the UK
1.5 million pounds invested by Kent Social Services.
Evaluative Trial Programme 18mths.
A contribution to the overriding goal of promoting independence.
Four key Chronic Diseases:Chronic Obstructive Pulmonary Disease (COPD) & Asthma, Congestive Heart Failure,Diabetes,Depression.
Those with 3 + chronic disease conditions
will take up 32.5% of GP consultations
Chronic Disease ManagementSocial Care professional Health Care professional
Care PlanningCP ReviewWell Being
IndependencePrevention
Vital SignsMonitoring
Healthy BehavioursHealth Education
PhysiotherapySpeech Therapy
Mental Health
Single-Assessment Process
New vision Modernise
Working together
A contribution to the overriding goal of promoting independence
Self Managing
Occupational Therapy
What does Telehealth do?
This particular TeleHealth Technology consists of:
Disease management tools combined with unique user friendly interfaces specifically focused on the needs of older people to easily access and use the technology with confidence.
Reporting tools include tracking and alerts
Messaging devices, customisable, personalised scheduler, reminder and alarm.
Q&A technology Video Link with real-time video monitors and Instamatic digital cameras.
Portable, simple telephone connection to the provider via the web
Telehealth – The Future? Shift of power from practitioners to users
It will be a normal part of public and private infrastructure within 10 years, without diminishing professionals’ quality personal contact with the general public
Potential to go beyond intensive case management of people with chronic diseases with the Viterion equipment
Integrate TeleHealth into other community settings to promote
independence and self-management including the health, education and social-care economies
Integrate into other Social Care work, e.g. assessment and referral, care planning, review and single assessment. This form of integration brings back-office efficiencies but more importantly, better outcomes for citizens
It offers with other IT products a real step change in the way that the citizens are offered choice and, increasingly for many, self-manage their services
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
ROUND TABLE WORKING
Department of Health ConferenceDepartment of Health Conference
Strategic Services and Investing in Strategic Services and Investing in TelecareTelecare
“Transforming Lives “Transforming Lives Transforming Services”Transforming Services”
Tony Hunter,Tony Hunter,
Executive Director, Liverpool City CouncilExecutive Director, Liverpool City Council
andand
President, Association of Directors of Social ServicesPresident, Association of Directors of Social Services
ThemesThemes
• We make lives “bearable”We make lives “bearable”• Lots of green shootsLots of green shoots• Emerging local government rolesEmerging local government roles• From telecare to smart livingFrom telecare to smart living• Our leadership challengeOur leadership challenge
We make lives “bearable”We make lives “bearable”
• Lives → services: the right way roundLives → services: the right way round• Facing realityFacing reality
-- “He asked me silly questions I couldn’t “He asked me silly questions I couldn’t answer”answer”
-- Criteria driven assessments – no Criteria driven assessments – no added valueadded value-- Vision statements Vision statements ¼ ¼ hour home care hour home care slotsslots-- Marginalised social careMarginalised social care
Lots of green shootsLots of green shoots
• Children Act, Green Paper – 150 change Children Act, Green Paper – 150 change programmesprogrammes
• From “you need me” to “we need each other”From “you need me” to “we need each other”• Bottom line: “We can’t go on as we are”Bottom line: “We can’t go on as we are”• Unhelpful barriers coming down, LSPsUnhelpful barriers coming down, LSPs• Technology supported shift from hierarchical Technology supported shift from hierarchical
management and meetings…management and meetings…• ……to fluid networks, focused discussions and to fluid networks, focused discussions and
contributions to shared agendascontributions to shared agendas
Local government of the Local government of the futurefuture
• Force for change - community leadershipForce for change - community leadership• Heads up enabler, not heads down Heads up enabler, not heads down
delivererdeliverer• Knowledge based interventionsKnowledge based interventions• Blurred staff/agency rolesBlurred staff/agency roles• BPR/ICT around the customerBPR/ICT around the customer
From telecare to smart livingFrom telecare to smart living
• Policy context: shift from yes/no eligibility Policy context: shift from yes/no eligibility to wellbeing and inclusionto wellbeing and inclusion
• Telecare part of the former or the latter?Telecare part of the former or the latter?• Should any home be without the new, Should any home be without the new,
inexpensive “Smart living” Safe inexpensive “Smart living” Safe Environment Monitoring System?Environment Monitoring System?
• What’s our role? Sit back, or pro-active?What’s our role? Sit back, or pro-active?
Our Leadership challengeOur Leadership challenge
• Getting the “wellbeing” ducks lined up – Getting the “wellbeing” ducks lined up – adults social care, primary health, public adults social care, primary health, public healthhealth
• ““Shadow of the leader”:Shadow of the leader”:-- being empowering, decisive, being empowering, decisive, accountableaccountable-- listening, reflecting, learninglistening, reflecting, learning-- investing in partnershipsinvesting in partnerships-- embracing new ideas and technologiesembracing new ideas and technologies
• Are we up for it?Are we up for it?
For printed copies of each presentation
please complete the Conference
Evaluation sheet (in the handout pack) at the end of the day and hand it to the conference
registration desk
THANK YOU FOR ATTENDING