Telecare LIN

1. Telecare and Telehealth – How can they help promote dignity? Mike Clark, Telecare LIN 25 November 2008 Telecare LIN

2. Mike Clark leads the Telecare and Telehealth implementation programme working with health, housing and social care commissioners and service providers to develop integrated services to support people at home in a wide range of settings. Our networks provide a wide range of services to support housing, commissioning, leadership, personalisation and integrated care programmes. www.icn.csip.org.uk/telecare telecare@csip.org.uk Telecare LIN

3. CSIP Networks does not endorse suppliers/products Records Cholesterol monitor • NHS • Social Care • Housing • Personal Health Record Telehealth Blood-pressure cuff Care professionals Glucose meter Telecare LIN Telecare Out of hours services NHS Direct Medication tracking Sensor networks Service Hub Home Hub Appliance Mobile response Home automation Care response service Lights Doors / Windows Motion / Activity Bed Kitchen Bathroom Friends, carers and family Emergency services

4. Telecare and Telehealth Agenda • ‘Building Telecare in England’ and Preventative Technology Grant (£80m) • White Paper - ‘Our health, our care, our say’ – Whole System Demonstrators • Putting People First Concordat (December 2007) • Prime Minister’s Statement on the NHS (January 2008) • Transforming Social Care – LAC (2008)1 (January 2008) • Darzi and SHA Reviews (July 2008) – references to technology • 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, focus on outcomes • Better procurement, performance management and value for money • Telecare and telehealth as mainstream service options • User choice, independence and consultation through direct payments, personal budgets, self care and self assessment, preventative services, extra care, Supporting People, integrated care and health IB pilots • Standards – interoperability, connectivity, electronic health records • Workforce design, education and training Telecare LIN

5. 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…… 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….. 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…… Telecare LIN 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

6. “….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 Telecare LIN www.networks.csip.org.uk/telecareoutcomes

7. “…. Health Secretary Alan Johnson today launched an intense six month debate about the future shape of care and support services. A rapidly ageing population means that in 20 years' time a quarter of the entire adult population will be over 65 and the number of people over 85 will have doubled. The growth in the number of people with care and support needs will put tremendous pressure both on services and on the financial support that they receive through benefits and other funding streams. …. Today we are rolling out a £31million programme to test the potential of innovative technologies like telecare in supporting care for those with complex health and social care needs. Improving care with new scientific advances and innovation is vital if the NHS is to continue to offer the very best services, but this innovation must be at the frontline of the NHS to help people manage their conditions better themselves.” Alan Johnson, Health Secretary, May 2008 Telecare LIN www.networks.csip.org.uk/telecareoutcomes

8. Cornwall, Kent, Newham • Evidence of Progress • Over 300 telecare sites and over 50 small scale telehealth sites in England • Extensive use of telecare in extra care and housing schemes • Estimated 1.4m users in 2005 (‘Building Telecare in England’) • Survey of 150 social care authorities – 160,000+ additional users since 2006, information about outcomes and mainstreaming, events and evaluations • Better understanding of the best care pathways and the importance of preventative as well as reactive approaches • 3 Major demonstrator sites and a further 12 in the Whole System Demonstrator action network • Launch of evidence web site • Over 2500 items on the NHS PASA framework • Assisted Living Innovation Platform launched • References in key policy documents across health, housing and social care • Academic reports, evaluations, journal references • Major conferences featuring telecare and telehealth • Wider initiatives on interoperability, standards, consumer products • Major global companies, expansion in Europe, North America, Far East etc Croydon Leeds Birmingham East Riding Barnsley Norfolk Southampton Lincolnshire Telecare LIN Nottingham Lancashire Leicester Hull www.wsdactionnetwork.org.uk

9. Potential challenges and barriers to implementation • Human contact and technology – getting the balance right • Usability, ethical and consent issues • Savings may accrue in health from a social care or housing investment • Local authorities, health trusts and their partners fail to plan for the longer term and do not shift activity out of acute care • Poor engagement with users, carers, GPs, third sector and other key stakeholders • Control centres, warden services and floating support • Inconclusive benefits for investments made • Service costs, charging, business case • Fragmented services and poor uptake, potential for inefficiencies, problems with referrals • Insufficient focus on outcomes • Product and service innovation – design improvements required in some areas • Questions about the evidence base • 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 • Some devices may need to be replaced with changes to the telephone system Telecare LIN www.networks.csip.org.uk/telecareservices

10. Performance and support HEALTH Telecare LIN Third sector and others Social Care Housing

11. Still a challenge - In your area, how many people…… Telecare Commissioning - Agenda Have dementia? Fell at home in the last week? Telecare LIN 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 A&E regularly? Could be in a care home in the next year? Could benefit from preventative support? Could benefit from integrated telecare/telehealth services?

12. What services are saying… Haringey “Our partnerships use technology to improve levels of independence. Feedback from service users, carers & professionals highlighted the impact on quality of life, reducing anxiety & enabling people to manage risk & live with more dignity. This linked to LAA targets to increase number of vulnerable people supported at home”. Hounslow “Discussions with some of the borough’s LD providers have resulted in improvements being made to a supported living environment - change from waking to sleeping night staff. This prevents the need for staff to regularly check visually that clients are safe and well – thus affording greater privacy and dignity. These providers have committed to assess for Telecare options for all new referrals to their service”. Rutland “Where life-line systems have been put into place it has been reported that this has enabled people to regain a greater level of independence. A local housing provider has installed a telecare systems in all of it's 85 flats. This has led to some significant benefits to tenants. For example hand held electronic portable door opening devices have increased independence and dignity”. Sunderland “In a local survey of customers, around one quarter of respondents had used service over last year. Overall, 89% of customers rated service as at least good, with 97% at least satisfied with the response times of the mobile teams that were called out. All individuals reported that all staff in the service respected their privacy/dignity, and found the mobile response teams both helpful & friendly. Some 81% stating they felt Telecare helped them remain at home”. Suffolk “The locator device is a small, pocket sized GPS based piece of equipment carried by the individual. It allows the individual to press a button that sends an SOS signal to the schemes call system if they need help. It enables the staff to locate the individual in the event of an emergency. The equipment has enabled these individuals to continue to go out and about to shop and be part of the community and has contributed to their care plan by enhancing their choice, independence, dignity and safety”. Telecare LIN

13. Telecare LIN www.networks.csip.org.uk/telecare telecare@csip.org.uk www.wsdactionnetwork.org.uk wsdnetwork@kingsfund.org.uk

14. Thank you for listening CSIP would like to thank local authorities and their partners mentioned in this presentation Housing & Telecare Learning Improvement Networks Putting People First Department of Health Wellington House 135-155 Waterloo Road London SE1 8UG e-mail: telecare@csip.org.uk Website: www.networks.csip.org.uk/telecare Telecare LIN