Help people to help themselves; a key component of Making It Real An outcomes focus across integrated services is essential- technology is an enabler for thisIntegrating technology into an initial service offering (i.e. a default component of assessment and support planning) is essentialTechnology is broader than telecare and can range from shoe horns to complex toolsIn order to sustain investment in preventative services both qualitative (human experience) and quantitative (cash savings and cost avoidance) is required.Technology is an enabler of choice and control but must be as a response to individual need and not define those needs.
Heard about it at a carers group – went to argos and purchased one off the shelf and now getting on with her life.
Adass Spring Seminar Taming Technology slides 17.4.13 v2
ADASS Spring SeminarTaming Technology for Personal Benefit18.4.13
Making Prevention RealLowHighPoint of Change inCircumstancesIncreasing dependence onservicesDependenceAge
Making Prevention RealLowHighPoint of Change inCircumstancesLevel of independencemaintainedIncreasing dependence onservicesDependenceNeed for moreintensivesupport / careAge
Making Prevention RealLowHighLevel of independencemaintainedDependenceAge
Mary missed her cups of tea• Her arthritis made it hard to lift her kettle• She struggled to prepare hot drinks• She cancelled her weekly tea party• She missed her friends visiting• She became dehydrated• She was regularly admitted to hospitalUntil her new kettle arrived– It cost £55– She remains independent– She has not been admitted to hospital since– She demonstrates it to her friends when theymeet at her tea party each week
West Midlands Regional InitiativesAutomated Pill Dispenser Project :The right pills at the right time delivering the right outcomesSaving social care and the NHS 431k.The two largest areas of savings are from reductions in medication promptingvisits at the patient’s home and reduced hospital re-admissions for those onthe pill dispenser.
The two largest areas of savings are from reductions in medication promptingwere visits at the patient’s home and reduced hospital re-admissions forthose on the pill dispenser.Home visits amounted to £107k ie 52% of total social care savings, andhospital admissions amounted to £151k and ie 68% of total health saving
West Midlands Regional InitiativesLearning Disabilities & Technology Sandwell & Wolverhampton: Challengingtraditional methods of intensive support using complimentary packages oftechnology and support• In Sandwell 70 service users with high cost packages were re-assessed. In 31casers, less support hours were provided as technology replaced the need fora physical presence being required• Encouraged positive risk taking and promoted the independence of serviceusers and greater choice and control• Actual budget savings in 2012/13 = £465,460• Supporting People Budget 65% and Pooled LD Budget 35%• All levels of technology provided, including standalone AT, Telecare andVirtual Visiting systems• Similar levels of savings made in Wolverhampton
Technology for Whole Life ServicesProvision for Children’s ServicesIn Schools for teaching gifted childrenAllowing 1st line nurse triage in schoolsSupporting Foster Parents & Looked After ChildrenAssessments / Reviews / Regular Contact / SafeguardingSupporting Younger PeopleTechnology to support daily lifestylesRemote peer support at work for young people who require itContinued Support Through LifeProvision of technology throughout a person’s lifeEnabling greater independencePositive risk takingServices delivered in the community
Telehealthcare – bringing care homeMaking it happenWhat have we learned??
Contents• Examples of making it happen– Scale, speed and certainty• Some lessons learned
Examples of large scaletelehealthcare deliveryScale,Speed,Certainty…
North YorkshireLong term commitment to TelecareBackground• Started in 2006 with the PTG funding• Monitored performance and identified £1.1m net saving over 12 months for 330 cases• Partnership approach with local service providers• Full programme of Telecare awareness training for front line teams and partners• Subsequently added reablement services, with Telecare embedded17Source:-NASCIS data NYCCComparatorGroup % England %2009-10 519 655 79% 710 73%2010-11 496 637 78% 687 72%2011-12 490 658 74% 696 70%
First of its kind City-widetelecare service27,000 people over 3 years to benefitBackground• Birmingham is most ethnically diverse city in UK, with population in 2011 of 1.073 million• 65+ population will increase around 23% to reach 168,000 inhabitants, by 2030• Birmingham is ranked the 9th most deprived Local Authority in England• The prevalence of diabetes is estimated to be 9.1%, (Eng prevalence 7.6%)• Birmingham has higher rates of hospital admissions (5.2%) due to falls than Eng (3.3%)Telehealthcare service – key successes• Investment of £14 million over three years making it the largest, city-wide telecare service in UK• Launched on 1 February 2012 by former Health Minister Paul Burstow MP and is benefitting 7000 people• It has created new jobs and is locally based, locally developed and locally resourced.Outcomes• Significant savings, in excess of £900,000 to date• Reduced waiting times for social care• Reduced ambulance call outsTunstall is responsible for providing a „whole service‟ for CitizensANALYSIS REFERRAL ASSESSMENT INSTALLATIONMONITORINGRESPONSEMAINTENANCEREPORTINGhttp://www.guardian.co.uk/government-computing-network/2012/feb/02/telecare-birmingham-city-councilhttp://bhwbb.net/?wpfb_dl=308“Telecare has given memuch more confidenceand peace of mind. I cansleep easy now, knowingsomeone is there to help”Louis
Blackburn with DarwenIntegrated telehealthcare programmeBackground• ranked the 17th most deprived LA in England (out of 354)• 85+ to increase by 30% by 2025 to 1,600• 1,100 patients with 4+ emergency admissions pa• Adult social care had to find efficiencies of £6.6m (15%) during 11/12Integrated working• Joint funding integrated telehealthcare programme (BwD Council – telecare, NHS BwDTeaching Care Trust Plus – telehealth)• Joint infrastructure cost is shared equally• Demand managed programme with acute sectorOutcome highlights• Total net savings achieved for telecare and reablement £2.2m in 11/12 (£1.4m fromtelecare and reablement, £800k from telecare alone)• Residential care admissions reduced by 18% in 11/12• Telecare users have risen from 60 to 1000 in 18 months19
London Borough of HillingdonBackground• The overall strategy is to reduce the reliance on long term residential/nursing placementsenabling people to remain living in their own homes rather than be placed in institutionalcare• 1,120 TeleCareLine installations (target 750 for 2011/12)Outcomes• Cost savings – £4.7m saved in first year– Second year figures available very soon, but savings trajectory has been maintained• Prevention – residential and nursing home placements halved– Reduction in long-term residential and nursing care placements from 8.08 per week in 2010 to 3.57per week to end Feb 2012• Accessibility – telecare free to everyone over 85• Reablement – highest number of referrals come from hospital discharge teams, after selfreferrals– Reablement with telecare has led to steady reduction in homecare hours purchased of 10% fromApril 2011 to date, forecast continued year-on-year reduction of 7.8%20
What have we learned??“Whole service” model requiredCommit to scaleSpread out from Social Care
“Whole Service” Delivery Modelthe enabler to scale22