Source: Social Care Institute for Excellence (SCIE)
Putting people first (HM Government, 2007) proposed that all social care users should have access to a personal budget, with the intention that they can use it to exercise choice and control to meet their agreed social care outcomes.
Over 15,000 adults in England were receiving a personal budget or direct payment (6.5 per cent of all adults using services)
The government expect all 152 councils in England to have made significant steps towards transforming their adult social care services, including having at least 30 per cent of eligible adults on a personal budget, by 2011
Revision to the Operating Framework for the NHS in England 2010/11 Re-ablement and post-discharge support: intention to ensure that hospitals are responsible for patients for the 30 days after discharge. If a patient is readmitted within that time, the hospital will not receive any further payment for the additional treatment. Such an approach creates real opportunities for acute providers to work with GPs and Local Authorities and would require the full engagement of the wider health and care economy before discharging patients. It should encourage the use of services such as community health services; social care; home adaptations (including telecare), and extra-care housing. These services should contribute to improved patient outcomes and significantly reduce the risk of emergency re-admission into hospital
Telecare is a term used to describe technologies and services used to monitor the safety of an individual remotely. Telecare is typically applied in cases were an older person is living alone and vulnerable to falls or is showing signs of dementia. Telecare devices are usually connected to a central hub which is in turn connected by the phone line to a call centre. A wide range of devices can be connected to a Telecare hub including flood detectors, smoke alarms, fall detectors and panic buttons.
Telecare systems usually consists of a hub connected to a range of devices. Including: -Smoke alarms -Carbon Monoxide -Fall detectors -Enuresis detectors -Panic buttons -Flood detectors -Occupancy monitors -Wandering alarms Stand alone Telecare includes -Medication reminders -Memory prompters Response service linked to monitored alarm call centres via phone line or internet connection. Devices are not linked to a service, instead they provide audible and visual prompts to the user.
Telehealth is a term used to describe technologies and services which monitor the health of an individual remotely. This is typically applied to individuals with Long Term Conditions (LTC’s) such as coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD). These individuals require monitoring to ensure their condition remains stable; this can include technologies which take regular physiological readings such as blood pressure and blood oxygen levels. Monitoring of these physiological readings is typically done remotely by a clinician who can intervene to avoid the condition becoming acute.
A central Telehealth system usually consists of a hub connected to a range of devices. Including: -BP monitor (Blood pressure) -ECG (Heart rate) -Sp O2 (Blood Oxygen) -Scales (Body weight) -Spirometry (lung function) Results are sent over the internet or mobile network to a central web server. Data and alerts can then be viewed by clinical support staff.
This is a broad category covering environmental control and communication aids. These technologies are increasingly being integrated into Telecare packages. Devices in this category help the user to control their home environment and communicate
Stand alone Environmental Control Home Automation Communication devices
Technology is developing at significant pace with many developments are centring on advances in the mobile phone. GPS tracking devices are now being used to locate people who are at risk of wandering. These systems use mobile phone and satellite navigation technology to create “Geo Fences”. When the wearer steps out of the virtual boundary an alert is sent to a response centre.
Medication compliance systems are also advancing. Using Near Field Communication (NFC) mobile phone technology and smart packaging it is possible to track when a user has taken a tablet. The same technology can be used to re order prescriptions when the medication has run out.
Proof of presence systems for care workers are also developing around NFC mobile phone technology. NFC tags located in the service users home can be tagged by the carer on entry and exit, logging the time the carer was in the home.
Miniaturisation of sensors are helping to create wearable Telehealth systems. This disposable sensor sits within a sticking plaster and can be worn all day discreetly.