Building Telecare in England – the Preventative Technology Grant Mike Clark Care Services Improvement Partnership (CSIP)

Building Telecare in England People are living longer but less likely to have family support Over next fifty years, over 65s will rise from 9.3 million to 16.8 million 6 million people are carers Number of people requiring community based health and social care support is expected to increase considerably over next decade People will have higher expectations, want greater control and be able to manage their own risks People want independence and dignity

Telecare is vital 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 user choices Not realistic to plan to deliver care and support services in the way we do at present New ways of working to meet needs and aspirations of service users and to take advantage of new and developing technologies

Telecare is vital to unlocking the future Choice and flexibility of service provision – from community alarms and sensors to vital signs monitoring Potential of telecare is gaining in recognition eg Health Select Committee which recommended stronger links between health and social services to roll out these technologies 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 could be supported in their own homes/extra care housing with telecare Over 1.6m emergency admissions were made in 2003/4 – telecare has potential to reduce unnecessary admissions and improve quality of life

Balance - the importance of human contact Balance between use of technology and continuation of human contact Must take care not to allow the technologies to control or isolate people Some care services will always be delivered personally Human contact is vital to maintaining quality of life Technologies will complement traditional forms of care

About the Preventative Technology Grant Announced in July 2004 Aims to increase the number of people who can benefit from telecare services £80m in grant finance over two years from April 2006 Designed to help local authorities and partners address challenges of a changing and ageing society – increased expectations, choice, control, independence and dignity Co-ordinated approach to create best possible atmosphere for industry to flourish

PT Grant – expected outcomes (1) 160,000 increase in numbers of older people benefiting Reduce need for residential/nursing care Unlock resources and redirect them elsewhere Increase choice and independence for service users Reduce burden on carers – more personal freedom Contribute to care and support for people with long term health conditions

PT Grant – expected outcomes (2) Reduce acute hospital admissions Reduce accidents and falls in the home Support hospital discharge/intermediate care Contribute to the development of a range of preventative services Help those who wish to die at home to do so with dignity Increased user re-assurance, less risk- averse policies, responsive to lifestyles Contribute to wider health, housing and social care policy agenda

PT Grant allocation Allocated to local authorities in England with Social Services responsibilities £30m in 2006/7 and £50m in 2007/8 Not ring-fenced, based on formula Joint circular to provide formal grant determination in early 2006 LAs expected to work with partners in housing, health, voluntary and independent sectors and service users and carers LAs/partners may wish to consider pooled fund/joint commissioning (S31 HA 1999)

Current telecare provision Around 1.4m are thought to have a community alarm service The alarm service infrastructure is capable of extending provision to millions more In some parts of the country telecare is becoming a mainstream option Some local integrated community equipment services (ICES) provide equipment and adaptations including telecare

Using the grant effectively Grant should be used to increase numbers of people who are supported to remain independent with telecare Most beneficiaries will be older people (but could be used to support people of all ages including children) Recent reports eg Audit Commission, highlight role telecare can play in delivering responsive, modernised, person-centred services for older people LA’s with partners to decide how best to use the grant to incorporate telecare into mainstream health, housing and social care services

Infrastructure for telecare Grant intended to pump-prime infrastructure in place to deliver: Staff training and development Supply and management of equipment Supply of relevant 24-hour/seven day care contact services Supply of 24-hour/seven day care response services

Partnerships Telecare should be an integrated health, housing and social care service. Key partners include: Housing providers Health (incl PCTs, ambulance service, out-of- hours, GPs and where appropriate hospital and foundation trusts) Police and fire services Equipment suppliers Independent and voluntary sector Service users/carers

Commissioning and Planning Develop a local telecare strategy incl governance, assessments, response services etc Link to other strategies, frameworks, priorities, integration approaches, care pathways Consider existing infrastructure of community alarms that can act as a platform for telecare services Strategies and polices should support user choice including self-care Smaller authorities may wish to work with neighbours for planning and commissioning services Training and workforce issues are very important

The wider policy context NHS Improvement Plan White Paper Green Paper on Social Care NSFs White Paper, Valuing People Social Care Long Term Conditions Model Expert Patient and Self Care Programmes Carers (Equal Opportunities) Act 2004 Choosing Health Delivery Plan Delivering the 21 st Century IT Support for the NHS Supporting People Quality and Choice for Older People’s Housing Improving the Life Chances of Disabled People Opportunity Age

Contribution to key targets National Standards, Local Action – Health and Social Care – Standards and Planning Framework 2005/6 to 2007/8 –Priority II – supporting people with long term conditions (reduction in emergency bed days) –Priority IV – Increasing proportion of older people being supported to live in own home and increasing proportion of intensives Minimal levels of delayed transfers of care Increase in patient choice within primary care and for people with long term conditions Reduce unnecessary hospital admissions linked to Payment by Results and the national tariff

6 months Project Mgr Ethics Pilot(s) Charging FACS, SAP Protocols Commence Review Awareness, training Funding>Procurement Suppliers Contracts/SLAs Implementation of telecare – too long

Sept 2005April 2006Sept 2006 Telecare Champions Ethics FACS, SAP, fairer charging Protocols Commence Review Awareness, training Funding and 2005/6 Plans Evidence-base, suppliers, procurement Contracts/SLAs Implementation of telecare – reducing the timeline using the Guide and Factsheets Dec 2005 Partnership working

PT Grant – implementation support Building Telecare in England, DH (July 2005) ublicationsPolicyAndGuidance/PublicationsPolicyAndGuidanc eArticle/fs/en?CONTENT_ID= &chk=AZNQjz CSIP Telecare implementation guide and factsheets CSIP CD ROM - ‘Telecare – living with independence’ available from CSIP Housing Learning and Improvement Network at: CSIP information: