Telecare in Portsmouth Telecare Knowledge Network University of Portsmouth 9 th February 2007

Putting People First Portsmouth City Council 2 National Policy Drivers for Telecare Telecare will contribute to a number of important agendas: The White Paper ‘Our health, our care, our say’ National Service Frameworks – older people (falls), LTC self care, intermediate care and extra care preventing unnecessary admissions to hospital and residential care supporting earlier discharges from hospital, community rehab Valuing People Supporting People Support for carers Preventative Technology Grant

Putting People First Portsmouth City Council 3 Preventative Technology Grant Portsmouth’s allocated grant is £106,684 for 2006/07, and £177,099 for 2007/08 Grant effectively ring-fenced Paid into budget of telecare lead, Strategic Partnerships & Well-being Manager, in Health Improvement & Development Service (post holder retired Dec 06 – awaiting replacement) Under-spend to be carried forward into next financial year Objectives:- set up robust infrastructure - test the infrastructure through series of pilot schemes

Putting People First Portsmouth City Council 4 Telecare’s contribution to Portsmouth’s community strategy Health & Social Well-being Vision: ‘A Portsmouth that celebrates individual confidence and good health’ Protecting older people from dangers in their own homes Supporting older people and those with disabilities to continue living at home

Putting People First Portsmouth City Council 5 LOGISTIC & INFORMATION PATHWAY OF A TELECARE SERVICE Entry (Re) Assessment of Need (SAP) Care Package Development Home survey Telecare Prescription and a Response Protocol Equipment Provision Installation and Maintenance Monitoring Call Handling Community Response Review

Putting People First Portsmouth City Council 6 Awareness raising Addressing the need for comprehensive awareness of the potential use of preventative technology in supporting vulnerable people to live independent lives Senior managers, commissioners, practitioners Front line staff in all partner agencies, and in community and voluntary agencies Potential users and their carers General public

Putting People First Portsmouth City Council 7 Training programmes Developing induction and training programmes for practitioners: - assessing for telecare as part of community care assessment - options to improve independence - knowledge of equipment & how to access it - tailored solutions to manage or reduce risk Working with Learning and Development Departments in PCC & PCT, and suppliers

Putting People First Portsmouth City Council 8 Partnership with Community Alarm Service Telecare being built on platform of existing Community Alarm Service Community Alarm Manager on Telecare Steering Group Alarm Contract re-tendered in Spring 06, to ensure supplier had equipment/capacity to support development of telecare. Awarded to Initial Attendo Close liaison with Community Alarm Manager to ensure her staff are trained in the new technology, to provide a streamlined environmental assessment, ordering, fitting and maintenance service

Putting People First Portsmouth City Council 9 Partnership with Alarm Monitoring Service Control centre is in Southampton Existing excellent working relationship between Portsmouth and Southampton By working together we achieve cost-effectiveness/ economy of scale Watching brief on changing work load

Putting People First Portsmouth City Council 10 Demonstration/training facility Plans to develop ‘SmartHouse’ - working with Community Housing to identify suitable, accessible property Display of safety and security equipment, telecare, teleheath and environmental control systems Live link to control centre Future development as lifestyle centre, show-case for future-proofing of domestic environment Demonstration/assessment centre for users, carers Training facility for staff Dispel myths about technology Market the service to the public Attract sponsorship from commercial partners Information point for Self Assessment users, sales point for Direct Payment users and private customers

Putting People First Portsmouth City Council 11 Portsmouth’s pilot: Falls Falls management scheme for 20 users Supporting people who have fallen or who fear falling Members of Mountbatten Centre ‘Strength and Mobility Group’ (Physio-prescribed, evidence-based, 20-week exercise programme) Already demonstrated motivation to participate in managing their health and well-being Anticipated outcomes of telecare provision - improved confidence, maintenance of ‘fitness gain’ once group finished, reduction in falls, improved quality of life

Putting People First Portsmouth City Council 12 Falls response service Previous offer from Home Care, to provide staff for falls response service, now withdrawn New proposal from Ambulance service to develop First Responders to provide falls pick up – managed/despatched by Ambulance, compatible documentation, falls pathway (GP, SPA) Data from Ambulance indicated that the number of responders to cover 24/7 for falls pilot would be sufficient to provide city–wide service for uninjured, non-conveyed fallers (2-3 per day) Need for joint commissioned mainstream falls response service with financial support from all stakeholders Discussions on-going with health, social care & ambulance

Putting People First Portsmouth City Council 13 Portsmouth’s pilot: Medication Grass root suggestion to meet identified need 20 users with early stage dementia History of problems safely managing medication Programmed carousel provides prompt to take medication If not taken, Control Centre alerted Response protocol activated Responders likely to be family and professionals (Home Carers & CPNs) already involved in ensuring medication is taken, and crises due to non-compliance with medication One meeting of planning group

Putting People First Portsmouth City Council 14 Information collection and flows Electronic social care and health record systems, but they do not talk to each other Single Assessment Process not in general use Information needs to be passed manually Identifying existing data-sharing systems Identifying what else needs to be included to ensure info is passed around the telecare pathway Developing Telecare referral form

Putting People First Portsmouth City Council 15 Data capture Developing Telecare Referral Form, to enable data for evaluation to be recorded simultaneously with provision and review:- identifying the risks recommending equipment to meet the need location of sensors response required to each sensor alert feedback mechanism to ensure event record is passed onto referrer for any necessary action qualitative evaluation based on user/carer views, before and after installation quantitative information to identify likely outcome if telecare were not provided probable reduction in resource impact if telecare is provided

Putting People First Portsmouth City Council 16 Identifying priority areas for mainstreaming Identify other areas where take up of telecare would provide most positive impact to inform plans for mainstreaming:- Staff asked to consider whether telecare, if it were available, could contribute to management of risks identified in their community care assessments Note it as unmet need and pass info to manager and to Telecare Co-ordinator Regular presentations and consultations with users and carers, via carers’ groups, Prevention & Well- Being Network meetings, Portsmouth Disability Forum

Putting People First Portsmouth City Council 17 Charging policy Charging policy not yet agreed Health Improvement & Development Service grew out of Prevention Team Strong commitment to preventative interventions to avoid crises arising In favour of outcome objectives (e.g. supporting falls management, supporting carer, enabling early discharge from hospital) rather than eligibility criteria Will support users to maximise their income/ benefits/ grants to enable funding of telecare

Putting People First Portsmouth City Council 18 Sustainable funding Beginning to identify sustainable funding sources to support transition to mainstream community service Raising profile by ensuring telecare is included in jointly agreed service development plans and Local Area Agreements Trying to identify political champion, councillor, who is prepared to support future bids for funding once PTG expired Beginning to build business case on cost/benefit evidence from other telecare services

Putting People First Portsmouth City Council 19 Evaluation By the Centre for Healthcare Modelling and Informatics, University of Portsmouth Qualitative and quantitative evaluation Collect data on costs and benefits, demonstrate sustainability and cost-effectiveness Investigate contribution of technology to quality of life Inform further development

Putting People First Portsmouth City Council 20 Key points Consult/involve potential users in the development of the service Telecare = 20% technology, 80% people Integrate telecare into existing health and community care Build on what you’ve got Keep flexible in implementing telecare User centred and contextual assessment is the key to appropriate provision Response protocols need to be tailored to individual Events record needs to feed back into health/social care plan Capture data - evidence for re-configuring services

Putting People First Portsmouth City Council 21 Contacts Rosanne Brown Telecare Co-ordinator Health Improvement and Development Service Portsmouth City Council Floor 1, Core 1, Civic Offices Guildhall Square, Portsmouth, PO1 2 EP Tel: Fax: Dr. R. G. Curry Senior Research Fellow Centre for Healthcare Modelling and Informatics University of Portsmouth Tel: