Portsmouth Telecare Initiative Health Improvement and Development Service Portsmouth City Council

What Is Telecare? Technology that enables the continuous, automatic and remote monitoring of real time emergencies, as well as lifestyle changes over time, in order to manage risks associated with independent living Using a combination of sensors and information and communication technologies, telecare supports the delivery of health and social care services to people in their own homes

How Does It Work? Sensors worn by user or placed in the environment around the user Wireless sensors placed around home Link to control centre via Home Hub (Community Alarm) and phone line Sensors can monitor: - the person - falls, inactivity, wandering, epilepsy, night-time incontinence - the environment - extreme heat or cold, gas, flood, smoke

How does it Work? Client activated calls for assistance Automatically activated calls for assistance. Passive system, doesn’t need the user to initiate the alarm call Automatically reported activity level monitoring. Preventative as well as reactive

Benefits Increases choice and independence for users Reduces strain on carers Contributes to care and support for people with Long Term Conditions Reduces accidents and falls in the home Reduces acute hospital admissions Reduces the need for residential care Supports hospital discharge & community rehab Enables those who wish to die at home to do so with dignity Unlock resources, re-direct elsewhere in the system

Telecare will contribute to a number of important agendas: National Service Framework For Older people, DoH, 2001 The White Paper ‘Our health, our care, our say’ DoH, 2006 A ‘Recipe for Care’ Prof Ian Philp, National Director for Older People, 2007 ‘Putting People First’ A shared vision and commitment to the transformation of adult social care. Chief Executive NHS, Secretary of State for Health, Secretary of State for Work and Pensions, National Care Association et al. 2008

Vision An integrated service across health, housing and social services that supports people to stay in the community longer or return more quickly after hospital stays.

Funding The project was initiated through the Preventative Technologies Grant (PTG) from the Department of Health (DoH) which was “to bring about a change in the way that services are delivered to support people living in the community”, The grant was for £80million over two years. Portsmouth’s allocated grant was £283,783

Approach Started with pilots and was therefore developed from a solid base. Two pilot schemes were implemented: Falls Pilot – Falls detection monitors supplied to participants identified as ‘at risk of falling’ Medication Pilot – Medication Carousel to prompt / remind early dementia patients to take medication

Portsmouth’s Smart House ‘ SmartHouse’ - working with Community Housing to convert suitable, accessible property Display of safety and security equipment, telecare, teleheath and environmental control systems Live link to control centre Demonstration/assessment centre for users, carers Training facility for staff Dispel myths about technology Market the service to the public

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Telecare service integration Source: Barlow & Curry 2006 Social services Primary care Housing services Equipment suppliers Telecare service providers Acute care Social Housing landlords

Fall detector Bed exit monitor Chair exit monitor Medication reminder/dispenser Wandering person alert Night time incontinence alert Epilepsy alert Low temperature Activity/Inactivity Intruder alarm Bogus caller Natural gas Carbon monoxide Flood detector Smoke Extreme heat After assessment, the most appropriate sensors are provided for each situation. There are many sensors available, e.g.

Response Call Centre currently in Southampton. Staffed 24 / 7 Record call and contact most appropriate response service New First Line Response Service developed in Portsmouth

Entry (Re) assessment of need Care package development Home survey Telecare prescription & response protocol Equipment provision Installation and maintenance Monitoring Call handling Response Review Telecare service integration Source: Barlow & Curry 2006 Social services Primary care Housing services Equipment suppliers Telecare service providers Acute care Social Housing landlords

Review Process Questionnaire / interviews conducted with ≈ 36 subjects All have had telecare items for 6 months +

Review Questions Questions aimed to identify the following:  Fitness for Purpose Portability Comfort Timeliness Utility Responsiveness  Trustworthiness Reliability Safety Maintainability  Acceptability Usability Learnability Compatibility

Review Aims Does the provision of telecare need to be re-evaluated? Evaluation Tool-Kit for Social Services Systematic method for continuing evaluation Justification of telecare

People not Gadgets The technical aspects of telecare are relatively straightforward, it is the service integration which requires a high level of co-ordination to achieve success.

What Else Is There? New Technology Is Being Developed Rapidly: Lifestyle monitoring (e.g. activity, bathroom use, use of kettle and fridge) builds up picture of user’s normal behaviour patterns, available to carer/family or professional. Unusual behaviour triggers alerts that enable early intervention Long Term Condition monitoring (e.g. in heart and lung conditions, diabetes, asthma) enables user to check own heart, blood pressure, breathing, weight, blood sugar levels, blood oxygen saturation. Results go to Community Matron or GP. Advice and help can be provided by phone around the clock Results in increased confidence in managing condition at home Can enable timely medical intervention to avoid a crisis arising Reduced emergency admissions to hospital