Transforming Community
Equipment Services
Health & Wellbeing Board
26th October 2011
The purpose of this presentation is to:
 Understand the background to TCES and explain the
retail model
 What has been achieved
 What we plan to do and challenges to overcome
 Answer any of your questions
What is TCES?
A collaborative model for equipment service
delivery that puts users and carers at the heart of
the service, leveraging the strengths of the third
and private sectors
The model had to support central government policy and the nationwide Personalisation
agenda (2007) aimed at:
–
Early Intervention and Prevention: Creates a growing, accessible marketplace for community
equipment empowering individuals to self help
–
Choice & Control: Gives power and control to individuals to shape the services they need
–
Social Capital: Facilitates the development and sustainability of a vibrant and innovative third
sector
–
Universal services: To meet the needs of the whole population not just those supported by the
state
Total Increase of 33%
65 – 74 up by 32%
75 – 84 up by 28%
Hillingdon Demographics
Older People 2009 - 2029
85+ up by 48%
65-74
75-84
85+
2029
2024
2019
2014
2009
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
45.0
Increase in ‘000’s
The key drivers for a new model include:
Changing Central Government policy
Increased demand on services due to an increasing older and disabled population
Budgetary constraints
What is “Community Equipment”?
 Community Equipment is the term used to describe
products that help disabled, vulnerable and older
people live as independently as possible in their
own homes
 They have been separated into ‘Simple Aids to
Daily Living’ (£0 - £100) or ‘Complex Aids to Daily
Living’ (£100+)
 Equipment is currently loaned by the council or the
NHS through a contract that exists with Medequip.
Prescribers (e.g. an OT) orders the equipment from
a central store. Medequip deliver and collect all
community equipment in Hillingdon
The retail model recommends a separate
solution for simple and complex equipment
The Retail Model means Simple Aids
for Daily Living will be provided
through the retail marketplace
 Users will receive a prescription
enabling them to obtain products
free of charge
 Users have the option to ‘top up’
should they prefer a product that
better suits their lifestyle, within
the same functional range, and
pay the difference
In the future users will receive a prescription
that they can redeem at a retailer of their
choice
Needs
Assessment
Users will
continue to have
their needs
assessed as
currently
2
1
Prescription
Redemption
at Accredited
Retailer
Users who are
entitled to
equipment will
be issued with a
prescription
Retailers will
exchange the
prescription for
simple aids to
daily living
3
Reimbursement
by the State
Retailers will be
reimbursed for
redeeming
prescriptions
4
15
The prescription model is supported by a
National Catalogue and Tariff
 The National Catalogue covers all equipment any Local Authority
or NHS Trust is likely to prescribe
 It has been decided locally which products will be prescribed
from the National Catalogue
 The products have generic product specifications which retailers
then source
 Retailers choose which products to stock, where to source
products, and what products to physically display
 A national tariff has been set across England for each product in
the national catalogue
–
This is the value retailers will receive in payment for the items issued on
prescriptions
Retail Model in London – September 2011
Enfield
Barnet
Waltham
Forest
Harrow
Haringey
Redbridge
Havering
Hackney
Brent
Camden
Islington
Newham
Ealing
Hillingdon
H&F
Tower
Hamlets
City
Westminster
Barking &
Dagenham
Southwark
RBKC
Greenwich
Hounslow
Bexley
Wandsworth
Lambeth
Lewisham
Richmond
Merton
Kingston
Bromley
Sutton
Live Prescribing Boroughs x 17
Croydon
Undertaking model launch TBC x 12
Other x 4
To 30Sept 2011
15,500+ prescriptions
issued with over
240 accredited retailers
•20 - 25 local retailers; pharmacies and 3rd
sector partners are being accredited
•All retailers are being trained prior to
accreditation to ensure correct advice/
support and have to offer delivery and
installation if requested
•Neighbouring Ealing has processed over 1000
prescriptions in 6 months
National Accreditation Standards
Physical
Physical Criteria:
Criteria:
Competency
Competency Criteria:
Criteria:
1.
1. Fulfilment
Fulfilment of
of prescriptions
prescriptions face
face to
to face
face at
at aa
physical
physical retail
retail premises
premises (i.e.
(i.e. not
not internet
internet
shopping
or
mail
order)
shopping or mail order)
2.
2. Ability
Ability to
to display
display and
and demonstrate
demonstrate
equipment
in
a
form
convenient
equipment in a form convenient to
to the
the
business
business
3.
3. Premises
Premises open
open at
at normal
normal retail
retail hours
hours
including
weekend
opening
to
suit
including weekend opening to suit the
the
individual
business
requirements
individual business requirements
4.
4. Ability
Ability to
to offer
offer qualified
qualified home
home delivery,
delivery, and
and
fit
as
a
chargeable
service
(optional)
fit as a chargeable service (optional)
5.
The
5. The existence
existence of
of customer-facing
customer-facing staff,
staff,
trained
to
a
minimum
level
of
competence,
trained to a minimum level of competence,
who
who are
are capable
capable of:
of:
–– Communicating
Communicating effectively
effectively with
with Users
Users
–– Offering
advice
on
suitability
of
Offering advice on suitability of
products
products to
to the
the User
User
–– Supporting
decision
Supporting decision making
making
Customer facing staff will need to
demonstrate competency in Assistive
Technology gained from one of the
following:
1.
1. At
At least
least 33 years
years experience
experience in
in the
the disability
disability //
mobility
mobility // health
health retail
retail sector,
sector, with
with proof
proof that
that
they
have
received
equipment
specific
they have received equipment specific
training
training
2.
2. 66 months
months in
in the
the disability
disability // mobility
mobility // health
health
retail
sector
plus
professional
training
retail sector plus professional training (i.e.
(i.e.
Occupational
Therapist,
Physiotherapist,
Occupational Therapist, Physiotherapist,
Doctor,
Doctor, Pharmacist,
Pharmacist, Community
Community Nurse
Nurse etc)
etc)
with
evidence
of
equipment
specific
training
with evidence of equipment specific training
3.
3. Already
Already be
be accredited
accredited
4.
Commitment
4. Commitment to
to attend
attend appropriate
appropriate
accreditation
training
within
accreditation training within 66 months
months
Map of
retailers in
the Borough
Accreditation
Overall benefits of TCES
•
•
•
•
•
•
•
Normalisation / mainstreaming of the service - moving away from
institutionalised equipment
Increased innovation, choice and quality of equipment
User empowered to self help and has control over their independence
Reduced demand on the service for an assessment involving smaller items
More trusted knowledgeable and competent staff in the marketplace
Increased information to understand options through our communications
campaign
Efficiency review of current equipment catalogue and authorisation process
Specific state funded user benefits:
• Choice of Hillingdon retailer to
redeem prescription
• Choice of when to redeem
prescription
• Choice of brands of equipment
• Choice to personalise
equipment, “top-up”
• User empowered to self help
and has control over their
independence
Specific self funder user benefits:
• Easily accessible supply of simple
aids and equipment
• Removal of equipment provision
‘horror stories’
• Opportunity to have informed
support from accredited Hillingdon
retailers
• Non-dependency of having to
come to the service
So what has been achieved so
far?
•
•
•
•
•
•
•
•
•
•
Series of Prescriber & Retailer working groups
New equipment catalogue agreed
Prescription form defined
Prescriber criteria finalised
Financial benefits scoped and approved
Retailer event & visits conducted and accreditation approved
Waste management solution approved
Back office system developed to process prescriptions
Communications and awareness campaign developed including:
- Service user leaflet
- Dedicated information on Hillingdon LA/NHS webspace
- Presentation to Disabilities assembly, Carers forum, HCILL user
group and Health & Wellbeing board
Senior Management Team and Project Board approval obtained
What is left to complete to
implement TCES in Hillingdon?
• Retailer training on 8th and 9th November 2011 at DASH/
HCILL
• Retailer launch event on the 16th November in the Middlesex
Suite.
• Prescription training starts late November 2011
- 432 Prescribers across 23 teams trained over 3 months
• Finalise Hospital Discharge involvement in TCES
• Work with Neighbouring Boroughs Ealing and Hounslow to allow
freedom of movement for service users.
• First prescription planned for early December.
Thank you for listening
– any further questions?