Welcome
The Victoria Park Plaza Hotel
Victoria
London
Chair’s Welcome
Richard Humphries
Chief Executive
Care Services Improvement Partnership
The Gift of Peace of Mind
Liam Byrne MP
Parliamentary Under Secretary of State
for Care Services
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Health & Social Care Change Agent Team
STRATEGIC
COMMISSIONING OF
SERVICES AND THE
BENEFITS OF
INVESTING IN
TELECARE
LONDON
Tuesday 19 July 2005
Health & Social Care Change Agent Team
ARE YOU READY
TO SPEND THE
£80 MILLION?
Ian Salt
C.S.I.P. National Lead - Telecare
Health & Social Care Change Agent Team
“In looking at the new funding, as a Director of Social
Services I might be asking myself……..”
1. Is there any evidence for telecare – is it cost-effective?
2. How do I deal with the ethical issues like consent?
3. How do I get Social Services, Health, Housing and the
independent sector involved in improving services?
4. How does telecare fit in with other plans and priorities
for promoting independence and dignity?
5. How does telecare become a mainstream service?
Health & Social Care Change Agent Team
“Is there any evidence for telecare – is it cost effective?”
•
Examples of good practice and innovation showing that
telecare can help reduce care home and hospital admissions
and support independence programmes
•
Innovative housing schemes have led the way in providing
telecare support
•
Payment by Results and the National Tariff opportunities for
PCTs to monitor long term conditions outside of hospital
•
The CSIP Telecare Implementation Guide and factsheets
provide information, checklists and contacts including local
services and telecare experts
Health & Social Care Change Agent Team
“How do I deal with the ethical issues like consent?”
•
Users could benefit from telecare
•
Care should be taken to obtain consent and agreement
•
Follow-up, monitoring and review will ensure that telecare
meets the needs of users and is not intrusive
•
Complex situations will need special consideration
•
Innovative work would need local ethics committee
consideration – a factsheet is available
Health & Social Care Change Agent Team
“How do I get Social Services, Health, Housing and the
independent sector involved in improving services?”
•
ICES Section 31 or other existing partnerships to bring people
together – this could leverage in extra funding
•
Users may have reduced hospital admissions and those
supported by health services may need less care,– whole
systems thinking is vital
•
Telecare could provide considerable benefits for carers and
families
•
Fair Access to Care Services and Single Assessment will
enable services to be focused on users and carers
Health & Social Care Change Agent Team
“How does telecare fit in with other plans and priorities for
promoting independence and dignity?”
•
Audit Commission and the Health Select Committee reports
•
The Green Paper on Adult Social Care includes telecare
•
Standards in several of the NSF’s could be achieved using
aspects of telecare ( long term conditions, falls strategies,
intermediate care )
•
Telecare could support people as part of palliative care
programmes
•
‘Improving the Life Chances of Disabled People’ has many
references to assistive technology
Health & Social Care Change Agent Team
“How does telecare become a mainstream service?”
•
Innovation and programme evaluation identifies the value of
telecare services with a sound evidence base and
demonstrates value for money
•
Partnership working provides synergy and leveraging of
additional, recurring funds to provide long term development
•
A viable service option for health, housing and social services
provision with clear links to their strategies, policies,
commissioning plans and service priorities
•
Involving users and carers through consultation and care
planning focuses on independence, dignity and choice
•
The CSIP Guide and factsheets support local plans
Health & Social Care Change Agent Team
Implementation of telecare
Project Mgr
Suppliers
Ethics
Awareness
Procurement
Contracts/SLAs
Pilot(s)
Protocols
Charging
Commence
FACS, SAP
Review
Health & Social Care Change Agent Team
Implementation of telecare
Project Mgr
Suppliers
Ethics
Pilot(s)
Charging
FACS, SAP
Awareness, training
Funding >Procurement
Contracts/SLAs
Protocols
Commence
Review
Health & Social Care Change Agent Team
Implementation of telecare – too long
Project Mgr
Suppliers
Ethics
Pilot(s)
Charging
FACS, SAP
Awareness, training
Funding >Procurement
Contracts/SLAs
Protocols
Commence
Review
6 months
6 months
6 months
6 months
6 months
Health & Social Care Change Agent Team
Implementation of telecare – telescoping the
timeline using the Guide and Factsheets
Telecare Champion
Funding and 2005/6 Plans
Evidence-base, suppliers, procurement
Partnership working
Ethics
FACS, SAP, fairer charging
Awareness, training
Contracts/SLAs
Protocols
Commence
Review
July 2005
Dec 2005
April 2006
Sept 2006
Health & Social Care Change Agent Team
SO - ARE YOU READY TO
SPEND THE £80 MILLION?
We need to share information as it starts to
emerge
We need to gather evidence so that we can
move this telecare agenda forward together.
Ian Salt
C.S.I.P. National Lead - Telecare
Health & Social Care Change Agent Team
FOR MORE HELP AND ACCESS
TO THE CSIP TELECARE
IMPLEMENTATION GUIDE
PLEASE VISIT OUR WEB SITE:
www.icesdoh.org/telecare
www.changeagentteam.org.uk/telecare
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Getting the Right Balance of Care in your
Economy
‘Strategic Commissioning of Services and the
Benefits of Investing in Telecare’
Workshop 19 July 2005
Steve Arnold
Director, Integrated Care
North West London SHA
20
Long Term Conditions:
• are enduring
• are not curable and require ongoing care
• will get progressively worse
What’s included?:
• arthritis, diabetes, heart failure, COPD
• mental health
• renal dialysis, cancer and HIV/AIDS
• Sickle Cell and Thalassemia
• NSF on Neurological Conditions
The challenge ….
• 17.5m people with LTC, 8m
with multiple LTCs
• Discomfort and stress an
everyday reality
• Care has been reactive,
unplanned and episodic,
reliant on hospitals
• 5% LTC inpatients = 42% of
all acute bed days
• LTCs account for 80% of GP
attendances
• Only 50% medicines taken
as prescribed
Strategic Aims
• Embed a systematic
approach across health and
social care
• Reduce reliance on
secondary care – increase
primary, community and
home support
• Deliver high quality
personalised care
• Support for self-care –
linking to ‘Choosing Health’
and healthier choices
National Targets
• April 2008 - reduce Emergency Occupied Bed Days by 5%
• April 2008 - identify the cohort of Very High Intensity
Users - est. 240k nationally
• April 2008 – all VHIUs have care plans and are case
managed
• April 2007 – complete appointment of Community
Matrons - 3,000 nationally
Stratifying need and matching care
Case
Management
Disease
Management
Supported
Self Care
Level 3
Highly complex
Patients (5%)
High risk
Patients (15%)
Level 2
Level 1
Low risk
Patients (80%)
POPULATION WIDE PREVENTION
‘Supporting People with Long Term Conditions – An NHS and
Social Care Model’ (Jan 2005)
Albert’s story ….. present day
•Albert is 72, lives alone - diagnosed with COPD 15 years ago
•30% of normal lung function at rest - severe breathlessness especially when he
exerts himself, even in the most routine ways
•underweight; anxious, depressed, prone to panic; he feels hopeless and that he
can’t cope
• regular exacerbations - admitted to hospital - 15 days LOS
•delay in notifying the GP and in getting support - re-admitted to hospital
•not able to attend the follow-up OPD appointments offered at the hospital
•GP does not normally visit
•treatment - oxygen therapy, steroids, antibiotics and regular use of inhalers,
although he would often forget to take his medication
•meals delivered - carer support
Albert’s story ….. 2010
•Co-ordinated by Primary Care Centre - Nurse Case Manager contacts him
regularly both by telephone and in person
•Provides routine information daily through a hand held computer to the PCC assessed daily
•Contact him by video link re possible exacerbation - advice about additional selfmedication
•Other reports, inc weather conditions
•Urgent visits as appropriate
•Admissions to hospital reduced – and then:
– PCC stays in touch
–
LOS reduced - usually 3 to 4 days
– Co-ordinated discharge
• ‘Direct payments’ funds gardener
•Calmer and spends lots of time admiring his newly reclaimed garden.
Lessons for the Telecare agenda
• Whole systems approach
• Links to the broader policy agenda
• Staff training inc decision support
• Awareness raising amongst users
• What can the industry contribute?
Long Term Conditions – take home message
Be ambitious – this
is about
transformation
REFRESHMENTS
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Newham Home Monitoring
Project : Using Telecare to
Integrate Health and Social
Care
About Newham
About Newham
• Ranked 4th in Jarman scores
• 62% of population are from black and
ethnic minorities
• High proportion of under 24s
• Significant population growth forecast
Health in Newham
• Major areas of health inequality
• Significant burden of long term conditions
particularly diabetes, cardiovascular
disease and respiratory disease
• Age profile of LTCs different
• Huge potential for improvement
Mortality trend for coronary heart disease, in people aged
under 65
England
London
Newham
80.00
rate per 100,000
70.00
60.00
50.00
40.00
30.00
20.00
10.00
0.00
1993
1994
1995
1996
1997
1998
1999
2000
2001
Mortality trend for stroke, in people aged under 65
England
London
Newham
25.00
rate per 100,000
20.00
15.00
10.00
5.00
0.00
1993
1994
1995
1996
1997
1998
1999
2000
2001
A Relatively Small Number of Patients
Account for a Large Share Costs
Hospitalized Patients and % of Total Patient
Days
100%
100%
14.3%
26.4%
80%
19.0%
60%
80.0%
27.1%
40%
74%
20%
60%
15.4%
80.0%
29.9%
86%
40%
20%
10.0%
0%
Percent of Total
Percent of Total
80%
Hospitalized
Patients
10.0%
27.5%
7.0%
3.0%
Total
Patient days
All London
40.4%
0%
7.0%
3.0%
Hospitalized
Patients
Total
Patient Days
Newham PCT
What works in LTC management ?
• Managing the whole package of needs
• Single point of contact, particularly to promote
•
•
•
•
•
good cross sectoral and multidisciplinary working
Good quality, accessible information
Proactive management
Timely, effective and proportionate response in
and out of hours
Involved and informed patients and carers
Tailoring to individual needs, especially in
complex cases
Aims of the Home Monitoring
Project
• Increase patients’ knowledge of their condition
• Identify risk factors/ deteriorating condition and
•
•
intervene early
Increase access to information 24hrs a day for
health & social care professionals caring for the
patient
Manage health & social care needs and patient
anxiety
Target Group
• Older people living at home beginning to
•
•
•
develop a pattern of regular admissions /
attendance at A&E
At least one chronic condition
Anxious / socially isolated and in need of
support
Those with language needs and early stage
cognitive impairment actively involved
What the project consists of
Single Assessment
Risk Identification
Care Companion
Web Record
Case Manager based in Local Authority Call
Centre
Individual Escalation Protocol
AMD Care Companion System
Assessment Unit
Assessment Unit
+ wireless devices
Assessment Unit
+ wireless devices
+ videophone
Potential Value of Telecare
•
•
•
•
•
•
•
•
Extend care to home setting
Supports patient education and concordance
Relieves pressure on carers
Integrates in and out of hours care
Facilitates proactive care
High quality reliable information for decision
making
Underpins information sharing and joint planning
Enables most effective use of health / social care
resources
Lessons Learned in Newham
• Steep learning curve for NHS and
independent sector
• Dedicated resources essential
• Compatibility between systems needed
• Risk issues (clinical, financial)
• Enthusiasm from staff and patients
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Telecare
A Durham Perspective
Content

Part One (John Thornberry)
We like telecare because
 There are challenges
 Our strategic approach


Part Two (Dennis Scarr)
Pathfinder programme
 3 examples

We like telecare because it….
Increases choice for people
 Helps to manage risks in community
care
 Achieves targets and performance
 Helps with CSEP/Gershon
 Changes cultures and practices

Some Challenges
Complex organisational arrangements
 Overlapping policy initiatives
 Tight budgets
 Silo working practices
 Development to mainstream

Durham Strategic Approach





Whole systems approach
Partnership working as a key to success
Countywide groups for older people, CEB,
Supporting People
Locality Boards with SSD, DC and PCT
At Home and in touch project to link IT with
practice
Pathfinder
Programme
Three Examples
We are sometimes
providing the wrong
services at the
wrong time to the
wrong people -we
need to review how
and where we
spend our
resources
The rate of
changes in health
care must link to
changes in social
care and housing
provision-The key
providers must
co-ordinate their
service changes
more effectively
Not developing
the types of
care services
needed in the
future fast
enough - we are
too slow!
A case for
improved
integrated
working in
local
communities
We are still driving a
reactive approach to care
and housing provisionwe need to develop
enhanced preventative
services
33% increase in
people needing
care services in
next 10 yearsdemand is
increasing more
quickly than ever
before
Low overall user
expectation user expectations
will increase in
both needs &
wants
Govt will no
longer tolerate
poor performance
or slow progresscash rewards are
available to those
willing to change
Assistive Technology and
Extra Care Housing
Sycamore Lodge – Hanover Extra
Care
 Remote Health Monitoring & CDM
 ‘Well Elderly Clinic’
 Telemed / Community Alarms / GP’s /
Service User
 Making it happen
 Early learning

Assistive Technology and
SCATS
Sedgefield Community Assistive
Technology Service
 ‘helping someone with memory
related problems remain at home….’
 Telecare sensors/ Community
Alarms/Warden Service
 Making it happen
 Early learning

Assistive Technology &
Integrated Teams





Integrated Teams for services to Vulnerable
Adults – Social Care & Health / Health /
Housing Support services.
Assistive Technology / Community
Alarms/Warden Services
Single Assessment Process
Making it happen
Early learning
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Helping people to stay at home findings from an evaluation of
Northamptonshire's Safe at Home
Project.
John Woolham
Senior Research Officer
Northamptonshire County Council
Community Services Directorate
July 2005.
18 March 2016
Safe at Home: background
Northamptonshire’s involvement in the
EU funded ASTRID project
Putting principles into practice – the
Safe at Home project
Safe at Home: project structure
Three full time project workers located in Care
Management teams and
responsible for
assessing referrals, identifying and obtaining
technology needed and arranging its installation
3 ‘Demonstration houses’ to show technology in
action to professionals, carers, and service
users.
Project depends on multi-agency partnership
working and multi-disciplinary professional
skills within its management groups
Safe at Home: what it does in practice:
The story of Mrs White and her gas cooker…..
The Problem:
Forgets to light gas cooker
after turning it on.
Risk of suffocation or explosion
High level of concern from
neighbours and relatives
The Solutions?
Admission into care
Disconnect cooker
Substitute gas for electric or
microwave
Use technology to manage
risks
Safe at Home: evaluation objectives
To assess the reliability of any technology used in the
project
To assess the extent to which any technology used supported
unpaid carers and relatives
To assess the success with which technology helps service
users to maintain their independence
To examine the cost effectiveness of the project
Safe at Home: methods
Longitudinal design – 21 months
Criteria for inclusion in evaluation:
Met criteria for referral to project
permission given to use data for research purposes
Control group from Essex social services to collect some outcome
and cost data
No sampling.
Safe at Home: methods
There was a
fairly high drop
out rate before
a service was
provided
Safe at Home
service
users
and the control
group were very
well matched
Total no.
referrals
= 326
Total no.
assessments
= 291
SAH User group (n= 233)
Mean age
Gender
Ethnicity
Living alone
Total no. people
who received
technology
= 233
Comparator group (n= 173)
80.2 (SD=7.97)
79.4 (SD=7.41)
M = 62 (27%)
M=48 (27%)
White =
97%
Asian/Asian British = 1%
Black or Black British = 1%
Chinese = <1%
White = 100%
Y= 66%
Y= 40%
Diagnosis
dementia
of
Y= 90%
Y = 100%
Presence
unpaid carer
of
Y = 87%
Y = 94%
19.9 (SD= 6.07) (n=87)
18.9 (SD= 5.05)(n=93)
Mean MMSE
Safe at Home:
Objective 1. The reliability of the technology
Over 50 different kinds of device were used
Some were simple ‘stand-alone’ devices that don’t need to be
installed
Some were telecare devices which relayed messages to a local call
centre so a ‘social response’ could be provided.
Reliability and effectiveness checked every three months by
project workers
91% of devices worked perfectly over the course of six reviews.
Safe at Home:
Objective 2: The impact of the project on
relatives and unpaid carers
5
4
4.7
4.4
4.3
4.1 4.1
4 3.9
3.8
4.84.7
4.4
4.1
4.3
4.1
3.63.5
4
3.63.5
3.8 3.93.8 3.93.9 3.93.8
3
Before
After
2
Demands for attention
Health concerns
Standard of living
Inability to have holiday
Lack of pleasure
Feelings of frustration
Feelings of embarrassment
Upset to household routine
Worries about person cared for
Feelings of depression
Difficulties coping
0
Interrupted sleep
1
Fear of accidents/dangers
123 relatives and carers
were surveyed and 70%
replied.
A carer stress scale was
used to measure the
impact of the project.
In all but one of the
scored items the scale
score was lower (i.e. the
relative or carer was
less stressed) after the
project had provided
technology.
These changes in score
were
statistically
significant in 9 of the 13
items on the scale
(w=0.001)
Safe at Home
Objective 3: Extent to which project supported
independent living
12
11
10
8
8.8
9.2 9.2
7.3
7 7.1
6.8
At referral
5.4 5.5
6
4
3.3
2.4 2.3
12 mths later
2.9
2.5 2.5
Behaviours difficult for others
Practical issues
Ability to maintain control
Values beliefs and feelings
Physical health
Personality & dementia presentation
0
Contact with others
2
Thinking & communication
Aggregate score
Assessment
score
profiles for people
at referral and 12
month later declined
(i.e.
showed
evidence of slight
improvement)
in
functioning on three
of the eight subscales.
All sub-scale scores
were
statistically
significant
(x2=<0.001)
Safe at Home
Objective 3: Extent to which project supported
independent living
70
60
% who left community
A control group was
used to compare the
rates at which people
left the community.
People
from
the
control group left
the
community
sooner and in greater
numbers: they were
four
times
more
likely to leave the
community than Safe
at Home users.
50
40
Safe at
Home
30
Essex
comparator
20
10
0
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
months
Safe at Home
Objective 3: Extent to which project supported
independent living
The study considered if other factors might be responsible
for these outcomes
The composition of the two groups:
no sampling occurred
the two groups were large and well matched on a range of factors.
Provision of care: people from the control received
more services,
more hours of help
more visits.
The possibility that the differences may be due to difference in use
of ‘anti-dementia’ medication or some kind of ‘Hawthorne effect’
are unlikely but can not be entirely discounted.
Safe at Home
Objective 4: Cost effectiveness
2,000,000.00
1,705,837.50
1,500,000.00
expenditure
The
project
was
extremely
cost
effective as fewer
people spent less
time
in
hospital,
residential or nursing
care.
The net equivalent
saving
over
21
months
was
£1,504,773.
1,020,054.00
Safe at Home
1,000,000.00
500,000.00
Essex comparator
568,440.18
477,270.30
127,356.96
15,911.36
0.00
Residential care
Nursing care
Hospital
Safe at Home: conclusions
Operational teams need:
Training, training, training
Access to information about what technology is available and what it
does & doesn’t do
Ability to obtain relevant technology quickly as well as access to people
with the skills to install it safely
Need for access to call centre staff who are trained and have the
resources to meet the demands of an expanded service
To include a social response service
If the infrastructure is in place technology can help deliver
performance improvements in relation to several social care
performance indicators
May need to think about re-engineering of services and the creation
of new hybrid professional groups.
Safe at Home: conclusions
Risks
Use of technology is
‘technology led’ not
determined by need
Failure to understand or
apply ethical protocols
where
informed
consent to use is
difficult or impossible
Used as a substitute for
social care
Safe at Home: conclusions
Assistive & telecare technology a win-win situation?
Consistent with what most service users would prefer
Supports carers
Very cost effective.
Can be used to
Manage risk
Provide support and reassurance
Predict the occurrence of ‘risky’ activities
Limits to use are
Availability of technological solutions
Infrastructure and will to support
Skill and imagination of service providers
References
Barlow, J., et al. Flexible Homes, Flexible Care, Inflexible Attitudes? The
Role of Telecare in Supporting Independence (2003) Housing Studies
Journal.
Curry, R., et al. The use of Assistive Technology to Support Independent
living for Older and Disabled People (2002) ICES/DH.
www.ICESDOH.org Telecare Implementation Guidance Pack. (2005)
Marshall, M (ed) ASTRID: A Social and Technological Response to meeting
the needs of Individuals with Dementia (2000) Hawker, London.
Woolham, J. & Frisby, B. Building a Local Infrastructure that Supports the
use of Assistive Technology in Dementia Care (2002) Research Policy &
Planning Vol 20. No.2.
Woolham, J. Safe at Home – supporting the independence of people living
with dementia by using assistive and telecare technology (2005)
forthcoming)
LUNCH AND EXHIBITION
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Making Your
Investment
Decisions Work
Kent Telehealth Evaluative
Development Pilot
Peter Gilroy
Chief Executive
Kent County Council
A Personal Perspective on
the future of
social work & social care services
in the UK
(Kent Social Services & Pavillion Publishing, 2004)
“Services of the future must have at their core a
‘customer-care’ ethos and shift away from paternalistic
cultures.
Attitudes are changing and judgements made by the
general public on the quality of public, social-care services
will not be determined by what we say but what they taste,
see and feel.
They will be the ultimate arbiters as to whether we are
serious about modernising public services.”
Why Local Government?
A Modernising Force
Financial Savings
 Family of Services
 Modern and more effective service to the public
 Opportunity of a fundamental step change in front end services
 Better use of public resources:
 Compliments objectives of our ‘well-being’ powers and
provides choice and independence
 Competence/procurement
 Capacity/strategic/infrastructure.
Kent’s TeleHealth Evaluative
Development Pilot
 Kent Telehealth: Self-management of chronic disease using
Telehealth technology.
 KCC Social Services are the lead agency in this multiagency arrangement
 Exploiting emerging technology
 The largest UK pilot to date with up to 300 people.
 Improve the life outcomes of a pilot group of people in Kent
with chronic disease management requirements.
 Deliver a range of efficiencies across the Health and Social
Care spectrum.
 Links to PSA2
Partner organisations
Five PCT’s across Kent.
Viterion Telehealthcare LLC are a Bayer-Panasonic Company:

Offer comprehensive, affordable, quality healthcare,
particularly for people with chronic diseases.

Committed to developing with Social Services a UK/Kent
version of the US model.

Expertise and technology capabilities.
Veterans Health Administration (VHA), an agency of the US
Department of Veterans Affairs:

One of the largest independent health and social care
providers in the US.

Serving 4.9m patients from a registered client base of 6.9m

VHA is affiliated with 107 academic health and social care
systems within the US and across the world.

For the Kent TeleHealth Evaluative Development Pilot we
will be working with VISN 20 – VA Puget
Sound Health Care System, Seattle.
Kent TeleHealth Evaluative Development Pilot
VHA targeted their high cost, high health and social care supporting US
veterans with a range of related morbidities
Outcomes of the US programme : Hospital admissions reduced by 46%
 No. hospital bed days reduced by 61%
 Number of admissions to nursing facilities or similar reduced by 47%.
 Number of Nursing home or similar bed days reduced by 81%.
 Reduced (high) hypertensives (blood pressure) by approximately 15%
over 4 years.
 Reduced (mild) hypertensives (blood pressure) by approximately 8%
over four Years.
 After twelve months near perfect score on the cognitive status of the patient.
Kent TeleHealth Evaluative Development Pilot
 Opportunity to reduce admissions and costs in the UK
 1.5 million pounds invested by Kent Social Services.
 Evaluative Trial Programme 18mths.
 A contribution to the overriding goal of promoting
independence.
 Four key Chronic Diseases:
Chronic Obstructive Pulmonary Disease (COPD) & Asthma,
Congestive Heart Failure,
Diabetes,
Depression.
Those with 3 +
chronic disease conditions
will take up
32.5% of GP consultations
Chronic Disease Management
Social Care professional
Health Care professional
New vision
Modernise
Working together
Single-Assessment Process
Self Managing
Care Planning
CP Review
Well Being
Independence
Prevention
Occupational Therapy
Vital Signs
Monitoring
Healthy Behaviours
Health Education
Physiotherapy
Speech Therapy
Mental Health
A contribution to the overriding goal of promoting independence
What does Telehealth do?
This particular TeleHealth Technology consists of:

Disease management tools combined with unique user
friendly interfaces specifically focused on the needs of older
people to easily access and use the technology with
confidence.

Reporting tools include tracking and alerts

Messaging devices, customisable, personalised scheduler,
reminder and alarm.

Q&A technology Video Link with real-time video monitors
and Instamatic digital cameras.

Portable, simple telephone connection to the provider via the
web
Telehealth – The Future?
 Shift of power from practitioners to users
 It will be a normal part of public and private infrastructure
within 10 years, without diminishing professionals’ quality
personal contact with the general public
 Potential to go beyond intensive case management of people
with chronic diseases with the Viterion equipment
 Integrate TeleHealth into other community settings to promote
independence and self-management including the health,
education and social-care economies
 Integrate into other Social Care work, e.g. assessment and
referral, care planning, review and single assessment. This
form of integration brings back-office efficiencies but more
importantly, better outcomes for citizens
 It offers with other IT products a real step change in the way
that the citizens are offered choice and, increasingly for many,
self-manage their services
ROUND TABLE WORKING
For printed
copies of each
presentation
please complete
the Conference
Evaluation sheet
(in the handout
pack) at the end
of the day and
hand it to the
conference
registration desk
Department of Health Conference
Strategic Services and Investing in Telecare
“Transforming Lives
Transforming Services”
Tony Hunter,
Executive Director, Liverpool City Council
and
President, Association of Directors of Social Services
Themes
•
•
•
•
•
We make lives “bearable”
Lots of green shoots
Emerging local government roles
From telecare to smart living
Our leadership challenge
We make lives “bearable”
• Lives → services: the right way round
• Facing reality
- “He asked me silly questions I couldn’t answer”
- Criteria driven assessments – no added value
- Vision statements ¼ hour home care slots
- Marginalised social care
Lots of green shoots
•
•
•
•
•
Children Act, Green Paper – 150 change programmes
From “you need me” to “we need each other”
Bottom line: “We can’t go on as we are”
Unhelpful barriers coming down, LSPs
Technology supported shift from hierarchical management
and meetings…
• …to fluid networks, focused discussions and contributions
to shared agendas
Local government of the future
•
•
•
•
•
Force for change - community leadership
Heads up enabler, not heads down deliverer
Knowledge based interventions
Blurred staff/agency roles
BPR/ICT around the customer
From telecare to smart living
• Policy context: shift from yes/no eligibility to wellbeing
and inclusion
• Telecare part of the former or the latter?
• Should any home be without the new, inexpensive
“Smart living” Safe Environment Monitoring System?
• What’s our role? Sit back, or pro-active?
Our Leadership challenge
• Getting the “wellbeing” ducks lined up – adults social
care, primary health, public health
• “Shadow of the leader”:
- being empowering, decisive, accountable
- listening, reflecting, learning
- investing in partnerships
- embracing new ideas and technologies
• Are we up for it?
THANK YOU FOR ATTENDING
For printed
copies of each
presentation
please complete
the Conference
Evaluation sheet
(in the handout
pack) at the end
of the day and
hand it to the
conference
registration desk