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?