Positioning technology at the heart of care and support

wolverhampton.gov.uk

Linda Sanders,

Strategic Director for People, City of Wolverhampton Council

ADASS National Lead, Assistive Technology

Why is it needed?

Each year in the UK, up to 1 in 3 (3.4 million)

over 65s suffer a fall, costing the NHS an estimated £4.6 million a day

23% of the UK population is projected to be 65 and over by 2034

1 in 6 people over the age of 80

is affected by dementia70% of all inpatient

bed days relate to a long-term condition

Unpaid care provided by friends and family to ill, frail or disabled

relatives is worth £119 million every year

More than 15.4 million people in England live with a long-term

condition, and this is expected to rise to 18 million by 2025

Wolverhampton – The Challenge

The Health and Social care landscape is changing, bringing significant challenge for continued delivery of services and achievement of targets. Challenges are numerous but include:

•reducing admissions due to falls•rapid Hospital Discharges/Delayed Transfer of Care•reduced spend on delivery of care services both in care homes and at home•meeting needs of an aging population with reducing budgets•promoting independence and self management in the citizens of Wolverhampton

Objectives:•intervene and support people earlier•reduce, defer and delay the need for more intensive support•provision of better information and increased alternatives of less intensive care to help people be as independent as possible.

The expansion of the Better Care Technology offer across Wolverhampton is an integral part of the city’s ‘Promoting Independence policy’ and the ‘Home First Approach’ to support people to remain independent within their own home and community – integral to integrated health and social care through our Better Care work

• Target admissions due to falls for telecare users of less than 10% per annum for all users over the age of 65 (33% national average)

• Target reduction in the cost of care provision through “technology first” culture (particular focus in LD)

• Support at times of high demand (such as winter pressures) through proactive support for individuals in their own home

• Support for delivery of Public Health campaigns through proactive support services delivered via an integrated care and support hub

• Generating efficiencies and support for the broader Health Economy through receipt of referrals from multiple sources including self-funders

• Target the following areas through the large scale implementation of telecare:• Reduction in ambulance call outs• Reduction in A&E Attendance• Reduction in hospital admissions• Maximise discharges to home rather than care homes or intermediate care environments• Support re-ablement and promote independence allowing people to remain in their own homes for

longer

Wolverhampton - Desired Outcomes

VeraThe challenge• Vera has a tendency to visit the bathroom in the night• She was unable to get up and call for help and lay in the

bathroom for 6 hrs until her daughter fortunately visited her the following morning

The solution• A bed sensor was installed which gently turns on the

bedside light when Vera leaves her bed at night, lowering it automatically upon return (highlighting any obstacles)

• A timer raises an alarm with the response centre (or daughter if preferred) if Vera hasn’t returned to her bed after a short time.

“I know my confidence went. At first I didn’t like the idea but now I think... if I don’t make it back to bed I won’t have to spend another night on the floor.”Vera | 77

MichaelThe challenge

• Michael lives in a shared supported living house.

• Care support is given 24 hours a day (with sleeping care staff).

• He has now started to develop dementia and has increasingly been leaving the property at inappropriate times, leaving the door open or unlocked resulting in an increased risk for the other people living there.

• All of the clients who live in the property have their own key, and can come and go as they please. The staffs’ primary concern is that they do not want to impede the lives of any of the clients in the property by removing this independence.

The solution

• Lifeline unit linked to staff mobile phone and three property exit sensors

The outcome

• Telecare has enabled Michael to remain at home and potentially removes the risk of him having to be moved to an alternative property.

• Removed the risk of the property being burgled, or people entering the home uninvited.

“We didn’t want to see Michael leave us but it was proving to be very difficult to manage his wandering. Now telecare is keeping us all together.” Care Supervisor

Supporting outcomes through delivery of proactive support services

Slide content courtesy of Tunstall Healthcare Ltd

Equipment installation Response

MonitoringMobilise

emergency services

Support Level 1Response

Companion-ship / Care

Giver Support

Public health &

safety

Custom reminders

Proactive monitoring

Support Level 2Proactive outbound contact Post

reablement contact

Signposting/referral to prevention

services

Other support

Support Level 3Proactive follow-up in the

community

Quarterly Monthly Every 10 days (at most)

Leve

l of n

eed

Supporting outcomes through delivery of proactive support services

Learning from Spain – teleassistance

• 70% of calls are outbound

• Operators proactively call service users on a regular basis:• to check on their wellbeing• remind them of appointments• prompt them to take medication• wish them a happy birthday

• Frequency of contact adjusted depending upon the needs of the individual

• Contact service users in crisis, e.g. bereavement

• Protocols are in place for risk of suicide or abuse, and in the event of major disasters

• Significantly reduced the number of emergencies, improved the wellbeing of users and made effective use of public services

• The teleassistance model provides preventative, proactive support for more independent service users

• Vulnerable or at risk service users receive increased levels of support

• Care services are prioritised and coordinated to ensure effective use of resources

• Latest customer survey users gave the service 9.8 points out of 10

Health promotes healthy lifestyles, focused on people with long-term conditions, preventing nursing home and hospital admissions

Safety preventing falls, improving safety, reduction in emergency calls

Inclusion reducing social isolation

Carers reduction in carer emergency calls

Slide content courtesy of Tunstall Healthcare Ltd

Learning from Spain – initial outcomes

Future Vision: Technology enabled services

Supporting health and care via smart

technology

Apps & Health Tracking

Supporting Mobility

Real Time Hospital

Mobile health & care solutions

Real time patient location - automated

bed occupancy & discharges

Virtual Clinics

Videoconferencing supported by biometrics

Wearables Integration

Using consumer wearable tech to

support health/care

Connecting people with social

circles/activities

Social Inclusion Service Delivery Extension

Using telemonitoring centre as integrated

service hub

Behavioural Trends/Analysis

Building a picture of activity & responding to

changes

Supported Discharge

Hospital discharge support

Specialist Need Support

Tailored services supporting specific

needs

Future Vision: The Connected Resident – Enabling Positive Ageing

Rita

Acute

Primary care CCGs

National datasets

Family/carers

Additional Services

Social care and Public Health

Community care

Housing

"At Home" is a concept developed collaborately by WM ADASS, 14 local councils in West Mids (and increasingly others outside the region) and Naidex to raise public awareness of assistive technology and how it can support independent living for longer – www.athome.uk.com

• It is a campaign to increase awareness for those thinking about later life

• To increase public knowledge and confidence to access resources to help people stay at home for as long as possible longer.

Uniform marketing & communications messages at region-wide level

New ADASS resources

• Better Care Technology - Results of Call for Evidence• The findings cover 28 examples across England from

Brighton to Bury• As well as financial savings, you will read about some

fantastic people stories.https://www.adass.org.uk/better-care-technology-in-social-care-settings-good-

practice-examples/

• Guide to Supporting Carers through technology enabled care services

• As well as describing the different ways technology can help, it covers top 5 things we need to challenge when looking at technology enabled care to help support carers

http://uk.tunstall.com/Uploads/Documents/ADASS_Carers%20guide%20to%20technology.pdf

Things to consider

• In Barcelona the scale of the implementation is in the context of huge financial restraint and recognition there are still things you can do to support many people in terms of an invest to save argument.

• Think about prevention in a different way - to move away from a highly targeted, crisis model to a much more universal model, more widespread, commenced at an earlier stage.

• The importance is ensuring that Better Care Technology is seen as integral to a whole system shift, in order for some of the potential barriers in relation to perceptions of technology to be overcome

Key messages to commissioners and providers

• Shared leadership endeavour - the right people and a good business model. • Capture the imagination of members and partners, assuaging the fears and anxieties that we’re

doing techy stuff - view telecare as an essential core support activity rather than perceived as a replacement for personal care.

• Ensure an unequivocal focus on the change process – it should be a leadership priority across the system so things don’t drift.

• It’s not an optional extra• Embrace the passion and commitment about the difference it can make in empowering people