telecare in portsmouth

Telecare in Portsmouth

Telecare Knowledge Network

University of Portsmouth

9th February 2007

2 Putting People FirstPortsmouth City Council

National Policy Drivers for Telecare

Telecare will contribute to a number of important agendas:The White Paper ‘Our health, our care, our say’National Service Frameworks – older people (falls), LTCself care, intermediate care and extra carepreventing unnecessary admissions to hospital and residential caresupporting earlier discharges from hospital, community rehabValuing PeopleSupporting PeopleSupport for carers

Preventative Technology Grant


Preventative Technology Grant

Portsmouth’s allocated grant is £106,684 for 2006/07, and £177,099 for 2007/08Grant effectively ring-fencedPaid into budget of telecare lead, Strategic Partnerships & Well-being Manager, in Health Improvement & Development Service (post holder retired Dec 06 – awaiting replacement)Under-spend to be carried forward into next financial year Objectives:- set up robust infrastructure

- test the infrastructure through series of pilot schemes


Telecare’s contribution to Portsmouth’s community strategy

Health & Social Well-being Vision: ‘A Portsmouth that celebrates individual confidence and good health’

Protecting older people from dangers in their own homes

Supporting older people and those with disabilities to continue living at home


LOGISTIC & INFORMATION PATHWAY OF A TELECARE SERVICE

Entry

(Re) Assessment of Need (SAP)

Care Package Development

Home survey

Telecare Prescriptionand a Response Protocol

Equipment ProvisionInstallation and

Maintenance

Monitoring

Call Handling

Community Response

Review


Awareness raising

Addressing the need for comprehensive awareness of the potential use of preventative technology in supporting vulnerable people to live independent lives

Senior managers, commissioners, practitioners

Front line staff in all partner agencies, and in community and voluntary agencies

Potential users and their carers

General public


Training programmes

Developing induction and training programmes for practitioners: - assessing for telecare as part of community care assessment - options to improve independence - knowledge of equipment & how to access it - tailored solutions to manage or reduce risk

Working with Learning and Development Departments in PCC & PCT, and suppliers


Partnership with Community Alarm Service

Telecare being built on platform of existing Community Alarm Service

Community Alarm Manager on Telecare Steering Group

Alarm Contract re-tendered in Spring 06, to ensure supplier had equipment/capacity to support development of telecare. Awarded to Initial Attendo

Close liaison with Community Alarm Manager to ensure her staff are trained in the new technology, to provide a streamlined environmental assessment, ordering, fitting and maintenance service


Partnership with Alarm Monitoring Service

Control centre is in Southampton

Existing excellent working relationship between Portsmouth and Southampton

By working together we achieve cost-effectiveness/ economy of scale

Watching brief on changing work load


Demonstration/training facility

Plans to develop ‘SmartHouse’ - working with Community Housing to identify suitable, accessible propertyDisplay of safety and security equipment, telecare, teleheath and environmental control systemsLive link to control centreFuture development as lifestyle centre, show-case for future-proofing of domestic environmentDemonstration/assessment centre for users, carersTraining facility for staffDispel myths about technologyMarket the service to the publicAttract sponsorship from commercial partnersInformation point for Self Assessment users, sales point for Direct Payment users and private customers


Portsmouth’s pilot: Falls

Falls management scheme for 20 usersSupporting people who have fallen or who fear fallingMembers of Mountbatten Centre ‘Strength and Mobility Group’ (Physio-prescribed, evidence-based, 20-week exercise programme)Already demonstrated motivation to participate in managing their health and well-beingAnticipated outcomes of telecare provision - improved confidence, maintenance of ‘fitness gain’ once group finished, reduction in falls, improved quality of life


Falls response service

Previous offer from Home Care, to provide staff for falls response service, now withdrawn New proposal from Ambulance service to develop First Responders to provide falls pick up – managed/despatched by Ambulance, compatible documentation, falls pathway (GP, SPA)Data from Ambulance indicated that the number of responders to cover 24/7 for falls pilot would be sufficient to provide city–wide service for uninjured, non-conveyed fallers (2-3 per day)Need for joint commissioned mainstream falls response service with financial support from all stakeholders Discussions on-going with health, social care & ambulance


Portsmouth’s pilot: Medication

Grass root suggestion to meet identified need

20 users with early stage dementia

History of problems safely managing medication

Programmed carousel provides prompt to take medication

If not taken, Control Centre alerted

Response protocol activated

Responders likely to be family and professionals (Home Carers & CPNs) already involved in ensuring medication is taken, and crises due to non-compliance with medication

One meeting of planning group


Information collection and flows

Electronic social care and health record systems, but they do not talk to each other

Single Assessment Process not in general use

Information needs to be passed manually

Identifying existing data-sharing systems

Identifying what else needs to be included to ensure info is passed around the telecare pathway

Developing Telecare referral form


Data capture

Developing Telecare Referral Form, to enable data for evaluation to be recorded simultaneously with provision and review:-identifying the risksrecommending equipment to meet the needlocation of sensorsresponse required to each sensor alertfeedback mechanism to ensure event record is passed onto referrer for any necessary actionqualitative evaluation based on user/carer views, before and after installationquantitative information to identify likely outcome if telecare were not providedprobable reduction in resource impact if telecare is provided


Identifying priority areas for mainstreaming

Identify other areas where take up of telecare would provide most positive impact to inform plans for mainstreaming:-

Staff asked to consider whether telecare, if it were available, could contribute to management of risks identified in their community care assessments

Note it as unmet need and pass info to manager and to Telecare Co-ordinator

Regular presentations and consultations with users and carers, via carers’ groups, Prevention & Well-Being Network meetings, Portsmouth Disability Forum


Charging policy

Charging policy not yet agreed

Health Improvement & Development Service grew out of Prevention Team

Strong commitment to preventative interventions to avoid crises arising

In favour of outcome objectives (e.g. supporting falls management, supporting carer, enabling early discharge from hospital) rather than eligibility criteria

Will support users to maximise their income/ benefits/ grants to enable funding of telecare


Sustainable funding

Beginning to identify sustainable funding sources to support transition to mainstream community service

Raising profile by ensuring telecare is included in jointly agreed service development plans and Local Area Agreements

Trying to identify political champion, councillor, who is prepared to support future bids for funding once PTG expired

Beginning to build business case on cost/benefit evidence from other telecare services


Evaluation

By the Centre for Healthcare Modelling and Informatics, University of Portsmouth

Qualitative and quantitative evaluation

Collect data on costs and benefits, demonstrate sustainability and cost-effectiveness

Investigate contribution of technology to quality of life

Inform further development


Key points

Consult/involve potential users in the development of the serviceTelecare = 20% technology, 80% peopleIntegrate telecare into existing health and community careBuild on what you’ve gotKeep flexible in implementing telecareUser centred and contextual assessment is the key to appropriate provisionResponse protocols need to be tailored to individualEvents record needs to feed back into health/social care planCapture data - evidence for re-configuring services


Contacts

Rosanne BrownTelecare Co-ordinatorHealth Improvement and Development ServicePortsmouth City Council Floor 1, Core 1, Civic OfficesGuildhall Square, Portsmouth, PO1 2 EP Tel: 023 9268 8394Fax: 023 9268 8393E-mail: [email protected]

Dr. R. G. Curry Senior Research FellowCentre for Healthcare Modelling and InformaticsUniversity of PortsmouthTel: 023 9284 6662E-mail: [email protected]

telecare in portsmouth

Documents

vulnerable people

homessupporting older

development of telecare

budget of telecare lead

intermediate care

ltcself care

maintenance service

new technology