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Positioning enabling technology at the heart of health and (self) care
- 1. Positioning enabling technology at the heart of health and (self)care 3 December 2018
- 3. 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 dementia 70% 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 UK perspective – what is the role for technology enabled care? Social Care funding gap projected to reach £2.1bn by 2019/20
- 4. Lord Darzi Review of Health & Social Care, 2018 - https://www.ippr.org/research/publications/darzi-review-interim- report UK perspective – demand pressures
- 5. Budget Survey: Assistive Tech. & Savings www.local.gov.uk Source: ADASS 2018 Budget Survey 93% of Directors of Social Care to the ADASS Budget Survey in 2018 said that assistive technology was quite or very important in making financial savings (3rd highest area)
- 6. UK perspective – changing landscape of technology provision • 1.7m Telecare users – largely community alarms – button and box, analogue • Predominantly dwelling focused – independence in the home v accessing the community • Push from technology suppliers rather than pull from commissioners/’users and choosers’ – limited self-purchase activity and stifling innovation • Referrals in general have focused on prescriber model/selection of equipment and not on outcomes/risks or benefits tracking • Vast majority of service activity has been reactive – responding to incoming alerts and not delivering proactive interventions • Too often basic alarm services and Telecare has not included mobile response – users could be left waiting for ambulances for hours after a non-injury fall Lessons to be learnt
- 7. Technology is a key enabler for self-care, supporting people to invest in their future independence and a driver for demand management within health and social care Opportunities from a shift to digital solutions
- 8. Shifting the Technology Enabled Care conversation
- 9. The Connected Resident – Enabling Positive Ageing Rit a Acute Primary care CCGs National datasets Family /carers Additional Services Social care and Public Health Housing Community care Service users, patients, carers – must not be in position of leaving their everyday technology at the door when engaging with Telecare services
- 10. Data analytics & machine learning to support practitioners Using lifestyle monitoring to support informed decision making – promoting positive risk taking backed by data ‘Just enough support’ rather than ‘just in case support’
- 11. People/culture aspects underpin the systems/process approach – providing sustainability to achieving efficiencies. Sustainability will not be achieved without on-going support of frontline staff to embed cultural change. To achieve cost reduction/avoidance savings, services need to develop the technology offer around the following principle: Creating a technology first culture and positioning technology at a strategic level
- 12. Positioning technology correctly delivers cost avoidance and cashable results • Evaluations across 39 councils, initially led by the Department of Health in England, identified average annual savings of £1,163 gross / £890 net per user • Feedback from Hampshire Council demonstrates annual savings (including cost avoidance) of circa £840 net per user (£7.1 million net savings over 4 years supporting 9,750 service users) • London Borough of Havering have avoided £938k of cost relating to care home admission as well as £2.24 million from a 44% reduction in hospital admissions due to falls • By embedding technology within reablement and ongoing support, the evidence from Dudley MBC is that Personal Budgets are 8% smaller when Telecare is included (average £800 per user reduction) • Feedback from Lancashire Council highlights that 46% of the c.8,000 Telecare users (all Care Act eligible) are only receiving Telecare to support their needs; 34% have Telecare and home care, with an average care package cost of £627 less per person per year than those receiving a home care package without Telecare
- 13. Tim Mulrey tim.mulrey@tsa-voice.org.uk / 07739 196900 Contact information
Hinweis der Redaktion
- Socail care facing a huge funding gap Population getting older, living longer with more and more long term conditions There are issues around demand management so what is the role that technology can play for delaying the need for more formal services
- We are now at the point on the chart where there are more people over 65 than under 16 We are haing less children How do we introduce wellness technology far earlier to ensure people have a need for support far later This is not just happening here in the UK but look at the Dutch model, look at Sweden, a lot of their work is using technology to delay entry into care services There is a huge gap in terms of the amount of carers, its not seen by people as a long term career path, this is not to say that technology will replace all formal care but there may be instances where technology can alert if there is an issue
- Every year ADASS carry out a survey, what is interesting this year, Technology is quite or very important in making financial savings Majority of that saving is cost avoidance, technology is not there to make savings on existing embedded older peoples’ packages of care, that care has become a dependency for them However, huge opportunity to support people from a prevention point of view, in hospital discharge and in reablement
- It is relevant to talk about where we have come from and where we are now 1.7 million has remained static, majority is button and box on telephone line, the pendant with the big red button and a range of sensors The majority of people supported by the LA authority with technology will receive this type of service Majority is designed to keep people safe in their own home but not in the community Technology has moved on quite quickly, commissioners do not necessarily have the experience of the sector and procurement decisions can be guided by the supplier From a front line perspective, the question is often what equipment do you want rather than w needs and outcomes or risks such as addressing wandering, epilepsy etc… Model is reactive, pendant press, address the issue, take the next call. There is very little analysis and proactiveity to understand trends over time and take positive action with regards to exercise, hydration, nutrition or just get in touch to prevent social isolation Lots of services do not have a mobile response, even though someone may already have been identified as vulnerable
- The opportunities around digital transition are significant Average UK home 29 connected devices by 2020 Smart TV, Smart Speaker, Watches, etc… Water meter will already be able to provide trends as to water usage from shower / kettle In homes with people of a certain age, can issues be identified which may indicate an increased rsk of UTI or fall Technology is the easy bit,
- We engage with people at crisis We try and fit the technology in there, adding it on to an existing care package In shifting the conversation, we are talking about getting technology into reablement, working with GPs about the patients they are worried about being at the risk of UTI, on the cusp of admission, how can we support them: The cost of the indivual and the system for UTI is significant – average stay in hospital is 7 days for person over 65 with UTI, for those individuals staying in hospital for 10 days, they have lost 10% of their muscle mass Solutions that are working around the UK include where a simple wrist worn device, some buetooth scales and a grip strength meter used once per week can predict increased falls risk weeks in advance One area choose to invest in thermal imagining homes from the street, overlaying ONS data and social care date to understand older males living alone in colder houses unknown to social care
- There will soon be more people in the UK owning a smart speaker than the 1.7 million in receipt of telecare Speaker devices can link to apps, they can link to a range of devices that can provide alerts, links can be made to video screens, in some parts of the UK, direct payments are being spread further by the use of a combination of face to face and virtual visits It is important to think about how the technology of the future can link into the commissioning of the future, yes, safety critical is important but engagement f the public in this area is equally so In 2025, BT Openreach witching off analogue lines Argos sell low level aids, Avivia invest in tech as part of their insurance packages, vitality is giving away echo dots and deals on smart watches
- The data sde is crucial, understanding changes to peoples activities of daily living This information can help to let people know when to step forward and when to step back Perfect in reablement Recently carried out a study in a south west authority around using sensrs for clients recently left hospital, variety of outomes including reduced and increased care