Contact:

Caroline England Ext 7116 email: [email protected]

Julie Eden Ext 7153 email: [email protected]

4. Introduction

4.1 Telecare can be defined very simply as detectors or monitors (eg motion or falls detectors), usually linked to community alarm systems, which can trigger a warning to a control centre that can then be responded to by either named family or friends or by a response service. It includes pendant alarms, flood detectors, heat detectors and sensors. Some systems can also monitor people's activity levels.

5. Hampshire's Telecare pilots

5.1 Hampshire County Council has had an active interest in telecare for over three years. It has invested in telecare equipment, which it has piloted with a number of older people in their own homes, and has a dedicated Telecare Project Co-ordinator located in the Older People's Strategic Team.

5.2 The County Council has worked in partnership with district councils, housing providers, health, control centres and users and carers to develop its knowledge base.

5.3 Developments have been guided by the Telecare Steering Group, which has overseen the pilots, commissioned the evaluation and provided local knowledge.

5.4 Three types of telecare equipment have been piloted: the Insight system manufactured by Huntleigh, the Wisehome system manufactured by Tunstall and the Wristcare system distributed by Vivatec.

5.5 Hampshire was initially interested in the Huntleigh Insight system (originally known as Millennium Homes) which used sensors to monitor a person's activity. The information was fed to a computer, which was in turn linked to a telephone or loudspeakers which could alert the person if there was anything out of the ordinary. Unfortunately this system was not robust and Hampshire stopped using it earlier this year.

5.6 Hampshire has also evaluated the Wisehome system manufactured by Tunstall. This is a home unit with a range of personal alarms and detectors including flood detectors, gas detectors and pendant alarms.

5.7 The final system Hampshire has piloted is Wristcare, distributed by Vivatec. This is a wristband which has built-in sensors to monitor the wearer's wellbeing. It has manual and automatic alarms which can link into any alarm control centre. It also collects activity data for the person so it can be demonstrated how active someone is and how well they are sleeping. Case studies of how both this and the Tunstall system have been used can be found in Appendix 2.

6. Interim Evaluation

6.1 The Interim Evaluation of Hampshire County Council's telecare pilots was commissioned by the Telecare Steering Group in the autumn of 2003 and carried out by Carole Bennett of the Performance Monitoring Unit. A summary of it can be found at Appendix 1 and the whole report is available in the Members Room.

6.2 The Interim Evaluation gathered information from Hampshire's telecare pilots as well as mapping what equipment is available, what its uses are, locating the policy context and looking at other schemes taking place both nationally and internationally.

6.3 It found that Hampshire has so far focused on identifying suppliers of telecare and learning about the range of products available. It has also taken time to establish what the component parts are for a telecare service, including response centres, maintenance arrangements and prompt equipment provision. There have been some issues with the reliability of products and the capacity of providers, although this is not the case with all products. More time and more numbers are needed to assess the impact on service users.

7. Interim Evaluation Recommendations

7.1 The Interim Evaluation set out seven recommendations. These are to:

· Develop a telecare strategy with partners

· Use the Preventative Technologies Grant in line with the strategy

· Develop the steering group to include wider representation in line with the strategy

· Increase the evidence base by continuing to gather information for a further six months with a view to commissioning an evaluation of the experiences and outcomes for service users and carers.

· Continue to identify who will benefit from telecare, giving older people a chance to test it out.

· Raise awareness of telecare amongst staff and elected members, partners, potential users and the general public.

· Continue to participate in national and European opportunities to keep informed about wider developments in telecare and to influence policy direction to benefit the residents of Hampshire

7.2 It is proposed that these recommendations are adopted and that they set the framework for future work.

8. Preventative Technologies Grant

8.1 The Preventative Technologies Grant will be available nationally over two years from April 2006. £30m will be available in the first year and £50m in the second year. It will be allocated using the Formula Spending Share for Older People.

8.2 The Grant conditions and indicative amounts will not be released until January 2006. However, it is anticipated that Hampshire County Council will receive around £500,000 in the first year. The Department of Health has already developed supporting documents through a national Policy Collaborative, which Hampshire County Council officers have contributed to. There are therefore some clear messages about how the Grant should be used.

8.3 The aim of the Grant is to increase the number of people who can benefit from telecare services in order to help them to remain independent. The Government expects that 160,000 older people will benefit nationally, which translates to around 3,200 older people in Hampshire. It anticipates that by providing telecare equipment there will be a transformation in the design and delivery of health and social care services, although it must be stressed that there is not yet a strong evidence base for this.

8.4 The Grant is expected to be used in partnership to provide an integrated health, housing and social care service. Key partners include housing providers, health, police and fire services, equipment suppliers, the independent and voluntary sector, and users and carers.

8.5 The Grant can be used not just for equipment but also for the "hidden" costs of telecare including support costs, maintenance and information.

8.6 The Department of Health and CSCI will be developing a method of identifying the numbers of people benefiting from the telecare grant. Local authorities and partners have been advised that they may also wish to develop locally agreed targets or outcome measures.

9. Preparing for the Preventative Technologies Grant

9.1 The Preventative Technologies Grant is already a very high profile funding stream and a great deal of interest has been generated locally. Hampshire County Council will have to demonstrate how many older people have been helped so it is therefore recommended that an extra £500,000 above next year's FSS is committed for telecare equipment and infrastructure costs. Although the focus of the grant is on older people, adults who could benefit in line with the FACS (Fair Access to Care Services) principles will also be considered.

9.2 The Department of Health expects plans for the Grant to be made in partnership with housing departments, health, voluntary sector organisations, users and carers. Adult Services will begin this process by holding a workshop this autumn to establish a strategic direction.

9.3 The County Council can use the findings from the interim evaluation to develop a framework for how the Grant should be used. This will include provision for information, equipment, maintenance, assessment, staff training, commissioning, monitoring and evaluation. It will also build on work on how telecare fits in with other services including home care, ICES, Equipment Direct and the forthcoming Head of Wellbeing post. If the Grant does finish after two years then it will be vitally important that telecare is mainstreamed into existing services as tightly as possible.

9.4 An initial budget for the Grant is attached at Appendix 3. This is based on available evidence and utilises the Government's telecare documents. A number of different projects will be funded including enabling people to try out equipment through a demonstration site or sites, the extension of the use of Wristcare and the provision of support for people with dementia.

9.5 Telecare can be used as an enhancement to an assessed service, such as home care, as well as a more preventative service. The FACS criteria will be used as the basis for eligibility as it can cover both groups of people. The FACS criteria will then be used when assessing proposals for schemes to be funded by the Grant.

9.6 The telecare equipment can be either be part of a service user's care package or the service user can purchase it through a direct payment.

9.7 It is proposed that the focus of the Grant should be on telecare, rather than telehealth. However, proposals for the use of telehealth will be considered if they can be match funded by local health services.

10. Future Plans

10.1 It is not yet clear whether the Preventative Technologies Grant will continue after the two years and so it is important at this stage to consider the options for if it does come to an end.

10.2 The Department of Health expects large savings to be made through the adoption of telecare as it expects more older people to remain at home and not need residential or nursing care. It has provided two modelling tools to be used to show these savings, and this work would have to be taken into account in future plans.

10.3 If the Grant ends then there are three possible scenarios. Firstly, if savings can be demonstrated as the Department of Health predicts then the savings can fund the ongoing work.

10.4 Secondly, if savings cannot be shown then an exit strategy or scaling down of the work will have to be put in place. Telecare equipment is wireless and so can be used again and again, although it would need maintenance and upgrading. There would also be the infrastructure costs of any stand-alone project to consider, although all possible steps will be taken to integrate telecare within existing services.

10.5 Finally, if savings cannot yet be shown but it appears that future work would show success then this would identified as a cost pressure for the following year.

10.6 Once the future of the Grant is known then the work so far can be assessed against the above options. If it is decided to disinvest from the work then this would allow enough time for it to take place.

Appendix 1

Summary of Interim Telecare Evaluation

Appendix 2

Case Studies from the Telecare Pilots

Appendix 3

Draft budget for Year One of the Preventative Technologies Grant.

Section 100 D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been rel2ied upon to a material extent in the preparation of this report.

NB the list excludes:

1 Published works

2 Documents which disclose exempt or confidential information as defined in the Act

NONE

 ***

Ref/Initials/20-Sep-05