Telecare, assistive technology and telehealth.

1. Telecare, assistive technology and telehealth. South West Dementia Commissioners Network Meeting 12 January 2010

2. Objective 10 of NDS states: Considering the potential for housing support, housing related services and telecare to support people with dementia and their carers. The needs of people with dementia and their carers should be included in the development of housing options, assistive technology and telecare. As evidence emerges commissioners should consider the provision of options to prolong independent living and delay reliance on more intensive services. raising standards, improving outcomes, promoting excellence in health and care

3. And more recently… • Refinement of NDS into 4 objectives: • Early Intervention and diagnosis • Improving care in general hospitals • Prescribing rates • Care Homes and Community Support. And in addition for the SW : • QIPP, Carers, Transforming Services. raising standards, improving outcomes, promoting excellence in health and care

4. Telecare, AT and telehealth are all part of achieving some of these objectives: • Community support • Improving access to flexible and responsive community support services. • QIPP • delayed transfers of care/ LoS • Avoiding unnecessary admission • Patient and carer reported outcomes. • Carers Strategy. • Transforming Services – using the evidence base to determine service models and delivery. raising standards, improving outcomes, promoting excellence in health and care

5. Previous research indicated • Telecare activity is happening in every area – Preventative Technology Grant and ongoing work. • However, lack of coherent SW picture of dementia AT/Telecare/Telehealth activity. • Whilst included in NDS, locally delivery was variable. • Mainstreaming/bespoke ? (co-morbidities, case definition,). • Lack of leadership regionally to support local delivery. • Anecdotally, great opportunity for telecare implementation to support other strategies (Carers, QIPP) • But, lack of robust evidence to support localities in taking this forward. raising standards, improving outcomes, promoting excellence in health and care

6. Aim of project • On behalf of SWDP, to: • Further investigate current practice in Dementia AT, Telecare in localities • Investigate other SW “generic” telecare development work • Disseminate learning from localities • Inform Commissioning Practice • Method: Literature search, email contact and phone interviews with localities on current activity in dementia AT and telecare. raising standards, improving outcomes, promoting excellence in health and care

7. Findings - Key factors that promote and enhance telecare provision for people with dementia: • Local heroes. • Clear information for people with dementia and their carers • Local champions. • Training for teams (public, VCS, private) • Care pathway/ referral guidelines • Shared approach to telecare for telecare and dementia leads • Carers assessments include telecare • Marketing and promotion • Awareness of interdependence/opportunities of telecare to implementation of other activity raising standards, improving outcomes, promoting excellence in health and care

8. Implications/ reliability of findings: Part 1 • 5 areas responded. • Contact details for telecare leads. • Responses received from telecare leads. • Mainstream vs bespoke. • Case definition and demand known and not known. - needs assessment, not diagnosis triggered assessment. • AT/Telecare useful for: purposeful walking, inactivity, medication compliance and other prompts, safety and security (property exit sensors, flood alerts, bed and seat sensors, memo minders and pendants) raising standards, improving outcomes, promoting excellence in health and care

9. Implications/ reliability of findings: Part 2 • Just Checking feedback. • Low evidence base for evaluation from service users, carers and staff – area for development? WSD Cornwall, CSED business planning tool. • Telecare reduces carer stress – QIPP implications. • Financial benefits: variable but compelling. Benefits realisation. • Rural issues in dementia care • Capacity for training amongst telecare teams/leads. • Younger people with dementia and referral/access guidelines. raising standards, improving outcomes, promoting excellence in health and care

10. Findings – Other activity relating to telecare /telehealth and assistive technology in the South West and beyond. • Cornwall WSD • Supporting carers – Recognised, Valued and Supported. • Reporting Spring 2011. • Healthcare without Walls. • Health Innovation Challenge Fund. • Skills for Care Conference on Assistive technology and reablement (8th February) raising standards, improving outcomes, promoting excellence in health and care

11. Findings – Other activity relating to telecare /telehealth and assistive technology in the South West. • DH South West Telecare proposals. • DH SW Housing Lead convened a meeting for 8 local authority telecare leads to discuss proposals to mainstream telecare provision in older adults social care services – implications for people with younger onset dementia. • £100,000 budget to support delivery. • Options: • Mainstreaming telecare - CSED Reablement Business Planning Tool – 2011, 3 Local Authorities, part of CSED legacy. • Culture change, training and decision support – develop training materials on telecare. • Universal needs – developing information for staff service users and carers on benefits of telecare. • Consultation with localities, due feedback on this any day now…! raising standards, improving outcomes, promoting excellence in health and care

12. Summary/Next Steps. Report sent to SWDP for discussion. Likely further actions will result. Need to build local story and evidence base. Views, thoughts, feedback on implications for commissioners – what would really help you? raising standards, improving outcomes, promoting excellence in health and care