no company logocircle

Commissioning Differently in TECS: funding models, personalisation and outcomes

In the first of the Digital Care Futures Podcast Series by University of Sheffield's Sustainable Care Programme and TEC Services Association (TSA), Carla Dix, TEC Strategy Manager at Delta Wellbeing and Rupert Lawrence, former Head of amica24 now TSA's Operations Director talk about commissioning technology enabled care differently and new models of delivery in action.

Traditionally most telecare, and now ‘technology enabled care services’ (TECS), focused on managing the risks associated with living in the community when people were older or requiring support. TECS helped people to ‘age in place’ at home when discharged from hospital or when living alone following a bereavement. These devices and services were often reactive, creating an alert in emergency situations, either relying on the person triggering an alarm or the system automaticallydetecting changes in the home environment. There is now a distinct shift in approach in the UK from reactive to proactive and preventative services. Technologies are becoming ‘smarter’ and better able to relay information captured through a wider array of sensors and ‘Internet of Things’ devices. The design of services around the technology is also developing, using data gathered in more predictive and preventative ways as well as shifting towards ‘proactive’, in-bound calling systems. There is also a growing interest in mainstream devices and the role they can play in supporting people to live well in their communities and homes.

Findings from the Sustainable Care programme research from the University of Sheffield and from the TSA’s experience of engaging with the sector highlighted examples of local authorities and councils exploring and investing in TECS for prevention, taking a proactive approach as well as being focused on the wellbeing of those receiving support. The TSA has also observed in the past 12 months a rapidly growing appetite for more proactive services, both from adult social care commissioners and also people receiving support and their carers. However, this has been met with varying levels of technical service maturity and challenges, including issues related to interoperability, workforce pressures and limited capacity for analysis of the vast amounts of data generated and evidence-based decision making.

In the recent Sustainable Care and TSA Digital Care Futures podcast, Kate Hamblin (University of Sheffield) and Nathan Downing (TSA) spoke to guests from two examples of services which take a proactive and preventative approach.

Proactive, Preventative Services: What is the ‘Barcelona model’ and how have Delta Wellbeing adapted it?

In Spain, where there is a statutory entitlement to TECS services, the Barcelona provincial council shifted from a reactive service where an alert is triggered in an emergency to proactive, in-bound calls. In Wales, Delta Wellbeing Ltd – the first local authority trading company to focus on TECS – have adapted this approach to create a person-centred, strengths-based service that uses in-bound calls and Community Wellbeing Officers to coach and mentor people to achieve outcomes they themselves have identified as important to them. The CONNECT project is guided by Social Services and Wellbeing Act which includes a wellbeing focus but also a duty to provide information, advice and assistance. The project involves an initial Wellbeing Assessment to establish what their personal priorities are and identify what level of support the person requires to live well. Alongside regular proactive calls, a 24/7 Community Responder service and Community Wellbeing Support Officers empower and coach people to help them achieve their goals and aspirations with a ‘wraparound’ service that links them to local activities and support.

“TEC is really just the facilitator in this and it isn’t actually the main focus of what we’re doing- it’s actually the additional wraparound and enhanced service that CONNECT provides that’s where the success lies”, Carla Dix, TEC Prevention Strategy Manager, Delta Wellbeing Ltd.

Benefits realisation and prevention: a key piece of the puzzle

The ability to demonstrate benefits of TECS was a challenge identified both in the Sustainable Care programme and in our podcast discussion. Benefits realisation was felt to be particularly challenging when adopting a preventative service model, but absolutely vital in creating sustainable care and health systems. There is also a need for a broader approach to outcomes that does not just focus on cost savings to also include the implications of TECS for other parts of the care ecosystem and health, as well as for individual wellbeing.

amica24 have a ‘health, independence and wellbeing outcomes tracker’, which also includes the impact of their service of wider caring networks, as former head Rupert Lawrence explained “It’s fantastic because you’re seeing what the impact of that technology enabled care package is for that person and for the people around them as well… It’s not just a focus on reducing care package costs, although that is one of the key benefits that comes out, but there’s the whole prevention piece as well. And you can calculate this- you can use insights from social workers for example to formulate that”, Rupert Lawrence, former head of amica24, now Operations Director for the TSA.

“Don’t put benefits realization in the ‘too difficult’ pile. It can’t be something we do after the fact- we can’t go back and say ‘did this really make a difference’? It has to be right up front in everyone’s thinking”, Nathan Downing (Head of Advisory Services, TSA).

About the Sustainable Care Programme

The Sustainable Care: connecting people and systems programme is a multi-disciplinary Economic and Social Research Council-funded research programme (2017-2021) exploring how care arrangements, currently ‘in crisis’ in parts of the UK, can be made sustainable and deliver wellbeing outcomes. It aims to support policy and practice actors and scholars to conceptualise sustainability in care as an issue of rights, values, ethics and justice, as well as of resource distribution. Sustainable Care is a collaborative research programme, bringing together academics from eight universities and Carers UK, and works with an extended network of national and international policy, practice and academic partners.

The authors gratefully acknowledge the support of the Economic and Social Research Council (award reference ES/P009255/1, 2017-21, Principal Investigator Sue Yeandle, University of Sheffield).

Podcast released Wednesday 17 November HERE - http://circle.group.shef.ac.uk/digitalcarefutures/

 

 

 

 

 

 

Share this page:

Partners & Associates