New government guidance has been released setting out how health and care systems can ensure that people are discharged safely from hospital to the most appropriate place, and continue to receive the care and support they need after they leave hospital, now with an offer of an initial six weeks free support funding for local authorities.
Clearly an opportunity to fund Technology Enabled Care equipment and services within reablement and step down, it it is indicative that the language of proactive and preventative care models is starting to filter down into public health. Councils could make use of this funding to deliver enhanced use of enabling technology within reablement services and rapid discharge cases.
Though there were existing and established examples of hospital discharge using TEC in operation prior to Covid-19 - in Worcestershire and Cheshire and others - the pandemic has undoubtedly accelerated awareness and a drive towards a partnership approach between TEC industry organisations, CCGs and local authority, though there is still plenty of work to be done on embedding TEC within a true integrated community model.
TSA's recent release of its Sector Insight Report, From Stabilisation to Innovation: The Response and Redesign of TEC Services During Covid-19, a Department of Health and Social Care commissioned report, reveals an impressive number of evidence-based examples of agile and innovative redesign of TEC services and cross partnerships that resulted in keeping people safer during the pandemic, and better outcomes for patients, service users and the health services themselves.
The evidence within the report points to examples of proactive and preventative TEC services supporting public health services and signposting to safe alternative services to relieve statutory pressure. This in addition to swift hospital discharge employing remote monitoring for health observations to avoid readmission, reablement using assistive technology to support people to live independently following discharge and an adaptive, robust wraparound service model to support it. This can include:
Take-home mobile devices that can send an alert if someone needs help • ‘Self-install’ personal alarms posted or delivered to the door-step to reduce physical contact • Apps installed onto devices at point of discharge, encouraging self-care by helping people to monitor their own health and giving them quick, virtual access to a healthcare professional if needed • Discharge packages including medication reminders, mobile alarms and daily wellbeing calls.
A recent ADASS (Association of Directors of Adult Social Services) report that focuses on reablement into the community states that home should be the default "but there are not enough community-based services to support people at home," emphasising that the success of the home first approach is dependent on health, social care, housing and others working collaboratively, with parity between partners. Although there was no mention of technology within the report, there was strong recognition that success will be equally dependent on place-based leadership of which the TEC sector has distinctly shown during Covid-19 with exemplars such as Carmarthenshire working in partnership with Delta Wellbeing, and Hampshire alongside PA Consulting developing innovative, nimble solutions that directly address local needs.
The Government's commitment to bolster capacity in community care and step-down services, to help ensure patients can be discharged from acute hospitals at the right time for them, cannot come sooner, how far TEC is integrated into that model remains to be seen.
TSA Sector Insight Report - https://www.tsa-voice.org.uk/campaigns/download-the-tsa-sector-insight-report-2020/