Telecare Soapbox: Challenge to Service Commissioners

In his second Soapbox item, Paul Mitchell, social services consultant and general manager of Icom Technology throws down - in the most helpful kind of way - a challenge to telecare service commissioners to up their game.

An observer could be forgiven for thinking that many commissioners purchase telecare as they would cutlery...

It seems that a basic warden call or community alarm system can be regarded as telecare, even when not linked to a Service Level Agreement-driven (SLA) call monitoring service. Tender opportunities for telecare services are advertised without any reference to desired standards, or apparent intention to discriminate on the grounds of relative performance or fitness for purpose.

Commissioners put suppliers in a difficult position

The dilemma for the supplier is whether to respond with an absolutely basic system to ensure lowest price irrespective of suitability for the probable purpose, or to bid responsibly for the supply of good quality, up-to-date equipment in the reasonable expectation of losing the competition but being able to sleep with a sound conscience.

Commissioners owe it to service users who will depend on telecare being fit for its purpose, as much as to reputable suppliers, to set out in clear detail what they expect from suppliers in the system they will choose. Not all so-called telecare equipment is the same, and some of it can be downright dangerous for users to depend upon for their safety. Furthermore, much of the older equipment in the UK will become obsolete when and if BT succeeds in rolling out its BT21CN infrastructure.

Can all commissioners identify with confidence which items, in which users’ homes, may soon be obsolete? Whether or not they can, their organisations still owe those users a duty of care to protect them from redundant equipment the users assume will protect them in the event of a fall, gas leak or fire. How proactive will suppliers be in alerting care bodies to obsolete and unreliable equipment? No doubt there would be a considerable overhead involved in working with customers to track down each and every potentially defective item. Yet this issue is concerned with the care and protection of frail and vulnerable people who are unlikely to be aware of the risks. Where is the necessary debate about how we respond as communities taking place?

Specification for the future

For the future though, we owe it to dependent users to ensure that all future telecare installations will be fit for purpose and meet minimum standards of performance. Of course, telecare should be much more than simply a communication panel and a pendant. It should be a discreet monitoring and protection service which does the best it can to ensure the safety and peace of mind of the user, their family and friends but which, incidentally, is based around technology. Sadly, too many individual installations do not link to an effective response service, and were probably not intended to replace other services which continue to be provided as if the technology were not present.

I offer 14 point specification for a telehealth care service. I’d be interested to know what others think.

• Up to date, fully compliant equipment, swapped out when it becomes obsolete
• A single ‘lifetime’ system capable of growing with the needs of the user
• A single control panel which can meet all the user’s needs (building security, telecare, telehealth, assistive technology)
• Full wireless capability so that it can move home with the user and be built around their needs, rather than the reverse
• Full maintenance, repair and replacement service
• An up to date inventory of all installed equipment with its current operational status
• In-built safety features, such as auto telephone line priority for telecare signals
• Automatic self-test and auto-report of system malfunctions
• SLA-driven monitoring and control centre service
• Control of an open alert call until confirmation of resolution of the alert
• Multi-purpose rapid response services with due priority to emergency responses
• Three-way agreements with the supplier, commissioner and end user
• Fully integrated service between the supplier, commissioner, and response services
• Telehealthcare at the centre of care pathways rather than as a bolt-on afterthought