Although not named as such, both were referred to in the Chancellor’s 2007 Pre-Budget Report and Spending Review statement published yesterday. The banner phrase is “to promote greater independence and well-being in later life”, for which read, “reduce or postpone the cost of the ageing population on state resources.” (I paraphrase Paragraph 6.9, page 104) Also, the Department of Health (DH) will lead on the development of two cross-governmental Public Service Agreements (PSAs) in this area. Further, 6.8 signals a national roll-out of the Partnership for Older People’s Projects (POPPs) programme – these include strong telecare components.
Given what has come out of the Transforming Community Equipment Services project, it is interesting to see the statement signal a shift in emphasis from state provision for people who need it (as embedded in UK law, culture and expectations) to one of shared costs. “Many older people need help to prolong their independence and maintain their wellbeing, whether this is in their own home or in residential or nursing care. This help may include practical support in their daily lives and financial support from the state to pay for these services or to help with the extra costs of disability. In this, there is an underlying assumption that there is a joint financial responsibility between the Government and the individual or family.” (6.7) It may be an underlying assumption in the Treasury and DH, but it may come as a surprise to many people that this change will affect. It will be interesting to see if, when, and how, the forthcoming new Green Paper on Adult Social Care also announced this week, will lead to changes in legislation to enable this cost sharing.
Back to telecare: the strongest indication that it is firmly on the agenda is the statement “Individuals need to be supported to take control of their own care, while services need to be provided where and when they are most convenient. In the long term, increasing life expectancy and lifestyle changes pose additional challenges. Future technological developments need to be grasped to further improve [sic] the quality of life people are able to enjoy.” (D2.3, p209)
For broader takes on the Chancellor’s report, see this item by eHealthInsider and this by Community Care.
The statement itself can be viewed/downloaded from the BBC’s website.
Is telecare and telehealth monitoring doomed to Orwellian ‘Big Brother’ connotations? Yes, if this future scenario report is to be believed. A gloomy must-read! Scotland’s Sunday Herald story.
The really interesting pointers to future developments are towards the bottom of this item on wireless sensor networks.
In 2005, Masimo introduced Masimo Rainbow SET Pulse CO-Oximetry, which, for the first time, noninvasively monitors the level of carbon monoxide and methemoglobin in the blood, allowing early detection and treatment of potentially life-threatening conditions. Founded in 1989, Masimo has the mission of “Improving Patient Outcomes and Reducing Cost of Care by Taking Noninvasive Monitoring to New Sites and Applications.” Press release.
I’ve quoted the title of this item in full just to forewarn you that it is one of the most jargon-laden press releases I’ve seen for some time.
Survey of disabled people in Ireland shows, amongst other things, that “Only one in four people with disabilities use the internet, compared with a figure of nearly a half for the overall population. People with disabilities are almost half as likely as the general population to have an internet connection at home and are less likely to feel they will get one in the future. Less than 30pc are aware of assistive technologies that can help.” Item from Siliconrepublic.
The third SEN@ER Conference (Silver Economy Network of European Regions) will be held in Seville on 15 and 16 November 2007. The conference will focus on four areas: New Technology and Independence, Tourism and Culture, Nutrition, and Financial Services. Get behind the ‘EU-English’ of the conference website and you will see that this is a good European showcase with an audience of influencers with diverse interests in this field. Last year’s conference attracted 500 attendees.
The organisers are looking for speakers, sponsors and other participants – but the closing date for papers is 15 August. (Extension may be possible for people definitely interested.) Contact Margarida Colet (English speaker) by email or phone (+34 606 374138 (Mobile)) for more information on participation opportunities.
The Care Services Improvement Partnership’s telecare services site has now moved to: www.icn.csip.org.uk/telecare
Of particular interest, despite the information overload, is the presentation on Commissioning Telecare Services.
You can also access the CSIP Telecare Newsletters. In July’s edition Mike Clark has written an interesting section: Preparing for mainstreaming – overcoming implementation barriers.
Mike lists issues currently being raised by telecare services around the UK as picked up through telecare mailbox queries and network meetings. He usefully summarises the issues, risks and good practice on the following:
• Fair Access to Care Services (FACS) – which is probably reducing the numbers and types users who will benefit from telecare services.
• Business cases – lack of long term, statistically valid evidence.
• Care pathways – unlikely that existing pathways include telecare and telehealth.
• Charging – few authorities have addressed all the issues.
• Champions – difficult to get high level local champions.
• Joint and strategic commissioning – not well developed in many areas.
• Cost-benefit and cost-effectiveness – difficult to establish long term cost-effectiveness.
• Culture change – staff have not adopted telecare as a care option.
• Data sharing – no agreed protocols in place.
• Evaluation – lack of local evaluations. (Note: Interesting good practice suggestion here.)
• Funding – insufficient long term funding to mainstream telecare and telehealth.
• Health involvement – health trusts slow to engage with telecare.
• Installation and maintenance – not matching referral rates leading to delays.
• Mainstreaming and sustainability – services not ready to mainstream.
• Monitoring and response – standards and arrangements differ across service providers.
• Performance indicators and targets – performance being measured only in additional numbers of older people benefiting from services.
• Preventative approaches – lack of a broad view.
• Projects and pilots – many have not yet moved out of piloting mentality.
• Protocols – care pathways and protocols not in place.
• Referrals – poor demand forecast.
• Workforce – workforce issues for full implementation and mainstreaming.
Screening as many news items as I do for inclusion in Telecare Aware I constantly see a variety of terms used inappropriately to describe older people. At last someone has taken up the cause and written about it in an entertaining and informative way. From the Christian Science Monitor.
Get past the first few paragraphs of this press release to find a description of developments in bringing telemedicine technology to ambulances in the USA and comments on the US context of health monitoring.
Two stories on this topic:
1) Through Assistive Technology to Employment (TATE) is a European Social Fund Equal project. There’s a great website – see how they have presented the information for people with learning disabilities, using Widgit Ltd. software symbols. There are 18 project partners listed on the site:
Becta
Brandon Trust
CTAD
Carers UK
City & Guilds
Cornwall Adult Social Care
Granada Learning
Home Farm Trust
Inclusive Technology
Oxfordshire Social Community Services
Portland College
Right Employment
The Rix Centre
Social Care Institute for Excellence
SRS Technology
University of Kent – European Institute of Social Services
Disabled Living Foundation
Valuing People
But, according to Tunstall’s PR company, it’s all about…
2) Assistive technology could improve the quality of life of people with learning difficulties, but “entrenched attitudes” are limiting its use, according to Gadgets, Gizmos and Gaining Independence the report by Advance UK, launched on Monday. (But where is it on Advance UK’s website? UPDATE: Link in comment). Community Care provides the story.
The SC-1 features 440lb (31 stone) capacity, motion tolerance that provides correct readings even when patients are unable to stand still, and audible cues that allow use of the scale without the need to reach down to the floor. Sounds good.
Nice item from E-Health Insider. Includes links to recent Kent and West Lothian reports.