david rees and robert turnbull | local government chronicle | 12 august 2015
The benefits of telecare for people receiving adult social care are well established, but there is huge potential to extend its use to patients with health needs.
Hampshire CC, the local health sector and the council’s strategic partner (the PA Consulting Group-led Argenti consortium), are responding to this opportunity by developing one of the UK’s first integrated health and social care telecare pathways for people vulnerable to falls.
Building on Hampshire CC’s pioneering approach to telecare, which has already delivered over £2m in net savings and benefits for thousands of users, the council and its partners began to explore the potential of an integrated telecare pathfinder. It assessed the impact of this approach and found it would increase patient safety and reduce post-fall care costs by up to £1,440 per service user per year.
Falls are a common cause of hospital admissions and create considerable work and expense for the health and social care economy. To address these issues, the pathfinder operates alongside the interventions already being deployed and allows repeat fallers – who are known to the NHS – to receive the telecare service.
There is clearly a demand for this approach. In any 24-hour period, Hampshire’s South Central Ambulance Service (SCAS) attends, on average, one patient every 12 minutes, many of whom are repeat fallers. A telecare service could help prevent a fall or provide an immediate response if a problem occurs, without having to call SCAS.
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The pathway and evaluation framework were agreed by the North Hampshire CCG clinical cabinet in late 2014 and work is now under way to roll it out. It focuses on integrated care teams, community therapists, acute hospital therapists and lead consultants in geriatric medicine – some of the main referrers to the service.
The implementation work addresses the three key issues that emerged from the social care project. The first is to recognise that developing and embedding a telecare pathway takes longer than expected; many stakeholders need to be engaged and they will have conflicting demands.
Second, ongoing engagement, encouragement and support will ensure it is as easy as possible for referrals to be made. Third, flexibility will guarantee all relevant referrals can be made without delay. This means mechanisms need to be in place to respond to any issues that arise and focus on continually optimising the pathway and referral process.
The Argenti telecare pathfinder has initially been commissioned for four years for 100 patients. Significant progress has already been made and there is evidence that telecare is having a positive impact on patients. The experience of the Hampshire pathfinder project demonstrates there is now a practical way to extend these benefits to a wider range of people.
David Rees is head of local government services and Robert Turnbull is an assistive technology expert at PA Consulting Group