Essex County Council

We drew on a track record in the delivery of care technology services, wide experience in supporting public-sector organisations, and expertise in disciplines such as culture change, operational improvement, and business intelligence. Over the three-year period, we increased the number of care professionals referring patients to the service by 150 per cent, delivered financial benefits worth £6.7 million and garnered 99 per cent positive feedback from service users. We’ve also enabled Essex County Council to transform the lives of some 2,800 vulnerable people.

Key successes

• Applied an innovative approach to technology-enabled care to unlock opportunities to better support vulnerable residents
• Changed attitudes to care technology solutions among social care professionals to drive a 150 per cent increase in referrals
• Enabled the Council to support significantly more residents and to avoid some of the escalating costs of funding long-term care
• Provided the tools to track quality-of-life improvements and financial benefits to make the case for investing in service expansion

Unlocking the full potential of care technology

Care technology is life-changing for vulnerable people, providing the support and reassurance they need to live independently at home. There are important advantages for councils too, who work hard to deliver high-quality adult social care services within tight budgets. Care technology – which includes devices such as personal alarms, fall detectors, GPS trackers, robotic medication dispensers, use of consumer devices and apps in a care setting – can provide a cost-effective (and less intrusive) alternative to daily visits by care staff, delay the need for expensive residential care and allow people to rely less on family carers.

Like other councils, Essex County Council had been running a care technology service for many years, but was finding it difficult to increase take-up and realise the full benefits. Attitudes to care technology were part of the problem. With little experience of how care technology can transform lives, many social workers were reluctant to refer clients for the service.

A fragmented approach to commissioning along with mismatched charging models within the county were also preventing the Council from unlocking the full potential of care technology. In addition, the Council had no system in place for tracking the financial benefits, making it impossible to build the case for investing in expansion.

A fresh approach was needed. So, over three years, PA worked with the Council to trial and then continuously improve a new service delivery model. This pathfinder programme, which covered one quadrant of Essex, was designed to assess the potential for roll-out county-wide. Under the programme, we ran an innovative end-to-end care technology service on behalf of the Council over a three-year period.

Bringing a unique blend of expertise and experience

Having worked with some 30+ local authorities across the UK to support their care technology ambitions, we were well positioned to lead the programme. Through Argenti, our approach to delivering technology-enabled care, we have been running care technology services for Hampshire County Council since 2013, and ran them both for London Borough of Barnet 2017-2023 and Dorset Council 2019-2021. Through these three engagements, we support more than 20,000 people and their carers with high-quality care technology services.

To improve service delivery in Essex, we brought a wide range of expertise, including from our specialist partners. This included specialisms in culture change, organisational design, analytics and business intelligence, supply chain management, and operational improvement. Our partners brought world class monitoring services and outcome-focussed assessment and installation expertise. We applied this expertise in the context of our wide experience with public-sector organisations, where we work to support the delivery of high-quality public services.

Preparing to mobilise

It took us just three months to launch the new service in Essex. We implemented the tried and tested model that we use through Argenti to make this rapid start. The model provides clear and consistent processes for each stage of service delivery, so we didn’t need to design from scratch. Instead, we could focus on the specific challenges for Essex County Council and calibrate the model accordingly. For example, we worked with social care professionals to co-design a new referral form, ensuring it met their needs and helping win buy-in for the new arrangements.

We made other important preparations ahead of mobilisation. Our analytics experts worked with the Council’s finance and data teams to develop a framework to assess the financial impact of each care technology referral – vital to enabling the Council to make the case for investment. We also set up an operations board to bring together senior commissioners and social workers to make shared decisions on developing the service.

Our experts understood that it was critical to drive a change in mindset around care technology, so we ran training sessions for social workers, who are responsible for arranging support for vulnerable residents.

Ahead of the launch, we targeted training at priority teams before going on to train more than 300 health and social care professionals over the following three years. To embed the change in culture, we also ran follow-up comms. These included sharing case studies from our work demonstrating how care technology was improving quality of life for real people in Essex. We also ran annual surveys for service users and referrers to get their feedback on how well the new service model was working and get pointers for further improvements.

Key intentions to deliver more

Under the new model, PA worked with its partners to handle every aspect of service delivery – from managing the initial referrals made by social workers, to installing equipment in residents’ homes, to running a 24/7 monitoring centre, to retrieving and recycling equipment no longer needed by users.

At launch, we introduced several important operational improvements to deliver better outcomes for users, create a smooth experience for referrers and realise cost efficiencies.

For example, we began triaging all referrals to assess the potential quality-of-life benefits for each new care technology user. We also calculated the financial benefit in each case, comparing the cost of a care technology package against the cost of domiciliary support or residential care. Triage ensured that residents with the potential to benefit most had their care technology kit installed fast. It also enabled the Council to build evidence to support the financial case for investing in expansion.

We also improved processes to the point where care technology solutions are installed in residents’ homes. Instead of directing technicians to install a specific piece of kit, we ensured they were trained to holistically assess residents’ needs and capabilities in situ and identify the most suitable pieces of kit for each individual. For example, a referral might be initially for a basic personal alarm to provide reassurance and independence for the resident. However, with their new training technicians could identify other needs like potential fire hazards in the home or the need for automated reminders to ensure the resident remembers to do certain tasks. The technician would then be empowered to install other technologies to meet the residents’ needs.

This new approach meant social workers could refer based on risk, and leave it to technology experts to decide on the best technology solution. It also meant, with technology that was right for them, residents were more likely to use their care technology devices in their daily lives.

We also extended the range of response options for the monitoring centre. Before, the council-run monitoring centre had either resolved alarm calls over the phone, used a limited physical response service or, if this was not possible, had contacted the emergency services. We introduced the option to contact a local responder – perhaps a family member or neighbour. In this way, we unlocked a new (and free) resource to help the Council meet the challenge of supporting vulnerable residents.

Targeting continuous improvements

With the new service model up and running, we continued to explore opportunities to expand provision and make the benefits of care technology solutions more widely available. Over the course of the pathfinder, we introduced six new pathways – ways to get residents access to care technology. This included, for example, enabling medical professionals to refer their patients directly and supporting people that needed help with taking their medication, but didn’t have any other social care needs.

We also introduced innovative approaches to technology, utilising combinations of sensors to monitor environmental hazards such as smoke or carbon monoxide monitors, devices to prompt people to eat and drink, seizure mats to detect seizures in people suffering from epilepsy and much more. These innovations were instrumental in opening up care technology services to new groups, including young people with complex needs and older people with emerging memory and cognition needs.

The service we developed proved resilient and flexible. During 2020, when the COVID-19 pandemic was at its height, many vulnerable residents were isolating. Care technology solutions provided the ideal way to support these residents when it was dangerous for a carer or care technology assessor to enter their homes, for example using self-install kits. We successfully handled the surge in demand for services at this time, particularly for older people being discharged from hospital. 

Brilliant benefits for everyone

Over three years, PA’s work had a transformational impact on the lives of 2,800 vulnerable people – helping keep them safe in their own homes and making things easier for the spouses, partners and family members supporting them.

During this period, our 24/7 monitoring centre resolved more than 90,000 alarm activations. By providing reassurance or contacting family or neighbours to help, we reduced the demand on health resources by eliminating the need for ambulance attendances. Similarly, by completing 100 per cent of urgent installations within 48 hours, we facilitated safe and rapid discharge from hospital for more than 300 people.

Users praised the quality of our service. In surveys, 99 per cent say they would recommend the Argenti telecare service to someone else. Social care professionals were impressed too, with 96 per cent reporting that Argenti are ‘good or very good at achieving the desired outcomes’.

We succeeded in driving a shift in culture so that care technology is now embedded at the forefront of the Council’s social care offer. A better understanding of how care technology can transform lives means referral rates have grown by more than 150 per cent. By the end of the pathfinder, the service was receiving around 120 referrals a month, up from a handful each month when we began.

At the start, the Council had targeted financial benefits of £3.4 million from the new service delivery model. Over three years we delivered gross financial benefits of £6.7 million by enabling the Council to avoid costlier forms of care.