ADASS blog

Joy Hollister, Children, Adults and Housing Group Director at London Borough of Havering, kick starts a new series called the Better Care blog, produced in partnership with ADASS. Here, Joy discusses the importance of evidence when developing a business case for joint health and social care funding for assistive technology.

Weighing up the benefits of better care, integrated care and telecare

Lead members are crucial in decision making. But you have to give them what they want. In my case, my lead member is really passionate about assistive technology but only if it is seen to ‘wash its face’. In other words he wanted to see the evidence for himself before committing to a large proportion of funding next year.

So, we got to work on the evaluation of our service and are extremely pleased with the results.

Our special demands

With the only hospital in London in special measures, and one of the most challenged trusts in the country, my Chief Executive chairs the tri-borough group aimed at developing a series of initiatives to keep people out of A&E. It’s no surprise we see that telecare and telehealth has a key part to play here, linked to our community treatment out-of-hours response service, and together these services prevent ambulances being called out. Issues could be related to COPD, diabetes, falls and urinary tract infections and the right mix of assistive technology could tell us if someone hasn’t eaten today, if their temperature is higher than normal or whatever it may be.

Because we’ve used telecare to support adult social care (ASC) clients in Havering for some time we didn’t want to stand still – we’ve put in significant work to increase its use by improving operational efficiency in assessing, referring, providing, installing and monitoring equipment. We have around 2,500 telecare users today with plans for a further 2,500 over the next year.

Telecare evaluation results are strong

In brief, the results of our evaluation are:

  • Robust, longitudinal analysis of three key measures – impact of assistive technology and homecare (cohort A) compared with homecare only (cohort B) on
    • general hospital admissions – cohort A less likely to be admitted after 18 months by a margin of 25%
    • hospital admissions due to falls – reduction of 44% in 2013 compared to 2011 which would convert to estimated annual savings of £2.24m (or if attributing 50% of this to assistive technology then £1.12m)
    • residential/nursing care admissions – cohort A less likely to be admitted by a margin of 6% than cohort B which would equate to an annual net saving of £937,500
  • Quality of Life greatly improved – survey indicated:
    • 97% of users agree or strongly agree that they are more secure knowing that someone would respond in an emergency
    • 80-90% of users and carers agreed that people generally “feel better” with assistive technology in place
    • 50-60% of respondents agreed that assistive technology prevents escalation to hospital or residential care

So, we’ve evidenced significant cross-sector benefits of assistive technology with homecare and we believe that we have achieved better integrated care for our older populations.

What does the future hold?

Well, Havering CCG and adult social care are working together in partnership to increase use of assistive technology and maximise benefits realisation. It really is about a partnership approach as it is no good going it alone. There is low awareness within the GP community so we have embarked upon a big stakeholder campaign as the person people trust the most outside their family circle is their GP. So we’re identifying the patients at high risk of hospital admission so we can reach them before a crisis.

I’m looking forward to the future – our robust evidence has given our lead member what he needs to sign off a significant sum of joint funding for telehealth and telecare going forward via our Better Care Fund.

Now all we have to do is keep up the good work and improve outcomes for our communities.

Read more about the Havering evaluation in this Health and Wellbeing Board paper Jan 14

Find out more about ADASS (Association of Directors of Adult Social Services)