This afternoon, Simon Arnold, our Chief Customer Officer, delivered a talk at the Telecare Services Association (TSA) International Telecare and Telehealth Conference in Wales. If you missed it, or want a recap, here is what Simon said in his speech, in a blog format…
Today, I’d like to cover my thoughts around supporting integrated care in the future and the role we all have in delivering that future. I am going to talk about my perspectives, the challenges we face as an industry and what we need to be doing for the future.
So let me start by being a little contentious at our TSA conference – what I see is that we have to move away from seeing technology as an end in itself. Those who love technology get hugely excited about features and protocols, product and software upgrades, product redesign. But, I would argue that this mindset is letting the end customer down – the person who is depending on us working together. One of the results is that telecare is probably the world’s best kept secret! A life-saving technology, which few people know about…
Innovation and courage is needed to take our sector forward in a transformational way. Simply speaking, what we need to do is think about the individual and their needs and outcomes – and that is something we have been collectively poor at across our sector.
So, if it’s not just about technology, what is it about? Well, it’s about enabling the provision of the right services at the right time and using technology to enable those services to be provided as effectively as possible. Anything that makes life easier and better – and also eases the burden on the public purse. And that’s how we need to start thinking across health, housing and social care. We integrate services via technology in almost every other part of our lives, so why not in supporting us as we get older?
There are, of course, challenges. We have hit a ‘perfect storm’. There is less and less money in the social care and health systems and a growing need.
- Social care is in a perilous state, forecasting a £4.3bn funding black hole by end of the decade
- And don’t forget Simon Stevens’ well-heralded and looming £30bn funding gap in NHS finances
That means rethinking how we do things – transforming the way in which we support ourselves and our loved ones as we get older – meeting the needs and life goals of people in the most modern and intuitive ways. Joining up services in a meaningful way across different providers.
Yet the context is changing for the better – NHS England’s Five Year Forward View supports what we all do and highlights:
- A strong desire to reshape care delivery, harness technology, and drive down variations in quality and safety
- The need for system efficiencies
- A future that empowers patients to take much more control over their own care
- And a focus on out-of-hospital care
Northern Ireland, Wales and Scotland have similar priorities – it all makes sense.
Everywhere, people are talking about the nirvana of integrated care – if only we could achieve this, everything would be ok! We could focus on prevention as well as cure, develop the NHS to provide the services people of today require rather than what it was originally designed for in 1948. Care and health would cease to be two silos and housing providers would be recognised as a key channel for this vision. A lovely thought!
The thing is, we all know that enabling technology can support and provide a catalyst to integration – coordinating services for the individual and improving the efficiency of delivery. The challenge does not lie in whether we can; it lies in making things real and relevant. For example, the NHS is probably the most advanced user of technology in the UK – but there is a perspective that it only considers technology for the profession, not that which can enhance the patient experience and outcome. Is that their fault or ours? After all, who needed a smart phone? And then we have the housing sector – in many ways, the poor relation of the other two and yet, for the consumer, probably the most important of all three.
Through the recent CORC (Commission on Residential Care), which was chaired by former care services minister Paul Burstow MP, I was lucky enough to be one of the eight commissioners. We found that one of the answers to ensuring that people have truly personalised packages in line with the needs and desires of each individual, lies in taking inspiration from projects where housing with care is integrating technology. Services can be transformed to ensure people maintain independence and autonomy as their needs change, by the innovative use of technology enabled care. There are some great examples already, such as in Herefordshire.
We need to create that flexibility to coordinate care around outcomes – the Better Care Fund certainly gives a platform for this and technology can be the enabler to bring services together for people.
So how do we as a TECS community provide the right services and support to help the system cope with the challenges that have been so well rehearsed?
We need to focus on enabling and supporting those things that we know are most important to the customer…
- Freedom and mobility – making the seemingly inaccessible accessible once more
- Being valued – adding to the local community rather than feeling a burden
- Independence – giving back control and an ability to manage life for themselves, such as long-term conditions
- Overcoming isolation and loneliness – and here is another example of where we like to coin pithy phrases like ‘social inclusion’ rather than describe the real issue at hand
- Peace of mind – particularly for carers
- Supporting those with dementia – our work on the Dementia Friendly Technology Charter with Alzheimer’s Society and other organisations is a topic of a workshop tomorrow morning
So, what does this all mean for enabling technology?
For me, in practical terms, this all adds up to five considerations:
- Build on the traditional platforms for the future technology context – the drive to IP for example
- Integration of services on agnostic hardware – embedding software to enable service delivery
- Bridging the gap for people’s health needs using devices and form factors that people are comfortable with – easy-to-use touch sensitive screens
- Enabling connected health and self-management with app-based capability and data sharing
- Integrating software and solutions with services to help fight the burden of loneliness
And let’s all learn from innovations in the sector elsewhere…
Enabling technology is all about integrating services for the customer and the people supporting or caring for that person. For example, in Spain the breadth of services provided via what we would call the telecare monitoring centre is huge – including befriending calls, medication support and even concierge services, such as shopping. Some of this is starting here at scale. For example, with Birmingham City Council working with The Silverline, but there is still a long way to go.
As such, we need to change our frame of reference and develop enabling technology to meet these needs and take this opportunity to make a transformational change to how health and care is delivered in this country. We have the opportunity to enable much more – but only if we can step back and think of how enabling technology can support integration, rather than the other way around!