Presentation on theme: "Telecare in the UK home: general directions and commercial aspects for service delivery Paul Garner, BT 22/10/04."— Presentation transcript:
Telecare in the UK home: general directions and commercial aspects for service delivery Paul Garner, BT 22/10/04
Telecare definition The use of Information and Communication Technology (ICT) to support independent living for older, frail and disabled people
8 million over 65s 12 million over 65s The changing population 40% of NHS expenditure and 50% of social services expenditure is spent on people aged over 65
Type of careNo of recipients Amount purchased in 2001-02 Average cost per client per year Total cost Nursing care85,9603,580,186 weeks £19,136£1,317 million Residential care163,30011,557,035 weeks £15,836£2,861 million Community based care 925,000150,000,000 hours £1,956£1,810 million Assessment & management 1,088,300N/A£457£498 million Total1,088,300N/A£5,960£6,487 million Over £7.5B by 2026, without inflation! The Cost of Care
Less carers available 2.0 2.5 3.0 3.5 4.0 4.5 1995200520152025203520452055 Year Ratio Persons Aged 16-64 to 65+ 10 15 20 25 30 35 40 45 50 UK Long Term Healthcare Cost (£B) Support Ratio 1 UK Long Term Healthcare Cost 2 1.Office for National Statistics, 2002. 2.Royal Commission Report into Long Term Care, 1999.
National Service Framework for Older People: by 2006, an extra 100,000 people should be looked after at home Patient centric care – single assessment process Bed-blocking – over 65s cost the NHS 1.3 million bed-days each year £80M for Telecare pump priming in English LAs from 2006 (plus extra £1bn for social services) Political Drivers
There are now 1.5 million alarm support systems in the UK which use simple technology to provide support to vulnerable people... … but systems using new technology could provide much better support. 1st Generation Telecare Solutions
2 nd Generation: Telecare Pilot An automated intelligent supportive home care system using an array of environmental sensors and a broadband gateway Works with the occupant to help maintain their independence and safety.
End-to-end service Monitored residence Carer Voice call (PSTN) Liverpool Direct call centre Alert messaging Broadband Encrypted Voice call (PSTN) Monitoring data Internet Back office Managemen t interface Data server Telecare platform Firewall Messaging server Voice server Monitored residence RMU Automated Voice Call (PSTN) Broadband Encrypted
Existing/recent Telecare pilots Medway Council (Kent) –Phase 1 basic set of 7 sensors, now moving to phase 2 with fall, bed occupancy, X10 light control, bogus caller on TV plus panic link, wandering, gas shut off. Uses Tunstall kit including 869 Wireless sensors FOLD (N.Ireland) –1st gen = basic service linking family/friends 24/7. NI have 20,000 clients and 60,000 carers. 2 nd Gen = auto critical alerts, 24/7, warden/carer link. 3 rd Gen = pre-alerts, 24/7, care plan review and delivery is critical. Uses Tunstall kit as above at multiple sites. Sandwell (West Midlands) –Same equipment as above plus auto pill dispenser. Not appropriate for everyone, must be needs led, not equipment led. Now evaluation and consolidation. Kent County Council –One stop shop call centre to coordinate assistive technology packages including Tunstall kit. North Surrey and Woking PCT –Respiratory Disease telemedicine trial
Existing/recent Telecare pilots Carlisle PCT & Housing –Intermediate care pilot. Support independent living At home – rehabilitation, recovery and monitoring. Feb 02 – Mar 03 = 420 services users, 60% support early discharge, 20% prevent admissions, 20% monitor risk of falls. Average cost = £205 per week (6 weeks in hospital at £850 per week = £5.1k) Northamptonshire Safe at Home –Small pilot focused on dementia care. West Lothian Opening Doors –1900 people supported. 1200 home installations. 3364 NHS bed days saved. Warrington Housing with care –Telecare to monitor activity levels, includes flood, smoke and wandering. Columba Project (Surrey) –Linked with Imperial College and Tunstall. A re-enablement and skills gain environment for 65+ age group. 25 clients over 1 year. Telecare in a 4 bedroom housing unit and the client home. Tunstall extended kit as above plus fridge door sensor. Lifestyle monitoring and indicators of change in health and social status. Created Telecare checklist.
Existing/recent Telecare pilots Millennium Homes –Sensors and interactive voice/screens around the home. Only calls for help are transmitted outside the home. Now established the Huntleigh Research Institute at Brunel University to conduct Telecare R&D. Huntleigh have also launched the Huntleigh Insight solution. IST Vivago Wristcare –Wrist based wearable wireless monitor and alarm. Measures movement, temperature and skin conductivity. 5000 units in use across Finland, Sweden, UK, Germany, Japan, France, Ireland, Spain. 50% institutional, 50% used at home. WYMAS Respiratory Service – call centre support for asthmatics with condition control problems Salford CareCall Service – call centre support for type II diabetics with condition control problems Hanover extracare pilot –Based on Tunstall equipment.
DoH: Integrating Community Equipment Services Typical time to set up a Telecare project = 18 months – have produced getting started pack aim to reduce to 6 months. Pack includes statements on cost/benefits and advantages/disadvantages from audit commission Preventative Technology Grant - £80M to be made available from 2006 targeted at 160,000 vulnerable people. Move Telecare services from pilots and trials to mainstream delivery. E-Health and Telecare are required additional services under NHS LSP contracts NOW A showcase for emerging good practice and innovation: www.icesdoh.org
Local authority market – Telecare as a substitute for residential care Benefits to LA Reduces care costs – more services can be offered Promotes independence and client satisfaction Now Residential care costs Local Authorities on average £15,800 per client per annum Total cost - £2.8bn With telecare One third of residential care clients could become telecare clients Saving £12k per client per annum, £700m in total
Consumer market Reassurance market – typically adult children concerned about elderly parents 20% of UK population aged over 60 in 2001, rising to 30% in 2026 There is an opportunity to offer a consumer version of Telecare building on the home security and home entertainment markets 3.1 million single pensioner households 1.4 million single pensioners have no panic alarm and ABC1 children Consumer monitoring market alone worth > £150m per annum
Research - 3 rd Generation: Longitudinal trend analysis... Sense Analyse Display …combining a multiplicity of instrumented data with known human intervention to generate a sophisticated well-being indicator and assessment aid….. Other user knowledge
Centre for Care in Community Led by BT this Centre, by focusing on Telecare, aims to design and prove a system for continuous monitoring of client health and social well-being in the home.
Av Err: 12% 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 PERIOD TODAY 2 nd FALL MEDICATION CHANGE 1 st FALL PREDICTIVE REGION Well-being INDEX: 100 80 50 10 00 20 04 (Without Intervention) HISTORY REGION STAIR LIFT INSTALLED CARE INTERVENTION STARTS Major Moderate Mild NoneINTERVENTION LEVEL: Accommodation Change Medication Change Without InterventionPREDICTION TYPE: X Care Well-being Index CALCULATE OPTIMISATION: X Cost (£ per Week) X Preventative rather than reactive
Smart Homes for wellbeing Many questions still to be answered: Low cost ubiquitous sensor devices Scalable intelligent data analysis Seamless links to care records (ICRS) Privacy, ethics, usability/interfaces Standards: sensors, systems, messaging Opportunity for continuous objective measurement and support: Peace of mind for clients and carers Optimisation of home care services Timely intervention ahead of crises Government and consumer market Georgia Tech Digital Family Portrait