News archive - July 2014
Telecare: The future of health and social care?
In this special report, we explore the current market for telecare devices, including personal and environmental sensors and alarms that have the potential to support vulnerable people, particularly the elderly, to live independently in their own homes for longer.
Telecare may be a relatively new buzzword, but the principles behind it have been around for decades.
In the 1970s it was relatively commonplace for people living in sheltered housing or care homes to have a pendant or chord which they could use to summon help from a warden.
Fast forward more than 40 years and this technology is now known as ‘telecare’ and has paved the way for similar, albeit more-advanced, systems that have the potential to support people to live independently in their own homes for longer.
This is particularly important as the NHS struggles to make efficiencies and reduce reliance on acute hospital services.
“Telecare has been around for a lot longer than people imagine,” said Carl Atkey, head of CarelineUK, the UK’s largest provider of emergency alarm monitoring.
“It started as pendants for social housing so that residents could summon the warden and this evolved into a series of alarm systems. Later these were linked through telephone lines. It was not about an alternative to care, but to give peace of mind to residents and their families that they could summon support if they needed to.”
Under the radar
Pretty much taken for granted in many social care settings, the future potential of these systems stayed pretty much under the radar until recently.
“Telecare used to be all about the thing you plug into the telephone line - low-cost ‘button in a box’ technology,” says Atkey. “That is now slowly moving on.”
The major drive behind this relatively recent boost was the Department of Health’s Whole System Demonstrator (WSD) initiative, the largest randomised controlled trial of telecare and the more clinically-centred telehealth ever carried out anywhere in the world.
As a result of the trial the Government announced the launch of the 3millionlives programme. This will see three million people with long-term conditions or social care needs utilising telehealth and telecare devices.
Fiona Carmichael, sales manager at Buddi, a manufacturer of mobile personal alarm systems, said: “Three years ago I had never heard of telecare and I had never thought about what vulnerable people, regardless of age, would do to remain at home for longer.
“We are living longer and that’s great, but with that comes other issues, such as how do we support people as they get older and how do we do that cost effectively. The vast majority of people want to stay in their own homes and therefore assistive technology can be an enabler.”
Having moved on from the ‘button in a box’ systems of the late 20th Century, telecare is now a huge market with new technologies regularly being launched. These can be grouped into two main categories - environmental sensors and personal sensors.
The first group of solutions monitor the environment in which a person lives, setting off alarms or summoning help should a threat arise. These technologies include sensors that can detect fire or smoke, carbon monoxide and other gases, water or flooding, and temperature changes. As well as calling for assistance, many of these systems can also automatically shut off gas or water supplies, therefore minimising the potential impact.
In addition, with the increasing prevalence of dementia, there is a new market for systems that can detect when doors have been opened and when people may have wandered or someone is at the door, including bogus caller solutions, movement detectors and door entry and video security systems.
Peace of mind
Personal devices are much more user-centric. They include epilepsy sensors that know when a patient is having an attack; fall detectors; enuresis sensors; and personal location monitoring devices such as GPS technology.
A spokesman for the the Telecare Services Association (TSA), the industry body for telecare and telehealth in Europe, said: “Telecare is as much about the philosophy of dignity and independence as it is about equipment and services.”
Around 1.7 million people in the UK are already benefiting from some form of telecare or telehealth system, but it is still a relatively young industry and the advancement of technology has until now tended to happen at a faster rate than services have changed to accommodate it.
To address this problem the TSA has developed the Telecare Code of Practice. This lays out stringent standards, not only for the individuals in receipt of services and their families and carers, but also for those who commission services, such as NHS trusts and local authorities.
The resulting document is structured into eight process modules dealing with the deployment of technologies as well as the systems themselves.
Members of the TSA can apply for accreditation to the code and there is an audit scheme run by an independent body which undertakes site inspections to verify standards.
But, despite the good intentions of 3millionlives, the widespread deployment of telecare technologies will depend largely on how the market responds to the need for cost-effective, end-to-end solutions.
Carmichael said: “Traditional telecare tends to be home based, enabling people to summon help if something goes wrong inside the home. One of the biggest changes in terms of the demand for new technologies has been for systems that can offer the same kind of support when people leave their homes.
“People want solutions that are mobile. It is not about removing the risk entirely, but much more in the future it will be about being able to better manage that risk, whether at home or outside.”
Buddi is one of a new generation of mobile technologies that uses the latest GPS satellite and mobile phone systems to pinpoint the wearer’s location and alert carers and family members.
CarelineUK, rather than creating the technology itself, is an organisation that delivers the connecting service, picking up and reporting alerts when they are triggered.
It is this end-to-end service, linking the technology itself to those who will monitor it, that the TSA’s Code of Practice aims to enhance. This may then enable the Government to realise its vision of deploying solutions on a much larger scale.
One of the organisations that has embraced telecare is Blackburn with Darwen Borough Council.
The 17th most-deprived local authority in England out of 354, it is expecting a 43% increase in the number of people aged 85 and over by 2028. The borough also has the highest rates of admission to residential care in the North West.
Working in partnership with telecare supplier, Tunstall, the council has deployed a number of devices in the homes of vulnerable people, with the result being an 18% reduction in residential care admissions, total net saving of £2.2m in one year and an increase in people signing up for services.
Carmichael said: “I believe the evidence for telecare is there and that in general it is very cost effective, but we need to create a better framework that means we are not just concentrating on smaller pilots and can instead see the potential benefits of more widespread deployment.”
Atkey added: “Rather than putting all our resources into small pilot schemes that have been going on for years, we are really looking to create a better environment for the widespread future adoption of telecare.”