Evidencing in Havering - 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 CE 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 UTI and the right mix of assistive technology could tell us if someone hasn’t eaten today, 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 a strong
In brief, the results of our evaluation are:
- Robust, longitudinal
analysis of 3 key measures – impact of AT 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 AT 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 AT in place
- 50-60% of respondents agreed that AT 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 AT 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 BCF. Now all we have to do is keep up the good work and improve outcomes for our communities.
Source: Health and Wellbeing Board paper Jan 14