Reforming Social Care will require new methods of funding and care strategies, and the Good Governance Institute has completed a study of telecare services in England.
The Government has published detailed plans of how it intends to reform adult social care. Although questions around funding remain unanswered, the reforms do present an opportunity to radically alter the way care services are delivered in England today.
Traditional care delivery methods are no longer affordable or desirable. Whilst there will always be a need for more intensive care packages and institutional care, new methods of care at home need to be properly supported by commissioners to ensure people receive the support they need.
The role of telecare services in improving the outcomes delivered and savings achieved by adult social care services is significant and well recognised. Telecare solutions, which include sensors in the home, allow older people and those with long term needs to continue to live at home whilst having access to round-the-clock support in case of difficulties or incidents.
However, despite Government commitment to increasing the uptake to telecare and telehealth services through the 3millionlives initiative, access varies greatly across the country. Existing data on telecare usage captured by the NHS Information Centre is not viewed as delivering a completely accurate picture of availability and uptake.
Summary of recommendations
1 It is vital an agreed definition of telecare is developed. The Department of Health should work with industry and local government to develop a commissioning support pack for telecare services which includes a detailed and agreed definition of what constitutes telecare.
2 As part of the zero based review of social care data, the NHS Information Centre should provide a clear definition of what constitutes telecare services so as to ensure accurate information on cost and users is recorded by local authorities.
3 Health and wellbeing boards should ensure that local commissioning plans include details of how local authorities and clinical commissioning groups intend to spend additional funding identified for integration between health and social care.
4 In developing options for a new assessment and eligibility framework for social care, the Department of Health should include telecare in an identified best practice approach. Assessment tools, such as FACE, should be incorporated into the new assessment process with telecare included in the initial assessment process.
5 Joint health and wellbeing strategies should set out the role of preventative care and technology in improving the quality of life and experience reported by users of social care services and their carers. This should be part of the duty on local authorities to incorporate preventative practice into care commissioning and planning.
6 Local authorities should review the savings delivered from telecare services and include details of how they intend to reinvest savings from telecare services into other areas of social care in their local plans for reforms. Local plans for reforms were recommended in the Department of Health's A vision for adult social care to ensure councils are making the best use of available resources.
7 The Department of Health should expedite the development of the placeholder indicator in Domain 2 of the Adult Social Care Outcomes Framework 2012/13 on reablement. This will provide a useful metric with which to measure the impact of the additional reablement funding.
8 Local authorities should publish detailed information of how they are spending additional funding being made available to them from the NHS for services aimed at promoting integration and supporting people with re-ablement following hospital discharge. Auditors should be encouraged to review whether funds from health commissioners are being transferred appropriately to social care commissioners.
9 Health and wellbeing boards should consider introducing pooled budgets for investing in telehealthcare services to promote joint commissioning and more coherent, responsive and integrated services.
10 The Department of Health should launch an outreach programme with local authorities and health and wellbeing boards to raise awareness of the 3millionlives initiative, which includes clear guidance on how commissioners can use assistive technology to support people with long-term care needs to be cared for at home.
Read the briefing: Summary briefing of Care and support at home: An audit of telecare services in England