After my (editor Steve’s) comment about ‘fairy dust’ (3millionlives: Plan B and Plan C) certain Telecare Aware readers asked where is my Plan D? It is not fully formed, but here’s the outline.
The key is to get the Department of Health (DH) to exert some monetary influence.
However, we know that in view of the savings the public sector is going to have to make over the next 5 years (£20 billion for the NHS alone) DH is not going to come up with any new funding…[read more]
More than that, because DH continues the policy of refraining from directing councils or the NHS to do anything (which is why the Preventative Technology Grant (PTG) funding 2006-08 went off half-cock [TA PTG item 2006]) it is not going to insist that councils or the NHS improve the uptake of telecare and telehealth monitoring.
This is why DH wholeheartedly supports the 3ML initiative as proposed: industry carries all the cost and DH takes none of the blame if it flops.
But DH could leverage money that is already in the system AND without telling the local organisations what to do.
Councils
Many people have forgotten that the PTG funding was an addition to the baseline funding of councils with social services responsibilities. There was an additional £30m nationally in 2006/07, which was raised by another £50m in 2007/08. Yes, people with responsibilities for telecare in councils had to fight to have it identified at the time because it was not ringfenced, and it has been spent on many other things since, but it is still there, heading for councils’ coffers next year, the year after, and forever.
DH could withhold, say, half of the PTG-related funding over each of the next 5 years, but release it pound-for-pound to each council according to how much it had spent supporting 3ML initiatives locally. In that way DH does not need to tell councils what form that support has to take and it may even make some savings if councils do not play ball. There would just have to be some check on rebranding existing plans.
How much does each council receive every year as a result of the PTG? It is set out in this spreadsheet. (.xls file – right-click and ‘Save As…’ to download)
NHS
As noted above, the NHS has to make savings of £20 billion over the life of the 3ML initiative. DH could easily leverage existing funding, again without telling NHS organisations what to do. DH could just announce that any contributions that are made to local 3ML telehealth initiatives will be discounted from the contributing organisation’s savings target. Not only that, as expenditure on telehealth is expected to produce savings, these could also be counted towards the target.
Quantifying those savings should also generate enthusiastic converts to telehealth throughout the NHS more effectively than any media campaign.
As I said, it is not a fully formed plan, but if there were a will there would be a way to effect something like this, using existing funding in the system. DH should not be endorsing an initiative that depends on the larger companies to bank roll it, one that favours the market leader, which excludes the smaller companies and which runs the risk of creating a cartel.
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