Out now, the February edition of the Telecare LIN newsletter. It, together with the separate supplement, contains “over 1200 news and events links over the last month” and a reminder that if you have not registered for the ALIP showcase event in Liverpool on 5/6 March or the Healthcare Innovation Expo on 13/14 March you need to act quickly. The newsletter has more details. PDF newsletter. Links supplement. NHS reforms supplement.
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I have a scenario and a question. The answer may appear obvious and I probably should know it. The implications could be huge if the answer is one of the options I am considering. Please read and comment.
A social worker assesses somebody as needing a social alarm and Telecare and refers them to the provider. The social worker advises that there is a cost for this service and it will be (say) £4.00 per week/£208 per annum. The person is reluctant to pay this but will do so as they see there is a need for it.
As Telecare and monitoring is classed as community equipment does it fall under the Community Care (Delayed Discharges etc) Act (Qualifying Services) (England) Regulations 2003 where community equipment and Minor adaptations under £1000 (including buying and fitting) are required to be provided free of charge?
Okay I cannot answer your question but how about we make it a little more interesting? This does not apply throughout the UK but does apply in Scotland:
Under the policy of what is included as Personal Care, Community Alarms are specifically mentioned as may still be chargeable – even for those over 65 – HOWEVER personal care does include the following:
* counselling and psychological support including behaviour management and the provision of reminding and safety devices;
AND
The definition of free personal care covers physical assistance with care and help with the mental processes related to that care – eg helping someone to remember to wash.
The examples I have seen quoted as being personal care that involve telecare specifically are:
– Medication prompting
– Using night time lighting beside the bed during toilet visits to prompt the person to return to bed rather than risk wandering
– any prompting to undertake the personal care themselves
– and arguably GPS devices related to safety in the category I quote above.
So legislation stipulates that those things are considered to be personal care and that people over 65 are entitled to receive free personal care. What incentive does a local authority have to deliver these as free ‘personal care telecare supports’ when they can lump it in Community Alarm service and charge?
Appears to be open to interpretationacross the country. As I understood it the equipment element of the fee should be free but not the service (maintenance and monitoring), but as I say it will differ from place to place. Other factors that appear to have an impact would include whether the service provider is the social care authority or if they are different.
Put half a dozen people from different areas in a room together show them the legislation and prepare for many hours of fun debate!! If you accept it is equipment only, you then have to work out what element of your £4 per week relates to that and what relates to maintenance and monitoring.
Have fun.
Those with long memories may recall that a handful of local authorities across the UK provided social alarms free of charge (including monitoring and maintenance) over 15 years ago in the belief that they couldn’t charge for such a service. They subsequently accepted that they were wrong but struggled to find the political resolve to suddenly start charging people who had already been defined as vulnerable. The increased cost of providing telecare services (with extra sensors and higher standards of quality) gave most a new reason for charging.
The situation regarding community equipment remains confused but it remains the case that most kit is effectively on loan, and the value (when a couple of smokies are added) is rather more than the £100 threshold.
The threshold is £1000 – which is where the issue is – but I may be wrong on that. Age UK released a Fact sheet in January 2013 (FS42 Disability equipment and how to get it) with these two paragraphs in which appear to have a different take on it…….
‘Eligible’ equipment must be provided free of charge: The Community Care (Delayed Discharges etc) Act (Qualifying Services) (England) Regulations 2003 requires that any item of community equipment that a person is assessed as needing as a community care service, and for which the individual is eligible under the local eligibility criteria, must be provided
free of charge. This includes small, inexpensive, items of equipment, which are sometimes inappropriately charged for provision.
All minor adaptations costing £1,000 or less (which includes the cost of buying and fitting the adaptation) are also required to be provided free of charge. Councils retain the discretion to make a charge in relation to minor adaptations that cost more than £1,000 to provide.
The appearance of this is that if you are assessed as needing equipment then no matter the cost you will get it for free if you meet the required criteria. Minor adaptations is the area pointed out by Age UK as having the ‘under £1000’ tag.
This could be quite a major point seeing as it is set in law and yet has been down to interpretation (as a lot of law is until challenged). I think this could be challenged in court if the right procedures had not been followed when being assessed for services, equipment by a Local Authority and then being informed there is a charge. By definition you have been assessed as having needs and therefore shouls receive the equipment free of charge. All I need now is a definition of ‘health state monitoring’ and I will be off to become an Ambulance Chaser and use this as the NHS/LA version of PPI misselling.