Telecare Soapbox: The Genius of Tunstall, and Close Encounters of the Hampshire Kind

Despite Tunstall’s stream of eye-glazing ‘look-at-us-the-market-leader’ press releases one has to admire the genius of its directors for maintaining the company in that position.

Being a market leader has both advantages and dangers. Strengths and weaknesses are two sides of the coin. Generally, some of the sources of failure for market leaders include…

  • Upsetting customers by taking their loyalty for granted
  • Sales people indulging in dirty tricks to get between sales leads and competitors
  • Undermining reputation by over-promising and under-delivering
  • Not being quick enough to keep up with developments in the market or in technology, allowing upstart competitors to change the paradigm under their noses
  • Failing to keep a grip on setting the market’s agenda

Whatever other shortcomings Tunstall has, it is not guilty of the last on the list. In fact that’s where its genius has been.

Take, as an example, the way that it adopted and promoted the word ‘telehealthcare’ – even claiming it as its own coining, which it was not. Telecare services in large swathes of the UK were soon adopting that term. I’ve ranted about it at length previously, so will not repeat the points here, other than to remind readers that a company has a huge advantage if it ‘owns’ the terminology that its market uses.

Now Tunstall is doing it again. This time it is with the term ‘strategic partnership’. It is genius. Why is that so? Let me illustrate with something that is going on in Hampshire.

The situation is that Hampshire (a large county in southern England) has, on its own admission, made a dismal job of promoting telecare to older people in the past ten years. I quote from a paper presented to the council last week: (paras 2.5 & 2.6 – download link later.)

“Take-up of telecare in Hampshire is currently low, with only approximately 260 service users despite a number of drives in recent years to improve take-up. Current provision is delivered through four contracted providers for preventive telecare, and spot purchasing arrangements with five providers are used for critical and substantial cases. About one third of the critical and substantial service users reside within one district of the county reflecting the uneven distribution across the county…Other Local Authorities measure deployment in the thousands.”

To their credit, the council’s officers wish to do something to improve the situation.

They make a business case for switching £10.7m spend from the domiciliary care budget over the next 5 years into telecare provision. They wish to rationalise the provision described above and, laudably, to ensure that it is possible to provide telecare free-of-charge to people assessed as having the greatest care needs.

According to the paper…

“Consultation was undertaken in early 2012 with a range of partners into the development of telecare in Hampshire and as part of the process a workshop was held with senior Adult Services managers to discuss delivery options and the preferred outcome was to appoint a contractor.” (2.8)

Fair enough, the ‘appoint a contractor’ option scored highest in the option appraisal, which you can also download later. For the moment, pay attention to what happens next.

Out of the blue, in the following paragraph, and with no sense of the timescale involved, we find that an extra option has been added and low and behold it scores even better than the contractor option. What is it?

“…The conclusion of the business case is that the department proceeds to tender for a Strategic Partner.”

The paper then goes on to explain the difference between a contractor (= implements what the council tells it to do to achieve the council’s desired outcomes) and a strategic partner (= tells the council what to do to achieve the council’s desired outcomes and does it).

In other words, the council has a history of finding telecare too difficult to manage and at the last minute has discovered a way to hand the problem off to someone else.

If the decision was approved last week (I have no information on that and, given Hampshire’s history of dilly-dallying on telecare, it may not have been) there will now be an EU tendering process for the strategic partner.

Does anyone know of any telecare companies that have set themselves up to be ‘strategic partners’ for councils? Yes, of course. There’s…um…ah, yes, Tunstall, which has appointed Jon Lowe, its ex-UK managing director, as Strategic Partnership Director. Tunstall also announced in November 2011 an arrangement with the Mears company to deliver such ‘strategic partnerships’.

Unless someone challenges the tendering process it will take until May 2013 to complete. However, for a company to have a strong shot at £10.7m is a sweet reward for clever market positioning and a little patience. Genius. Just genius!

Download links:
Decision Report: Mainstreaming Telecare in Hampshire – Business Case
Appendix to the report: Options Appraisal Grid

Categories: Soapbox.

Comments

  1. Jo

    The really interesting section here is the Options Appraisal Grid – I wonder who put that together!

    Then looks more closely at the scores – and don’t bother to look further than the top two in the Hampshire exercise – Prime Contractor and Strategic Partner.

    The Hampshire scoring has them different in only 2 sections, Scope for Innovation, and Low risk of challenge.

    Somehow, the strategic partnership option scores top marks (3)for the former while the Prime Contractor scores only one. How can that be justified when it would surely be the same organisations bidding for the work irrespective of the model chosen?

    As for the low risk of challenge scores, perhaps Telecare Aware readers can quickly show them that this was wrong too.

    Perhaps Strategic Partnerships are needed for telecare, but is there a partnership that isn’t strategic? More importantly perhaps, is there any evidence anywhere of a strategic partnership actually delivering the benefits claimed or promised? (and this is where we do need independent evaluations rather than the ones written up by tame consultants or academics funded by grants from provider organisations).

    So perhaps Hampshire will add a few more rows to their grid and include evidence, flexibility and local approach.

  2. anon

    It sounds like like Tunstall threw Hampshire a lifeline (or should that be Lifeline?) and they grabbed it. What’s wrong with that?

  3. Steve Hards, Editor

    Just in, a new, relevant press release from Tunstall entitled:

    [i]Hillingdon Council Realises Savings of £4.7m Through Mainstreamed Telecare and Reablement Services: Provision of telecare service from Tunstall dramatically transforms service delivery, halves residential care home admissions and improves reablement for residents[/i]

    Hillingdon Council’s telecare service is available free of charge to over 85s as part of a reablement package. About 5000 residents are using telecare. The Reablement Services have halved residential care home admissions and saved £4.7m for the council.

    The Corporate Director for Social Care Health and Housing is clearly pleased with the arrangement: “Our partnership with Tunstall marks a significant milestone into how we are improving the lives of Hillingdon residents.”

    (Note the language used, although, of course, someone else may have written the quote for her.)

    [url=http://ta-images.s3.amazonaws.com/images/pdfs/tunstall-hillingdon-pr-june2012.pdf]Press release PDF download here[/url]

    ADDITION 9 JULY on behalf of an anonymous reader:

    Hillingdon have not SAVED this money, they have stopped themselves spending it, merely diverting the person from services. In these days of austerity managers and commissioners want budget savings – real money that you can touch, feel and do something with, that can be taken out of budgets and redirected or used to make proper savings as part of the cuts. We do need to show how the use of telecare and technologies can provide efficiencies and better ways of working, but we also need to save from existing budgets. I doubt that Hillingdon Council have £4.7 million hanging around in their accounts, just as North Yorkshire didn’t have their £1m from the telecare interventions. Commissioners want to see real savings and free spend as well as achieving efficiencies from not incurring costs etc.

  4. At last after my banging on for the past 10 years or more to those I have worked with about [comment moderated][, someone is sticking their head above the parapet and telling it as it is!

    Preventative Technology Grant was mopped up by the suppliers due for the most part, Local Authorities too lazy or too brainwashed by their existing suppliers to look at other valid options or to think outside the box. The Whole Systems Demonstrator (if we ever find out the full outcomes) will I guess show the same. Then we have 3millionlives and finally DALLAS… Will these two initiatives end up as history repeating itself? – Call me a cynic, but as an independent AT specialist for the past 16 years, nothing surprises me any more. The ultimate losers in this are those who would benefit in their daily lives from genuine choices in the AT they are supplied with. Until the allocation of government funding for AT is made more equitable, that is never going to happen!

  5. UpNorthAndToTheRight

    Local Authorities did waste money – a lot of money. They were naive and the comissioners that were asked to lead on this had no experience in this field and there was nobody to talk to or no experience elsewhere to feed off.

    That was then and this is now.

    There is now no excuse for LAs, PCTs, CCGs or any other sets of initials to rely on the word of a very good sales team from a private company. Even if colleagues in other parts of the service have dealt with ‘these guys for years’.

    The evidence is out there; conferences, discussions, blogs, websites, tweets, events, international conferences all provide a rounded idea of what to purchase, what not to purchase and not to rely on what you purchase as being the product/service you thought you had purchased.

    Based on the Hanpshire tender proposal I would say that they have had a decent amount of input and assistance from a certain company in putting the documentation together. 6 years post PTG and it still shows that LAs still have a lot to learn.

    When people offer to help you it is not always because they want to help you; sometimes, I know it is hard to believe, they actually just want to help themselves.

    PCTs do also – one had to scrap going ahead with a multi million pound tender recently due to the ‘assistance’ certain people had when putting the tender together which was so obvious it might as well have had the ‘helpers’ logo on the top of it.

    Sharp practice, business, life – I guess you don’t get to the top without crushing others on the way. We in care tend to trust, and for that we often fail those we are entrusted to keep from harm.

  6. Steve Hards, Editor

    A reader has written to ask what is the difference between ‘strategic partnerships’ and the ‘technical partnerships’ that Tunstall was pushing in the late 1990s and early 2000s? His own answer is that in the strategic partnership case Mears is paid per installation, which is a strong incentive to find telecare customers regardless of need.

    It’s an interesting point, but companies do what they can to make money and ensure their survival. They need to do it, and we need them to survive if consumers are to have choice.

    If you read the Soapbox thinking it was about Tunstall, please read it again with the mindset that it is actually more about what goes on in commissioning organisations.

    All the commenters above (including Anon, I suspect, who may have had tongue in cheek) alluded to it, but perhaps I did not spell it out enough… This looks to me like a classic case of a council being asked to approve a decision that will lead to a tendering process that will have the invitation to tender written in a way that will favour a particular supplier. Tenders are supposed to be about level playing fields. In Telecare Aware 3 years ago I highlighted that this is not always the case. It seems that nothing has changed.

    Refresh your memory here, including the three pages of comments: [url=http://www.telecareaware.com/index.php/dirty-telecare-telehealth-market-tactics]Dirty tactics in the telecare/telehealth market (UK)[/url]

  7. Kevin Doughty

    Though we haven’t had any official telecare results yet from the Whole System Demonstrators, won’t they conclude that there will be tremendous benefits to all stakeholders (including individuals, their informal carers, the local authorities, housing associations and the NHS)if the services are delivered appropriately to the right people at the right time. Yes – I could have guessed that 5 years ago – and so could most other Telecare Aware readers.

    Hopefully, the evaluations will also give us some more information on the who, the when and the how of telecare provision. No doubt they will agree that telecare should be a preventive measure – which is entirely consistent with an early diagnosis of dementia, for example. They should also help identify the winners – probably (and hopefully) family carers at the top of the list – which perhaps will lead to a carer focus in the future. But for the “how” bit, will they really explain what they mean by appropriate and will they suggest how the system can be changed to make sure that the provision is appropriate?

    If they do, then they might well conclude that local authorities should remain the commissioners of services but that they need to be integrated with other methods of support such as adaptations to the home and the provision of community equipment (including aids to daily living) in order to maximise the benefits and the efficiencies. This would be fine for those local authorities that already have Assistive technology and telecare strategies in place, and have therefore already a road map for implementation. Dare I suggest that fewer than 25% of LAs are in this position?
    The others must either:
    1. invest heavily in their services – exceedingly difficult in the current economic climate, or
    2. join with their neighbouring authorities to produce regional telecare delivery plans, or
    3. partner private companies (or establish JVCs) where telecare is outsourced in the same way as home care, for example.

    It would seem fundamentally wrong to criticise any local authority for choosing the latter route if they are behind the game with their existing telecare and AT services. Let’s forget the claims for savings for the moment – because we know that few people believe the numbers that are being banded about – we should be looking at the outcomes. That doesn’t simply mean the number of people who are at home rather than in a care home or the size of their domiciliary care packages that they might receive; it means the success of the service in delivering to the contract specifications – because if these are drawn up in such a way that they require best practice to be applied, and for money to be paid back to the commissioner if performance targets aren’t achieved, then we have a chance of seeing the benefits of the technology right across the board.

    Of course, the local authorities (and the NHS) will have to step up their game and learn how to monitor contracts in a more active manner – but that should be part and parcel of the review process.

    My prediction is that telecare services (which will include a number of health-related activities) will be partnerships involving several organisations from the private, the public and the third sectors. That’s the only way that they can ensure that services are focused on the needs of the individual, and on local needs, but with the efficiency and cost-effectiveness that the private sector will bring to the party. We should be encouraging UK companies to do this, because that will help them to offer similar services across the world.

    To keep the playing field level, local authorities must write their own service specifications, and if they want to maximise choice for their citizens, they have the means to insist on open inventories. If they don’t want to do that, then they must accept that there are organisations out there who will hold their hands all the way to the bank!

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