Published: NHS guidance on integrating TEC providers into urgent community response (UCR) (UK)

January 23, 2024 | by

Filling a ‘donut hole’ gap between technology-enabled care (TEC) and emergency response by using urgent community response (UCR) organizations. A just-published NHS guidance document developed in partnership with the TSA (Technology Services Association) is designed to provide guidelines for how TEC providers can utilize local UCR organizations in situations that typically now are answered by emergency ambulance services. According to the report, ambulance services receive around 2,600 daily calls from over 200 TEC providers, approximately 3% of all calls. What if UCRs can effectively supplement this, providing timely response to these call, treating people safely at home, and reducing demand on emergency ambulance services?

The guidance provides five “Gold Standard” indicators on whether TEC providers are ready for using UCR as an option versus referring to the local ambulance service, and clear standards for operating the TEC-UCR pathway:

1. There are direct referral routes in place from locally operating [TSA] Quality Standards Framework (QSF*)-certified TEC responder services into the UCR service, which don’t rely on clinician-to-clinician referral. (*TSA’s QSF is a United Kingdom Accreditation Service (UKAS) accredited scheme for TEC providers which aligns with the standards of a regulated service.)

2. Only activity which is inappropriate for UCR response is directed to 999, with responsibility being maintained by the TEC provider until this transfer of care occurs.

3. The UCR service has open lines of communication into its locally operating QSF-certified TEC responder services, which limit the amount of rejected referrals due to capacity limitations.

4. Training on appropriate referral reasons is available to local QSF-certified TEC responder services, with the UCR service having an ‘accept all’ approach to referrals from providers who’ve completed this training.

5. Induction and refresher training for TEC to UCR pathway is co-designed and co-delivered frequently, with at least quarterly plan-do-study-act (PDSA) approaches to understand the reason for and mitigate against future rejected referrals.

For those unfamiliar with the organization of TECs in the UK, TECs can be commissioned by local governmental authorities (e.g. borough or county councils) but some are private. Some TECs are local/regional, while other providers are national.

An idea of how TEC providers can work with both UCRs and ambulance services is in Dudley in the West Midlands near Birmingham. A gauge of the volume of calls to the local ambulance service was in a six-month audit (October 2020 – April 2021) of the North West Ambulance Service. It showed that of the 3,000 calls from telecare services to the service, 32% (959) required conveyance to ED, but 45% (1,347) were seen and treated and 23% (694) ‘hear and treat’ disposition (referred elsewhere), or closed by the emergency operations centre. Once implemented, the collaboration between Dudley Telecare and local UCR teams saw the number of ambulance callouts for injured fallers reduced by 85% within a month, with response within 45 minutes. In Warrington, between Liverpool and Manchester, the 24/7 UCR service reduced pressure on ambulance services while responding in less than 60 minutes. Outcomes are positive with 80% of people remaining at home following a visit.

The guidance includes information on requirements and best practices on how to map the pathway, developing a project team, implementation, measurement, and continual reviews. TSA Voice release; NHS Guidance: web page, PDF.  Hat tip to TSA’s post on LinkedIn

CEO to CEO: TSA’s Alyson Scurfield interview with Tunstall CEO Gordon Sutherland (updated)

April 25, 2020 | by | 1 Comment

If you are following the changes at Tunstall Healthcare, TSA’s Alyson Scurfield’s talk with Gordon Sutherland has some significant news. The investment from Barings, M&G, and the lender group has been confirmed as a change of ownership. It could be inferred from the release, but was not explicit.

From Mr. Sutherland: “The change in ownership deal is now subject to several legal steps including a European Commission review regarding Competition Law. We expect to be able to address any issues and the deal to be signed in late June/July.” Checking back on the Charterhouse website, Tunstall is still categorized as an unexited portfolio company (or ‘unrealised’ in a more delicate term).

Another reveal in this conversation is a strategic statement that segments care and presumably the company’s direction into four parts, somewhat like Roman Gaul (which was three or five, depending on the history you’re reading):

  1. Reactive care: for instance an alarm bell or PERS press
  2. Proactive care: reactive plus social care and well checks
  3. Predictive care: sensor-based tracking in the home. Presumably this would be rules-based (i.e. time) on ADLs.
  4. Tunstall has added to this Cognitive Care or “Intelli-Care” which would combine presumably #2 and #3 along with other healthcare data from the user which would be analyzed to deliver social or health ‘nudges’. While in its ‘infancy’ according to Mr. Sutherland, this type of system would also detect changes in vital signs which require intervention.

#3 and especially #4 referred to as in ‘infancy’ leave this Editor puzzled. Back in 2006-9, the QuietCare system (still sold by Care Innovations) had changes in ADLs based on a normative model baselined over two weeks pretty much nailed down. There are more advanced systems such as CarePredict that take that motion and movement and have put it on a wrist-based sensor system that is now sold for individuals at home as well as in group living–with fall prediction and a PERS for good measure. Vital signs monitoring can also be done with other personal devices, watches, and smartphone/tablet reporting, but medical grade monitoring is another step further with far more complex integration.

Part 2 of the conversation will discuss what are the anticipated changes to health and social care service sectors and the proposed strategic direction of TSA. Hat tip to one of our Readers

Updated 25 April: A further snippet on how the new investment will play out at Tunstall is found on healthcare business intel provider Laing Buisson’s Care Markets website. In their view, the Barings/M&G investment will be “supporting the restructure, which will see the business recapitalised and debt reduced to £180m….” The rest is unfortunately only available to Care Markets newsletter subscribers, of which we are not. Again, no mention of Charterhouse.

If the market’s expanding, where’s the telecare and TEC boom?

September 25, 2019 | by

A question this Editor’s been asking since 2007, wondering why the rising tide of the market isn’t lifting the business boats. Adrian Scaife’s brief article on the TSA blog rhetorically asks the question and speculates on some answers. Mr. Scaife starts with the Care Technology Landscape Review’s [TTA 18 July] simple fact that growth in the UK has been flat for the past decade at 1.7m users nationally. Yet the demographics, social care dynamics, and the desire to live independently at home, enabled by more accessible and usable technology, should mean otherwise. 

Some of the reasons why are addressed in the Care Technology report: the industry’s focus on bright shiny tech, what sells to organizations versus emerging needs–and not focusing on benefits to the end users or ‘design and delight in the way the solutions look’ (the Apple paradigm). As Mr. Scaife put it, “It is perhaps not surprising consumers are currently voting with their feet!”

What might get the feet going in the other direction?  A “new generation of telecare that builds on existing services” that “delivers proactive, preventative, consumer friendly services with positive reassurance”. The difference is that this can be enabled by both “interoperable devices” (that shiny tech) but integrated with data that can provide that proactive insight. But those insights must be supported by a health and social care structure, more in place in the UK than in the US, for instance–and that may require the transformation first versus later. Why Isn’t Our TEC Industry Booming?

The King’s Fund Digital Health & Care Congress next week on 10-11 July

July 2, 2018 | by

Time has flown by since this Editor first mentioned this event and now it’s next week. This year’s meeting features case studies in creating the right culture for large scale digital change, using digital technology to improve quality of care, prevention and changing behaviors, population health informatics, tools for self-management, reducing clinical variation, mobile working in community services, and much more. Featured speakers include Matthew Swindells of NHS England, the Rt Hon Paul Burstow of TSA, Ruth Rankine of the Care Quality Commission, and more. See the agenda here for Day 1 and Day 2. (TTA’s own Charles Lowe will be chairing Breakout T2B: Quality improvement 11:45am on Tuesday 10 July.) Two very full days 10-11 July, Tuesday and Wednesday, at The King’s Fund’s London location. For more information, click the advert in the right sidebar or here. 

OnePerspective: Analogue telecare is a dead horse: stop flogging it

June 13, 2018 | by | 3 Comments

Editor’s Note: ‘OnePerspective’ articles are written by industry contributors on issues of importance to our Readers. They reflect the opinions of their authors and are archived under ‘Perspectives’.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/06/Tom-Morton-CEO.jpg” thumb_width=”150″ /]By: Tom Morton

Call failures to alarm receiving centres in the UK are rising but the reasons for this are currently the subject of hot debate.

The problem is linked to the roll out of the next generation network (NGN) replacing the UK’s analogue Public Switched Telephone Network (PSTN), a task which will be complete by 2025.

What is not debatable is that 1.7m of the most vulnerable in our society are being placed at risk as calls to alarm receiving centres (ARCs) increasingly fail or are delayed in their delivery due to incompatibilities of existing technologies.

At the Telecare Services Association (TSA) conference in November 2017, technology-enabled care services company Appello, with circa 100k telecare system users, identified a 7.5 percent call failure rate and announced the problem as “deeply worrying”.

At the same event, Communicare247 presented a report which highlighted a significant 12.3 percent spike in call failures identified by Falkirk Council. This was part of an ongoing analogue to digital assessment program operating across 12 percent of the existing Scottish telecare user base, and significantly this spike occurred in Falkirk within a short three month period. Both Falkirk Council and Appello have published their evidence of increasing call failures in a TSA whitepaper.

The TSA white paper, A Digital Future For Technology Enabled Care, highlights that the 1.7million people in the UK reliant on telecare need answers as their service is “threatened by disruption as UK telecommunications shift from analogue to digital”.

Yet the link to call failures and the rollout of NGN has been called into question by a major equipment provider. In a recent blog, they asked a very challenging question: Are network issues causing a greater number of alarm call failures?

Their answer delivered by the blog was, in essence, ‘maybe not yet’.

In a comparison between one ARC, where call failures were high versus another where they were low, the blog claimed that “while the use of NGN networks has grown in the last few years this cannot account for the increasing trend”.

As a potential compromise, the author also said that they could overcome any potential issues through the use of hybrid terminal adaptors (ATAs).

However, evidence both in the UK and Sweden plainly demonstrates call failures increase as the network switches to digital. (more…)

Rounding up more Events of Summer–plus speaker submissions closing soon!

June 7, 2018 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”150″ /]Time flies and so does your calendar! In addition to the important RSM event next Wednesday (maybe more so than the G8 Summit or the NoKo talks, but neither are introduced by Editor Charles!), here are more for your consideration.

Wednesday, 13 June: New York State Chapter’s annual miniHIMSS, “Healthcare on Broadway,” has a full day of speakers in four acts with an emphasis on healthcare advances in NY State and technology applicability. New World Stages in Manhattan starting at 8am. More information here, registration here.

Tuesday, 26 June: Mission Physician Transition into healthcare tech hosted by Health 2.0 NYC and MedStartr, 6-8 pm. More information on Meetup.

Wednesday, 27 June: Newark Venture Partners hosts their 3rd annual Demo Day for their 2018 class at Prudential Center, Newark NJ. Doors open at noon, presentations start at 1:30pm. Investors in NVP span tech, financial, and healthcare with Amazon, Prudential Financial, Dun & Bradstreet, RWJ Barnabas, Horizon BCBSNJ, TD Bank, and Panasonic. Free registration and more details here. 

Saturday, 30 June: Deadline for speaker submissions for the Connected Health Summit: Engaging Consumers on 28-30 August in San Diego.  The online form is here. TTA is a media partner of the CHS.

Tuesday-Wednesday 10-11 July: The King’s Fund Digital Health and Care Congress. More information here. TTA is an event supporter of the Congress. 

Friday 10th August: Deadline for entries/nominations for the ITEC Awards 2018, to be awarded at the TSA’s annual International Technology Enabled Care Conference 2018 16-17 October in Birmingham. The winners in five categories will be announced on 16 October during the Gala Dinner. 

The UTOPIA Project evaluation of telecare in social care report published (UK)

February 14, 2018 | by | 1 Comment

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/02/Utopia-project-report-2018.jpg” thumb_width=”150″ /]An important and comprehensive evaluation of telecare in use in UK social care has been published this past week by King’s College London. The UTOPIA Project (Using Telecare for Older People In Adult social care) surveyed local authority telecare managers (114 valid responses or 75 percent of responders) November 2016-January 2017 to find out how telecare is being used by local authority adult social care departments in England to support older people.

This study springboards from the £80m Whole System Demonstrator (WSD) and its “curious neglect” by those engaged in UK telecare. The WSD’s findings contradicted earlier research in finding that telecare did not have long-term improvement of outcomes, gauged after only 12 months. It created, in the UTOPIA’s study’s terms, a ‘policy problem’ among major stakeholders. “The WSD remains an important study and its neglect is curious. The research team wondered why the findings had been overlooked and what, if any, consequences might have flowed from this.” The study thus looks at local authority aims, how local evidence is being collected, and how telecare is operationalized and delivered.

The areas surveyed and some highlights of the findings are:

  • Use of research: 33 percent were informed by research and 47 percent were aware of but did not agree with the WSD’s findings which were negative on the long-term value of telecare.
  • Where does telecare fit in?:  “Telecare ‘fitted’ best if it was provided alongside social care (77%), to support reablement (77%), for people eligible for and funded by the adult social care department (75%) as well as for people who pay for their own care (75%).” Only 24 percent collaborated with the NHS or other partners. There was full (100 percent) agreement that telecare helps to reduce risk and promote safety and 81 percent agreement that it supports unpaid carers. 
  • Achieving strategic aims and monitoring of progress: Over half (53 percent) of respondents said their local authority was accredited to the Telecare Services Association (TSA) Codes of Practice for Telecare and Telehealth. 
  • Barriers and facilitators: Barriers mentioned were skill deficits among professionals and installers, as well as contract inflexibility with suppliers. There was also concern about the reduction of face-to-face contact and care. Access to telecare and availability of advice and support were good for both users and family carers, but levels of awareness about it were only average.
  • Financial commitment: Not surprisingly, funding is scarce and usually cobbled together from several sources including local authorities, CCGs, and users. 24 percent felt it saved money but many found it difficult to provide hard evidence.
  • What’s considered in telecare assessments?:  Nearly all (92 percent) agreed that a key assessment included the user’s ability to move around, their memory status, the person’s ability to communicate, and their daily routines. Flipping the script, “40% of respondents said that their local authority’s telecare assessment focused on what it was hoped would be achieved through using telecare.”
  • Who are the assessors, and is assessment always required?:  (more…)

Impact of IP telephony on UK telecare systems

October 24, 2017 | by | 8 Comments

The Telecare Services Association (TSA) in the UK has recently released a white paper addressing the impact of a fundamental change to the [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/connecting-people-saving-lives.jpg” thumb_width=”150″ /]UK Public Switched Telephone Network (PSTN) that is now being contemplated. This change will eventually see the replacement of the current PSTN and Integrated Services Digital Network landline networks with IP telephony (the type of phone connectivity that has been commonly used in most modern office environments for some years).

Two years ago BT, who essentially owns practically the whole of the UK PSTN, proposed that the change of their network would be completed in 2025.

This has an impact on the telecare services to the extent that many telecare alarm devices in use connect to the call centres via the PSTN and hence such devices and/or the infrastructure used by suppliers of such services will need to be upgraded when the underlying network is changed. There are, according to the TSA paper, 1.7 million users of such devices in the UK.

The TSA is essentially the UK industry body for telecare and telehealth and as such it is understandably trying to raise awareness of the need for both the commissioners and suppliers of these services to prepare for the change. This paper is said to be a result of gathering views from “key stakeholders” related to this change.

The potential impact, however, seems to be somewhat exaggerated. It should be remembered that the UK very successfully underwent another major switch-over not that long ago in 2012 – from analogue to digital TV. It required every analogue TV in the country to be either fitted with a set top box or replaced with a digital TV.

TSA also suggest that this changeover be used as an opportunity to roll out more internet based digital health functionality to end users. Of course, such functionality is already widely appearing in the form of health monitors, exercise and medication reminders etc. and are not dependent on the switch over. So it is unfortunate that the paper flips between the two topics and asserts a dependence of internet based digital services on the PSTN switch-over.

The document feels more like marketing material than a white paper with about 1/3 of it taken up by irrelevant photographs of random happy smiling or laughing (mostly older) people. It reminded me of some of the material that came out the the 3 Million Lives project. If only our elderly people living alone or in our care homes were as happy as this!

The paper is available to download here.

TSA’s International Technology-Enabled Care (ITEC) Conference 16 & 17 October 2017

September 30, 2017 | by

The TSA is holding its annual conference on 16 & 17 October – one of their key issues will be the analogue to digital phone service shift which poses huge risks and opportunities for the TEC sector. The TSA will be unveiling their white paper on the topic at the conference – a great reason to attend! 

Even if that’s not uppermost on your mind, ITEC has much to offer – from politics to health science, demographics to robotics, many factors combine to shape new models of care nationally and internationally: find out how TECS fit into the bigger picture and how the sector can flourish within this complex and uncertain landscape!

Book here.

(Disclosure, this editor is presenting at the conference on a very important topic – be sure to say hi after his presentation!)

 

The King’s Fund 2017 Digital Health Congress: videos, presentations now posted

July 25, 2017 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/07/Digital-Health-email-banner.png” thumb_width=”175″ /]The King’s Fund’s annual two-day Digital Health and Care Congress now has videos and presentation decks posted on the event page.  If you missed it, or want to see the sessions you could not attend, here’s your opportunity to review and share with staff. All the plenaries and keynotes have both video and presentations. Selected workshops/breakouts have video along with PowerPoints on nearly all, including posters. Attendance this year was between 400 and 500. On Twitter: #kfdigital17, @TheKingsFund TTA was pleased to be a marketing supporter of the 2017 conference as we have for several years. Many thanks to events coordinator Claire Taylor.

For planning ahead, The King’s Fund Annual Conference will be two days this year, 29-30 November. Early bird registration is available until 1 September and sponsorships/exhibit opportunities are open.

TSA appoints new chair

July 19, 2017 | by

Paul Shead has succeeded Andrew Gardner as Chair of TSA. He has worked closely with the TSA and its membership since the organisation’s inception, and has been on the TSA’s board of directors since May 2012. He will chair the board for the next 12 months, working to develop strategy, monitor performance and extend the organisation’s sphere of influence. Paul’s experience of the telecare industry spans more than 20 years. Currently he is Managing Director of Verklizan, supplier of the UMO telecare and telehealth monitoring platform to housing associations, local authorities and private companies in the UK.

Commenting on his appointment, Paul said: ‘Social care and health are facing unprecedented pressures. The need effectively to commission, procure and quality-assure technology enabled care (“TEC”) has never been greater. The shift of analogue to digital also presents huge opportunities and risks. The fast-changing pace of TEC means that a new audience of digital health companies is springing up alongside more traditional telecare organisations. I’m keen to ensure that TSA can support and inspire every part of the UK’s diverse technology enabled care sector. I look forward to working alongside the TSA Board, Chief Executive, President and staff to ensure that we respond effectively to challenges, make the case for TEC and work to shape future policy. We must provide our growing and diverse membership with the knowledge, intelligence and ideas to sell their products and take the sector forward.’ (more…)

North West Telecare event, 23 November

November 21, 2016 | by | 4 Comments

Wednesday 23rd November 2016, 9:15am – 4:30pm
Village Hotel Club Ashton Moss, Pamir Drive, Ashton-Under-Lyne UK (close to Ashton Moss Metrolink Station)

This is a free event for housing and healthcare professionals with a full day of workshops on telecare in supporting independent living, case studies of best practices and demonstrations of the latest products. There are four workshops which run both in the AM and PM sessions. There are also three guest speakers: Dr Malcolm Fisk, Director of the Telehealth Quality Group, De Montfort University, Leicester; Gill Drummond, Dementia Lead for Greater Manchester West Mental Health NHS Foundation Trust; Alyson Scurfield, Chief Executive of the TSA. More information and registration here. Hat tip to reader Dawn Thornber of Contour Homes. UPDATE If you have last minute difficulty booking, please contact directly Andrew.Townsend@contourhomes.co.uk

TSA’s 2016 International Technology Enabled Care Conference (UK)

September 30, 2016 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/09/TSA-logo-400×400.jpg” thumb_width=”100″ /]18-19 October, the ICC Birmingham

A reminder than in a few short weeks the annual International Technology Enabled Care Conference will take place at the International Convention Centre in Birmingham, hosting UK organizations across health, housing, home care, social care, industry and more.

The event will focus on TEC with the theme ‘Connected Care, Connected Homes and Connected Communities’, and feature a packed programme with, as they put it, “challenging debates, thought-provoking presentations, interactive workshops and brand new interactive zones to inspire, inform and drive forward sector collaboration.” The draft programme is here. Find out more at the conference’s home page and register at the full website here.  There are also a few exhibition booth stands and sponsorships left, looking at the interactive floor map, so your company may want to check here as well.

If you are a Reader and attending, please feel free to send Editor Donna your thoughts for publication on where the industry is going and what is it doing. (Please indicate if it is for attribution under your name or a nom de plume)

Put them on the calendar: autumn/winter UK health tech events

September 14, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/09/calendar.png” thumb_width=”150″ /]September means that we come back from our holidays. Those smartphone calendars come out and the gaps are filled for the last part of the year into 2017 (gasp!) Here’s our (now separate) starter list for UK.

The RSM’s Telemedicine and e-Health Section (which is chaired by our own Contributing Editor Charles Lowe, who will be updating them as usual)…Event listings here and surely more to come (All at the RSM)

Point of care testing: disruptive innovation – is the NHS ready for it yet?   22 November

Recent developments in digital health   28 Feb 2017

The King’s Fund’s upcoming meetings involving healthcare technology (All at The King’s Fund)

Designing digital services around users’ needs   6 Oct 2016
Learning from clinician and patient-centred service design

Integrated Care Summit 2016   11 Oct 2016
Improving local population health and delivering accountable care (more…)

Put them on the calendar: upcoming US IoT, connected health events (updated)

September 13, 2016 | by

September means that we come back from vacations and holidays. The calendars come out and we start to fill in the gaps for the next few months into (gasp!) 2017. Here’s a forward look through to next August for US healthcare and IoT  conferences, including International CES.

If you’re in Dallas this coming Thursday, the Health Wildcatters accelerator is premiering their new office at Pacific Place with a bash starting at 5:30pm. Reserve tickets quickly and find out more #HWGrandOpening Hat tip to Hubert Zajicek

Since TTA’s been a media supporter of Parks Associates’ Connected Health Summit for the past two years, here’s a sample of their other IoT and connected home events.

CONNECTIONS™ Europe  (Smart home, IoT and the connected consumer)
November 2-3, 2016, Amsterdam     www.connectionseurope.com

CONNECTIONS™ Summit at CES
January 5, 2017, CES, Las Vegas    www.connectionssummit.com

CONNECTIONS™: The Premier Connected Home Conference
May 23-25, 2017, San Francisco   http://www.connectionsus.com

Connected Health Summit: Engaging Consumers
August 29-31, 2017, San Diego  www.connectedhealthsummit.com

December is a big month for US conferences; three of note (and likely partners again) are:

MedStartr Momentum (MedMo16) (more…)

Catch-up: what you may have missed whilst on holiday

August 31, 2016 | by

This was the month when the UK Press seemingly finally woke up to the existence of STPs (Sustainability & Transformation Plans). This article by Derek du Preez and this in Digital Health are two one of a few that pick out the hope that digital health can help with making the NHS more sustainable. Sadly the headlines were grabbed with concern over closing hospital beds, which politicians in the UK still seem to consider to be a Bad Thing. Even though hospital beds have been reduced in most European countries over recent years, and those such as Denmark now trumpet reductions in hospital beds as progress, we have still to break the connection in people’s minds in the UK that beds are a good surrogate for health service delivery volume, (even though when pressed no individual seems keen to spend longer in hospital than absolutely necessary, or would prefer a treatment as an inpatient over treatment as an outpatient.)

Though not directly connected, the NHS offered over £100m to acute care trusts for “global digital excellence” – in line with the previous comments, perhaps the money could alternatively be spent on the UK building on its excellent primary care IT with the specific intention of moving more treatment out of hospitals…and follow that up with a proposal to put the hospital that is judged to be the least “globally digitally excellent” (more…)