Editor Steve Hards frets about a dilemma for telehealth and telecare service purchasers.
Imagine that you are ‘a commissioner’ in a position to influence plans for local NHS or council spending, or you could be in a position of influence within an NHS trust, or a council.
You are acutely aware of past, current and impending funding pressures. Positive messages about telehealth and telecare technologies and their potential to facilitate changes in the way services are provided – and possibly to ease some of those funding pressures – have somehow penetrated your noisy environment.
You are reasonably convinced that services locally should ‘do something’ about it. You start convincing others. You build enough momentum to get to the point of someone drawing up a commissioning specification.
What do you put in it?
You reach agreement with local service providers about what you want to achieve in terms of service change and how much you are collectively prepared to invest on achieving those aims and over what timescale.
You now have to start specifying the competencies, qualifications and accreditations you want potential suppliers to have. Accreditations are particularly important because they are a shortcut to a significant area for due diligence, particularly in areas of technical expertise. You start to think through the options…
Option one. Limit bidders to companies on the Government Procurement Service’s (GPS) Telecare, Telehealth and Telecoaching Framework Agreement (FA).
But hang on, that’s over three years old and confining bidders to that, while an ‘easy’ route, will limit the field and exclude newer, possibly innovative companies that may have just what you require.
Also, if you have been reading Telecare Aware on the subject, you will also be wondering just whether being on the FA is any indication of good quality. There are doubts about what due diligence was done on the companies that made it through the tendering process by the original Buying Solutions (BS) organisation, which set up the FA. It was a flawed application process in which BS told tendering companies how to score well and therefore invited ‘creative’ responses.
Option two. Require Telecare Services Association (TSA) Code of Practice accreditation. If your plans include a telecare element then at least you will be certain that TSA accredited providers will work to a high standard. But the TSA’s telehealth provider accreditation will not be available until 2013. (TSA website.) You may also have a lurking concern that there may be providers who are perfectly responsible and ‘high quality’ that are not TSA accredited, because accreditation is only open to the TSA’s own members.
Option three. Alternatives to TSA accreditation? The recently-announced SSAIB UKAS-Approved Telecare Services Scheme (which started to be discussed three or four years ago) that is “run independently of any trade association, manufacturer or supplier interest” looks promising.
However, despite the claim in the press release that it is ‘prestigious’, what does it cover? In addition to the press release there is one other page on the SSAIB site and neither are particularly informative. If this scheme is a genuine alternative to the TSA accreditation one would expect a dedicated site promoting it, with full details and a general fanfare of launch publicity.
Option four. Give up worrying and fall into the reassuring arms of one of the major suppliers, particularly the market leader, Tunstall. The latter is on the FA, is TSA accredited and is the major player in the 3millionlives (3ML) initiative. It holds its market leader position by ticking commissioners’ boxes. Part of its marketing genius/leadership position is that it helps the commissioners decide what those boxes should be. And it can put out headlines such as: Tunstall Healthcare spearheads quality standards in telehealthcare. However, that press release refers to Tunstall attaining ISO/IEC 27001 certification regarding information security, not quality standards in general as you might suppose. Is it not reasonable to assume that all telecare service providers have high levels of security for users’ data? Hmm, perhaps we had better not go there!
These are not four confidence inspiring options, are they?
Ten years ago, council and NHS community equipment services (i.e. assistive technology in its general sense), with the support of the Department of Health (DH), their commercial suppliers and the industry body, the British Healthcare Trades Association (BHTA), began a process of service integration. By 2005 when the DH closed the shoe-string team that promoted the integration process, many of those services were making good progress in re-engineering themselves. DH followed that with a clumsy attempt to persuade community equipment services into the private sector. Now, it seems, the community equipment services industry has ‘come of age’.
It has taken accreditation seriously and produced a truly independent accreditation company, cleverly called CECOPS. Delving into the About Us page one finds that CECOPS is a form of social enterprise called a community interest company and it is run by some well known figures in the UK’s AT/disability field. Most importantly, the assessment process is contracted out to DNV Healthcare, a company with the credentials of working the NHS Litigation Authority for its risk management standards and with Macmillan Cancer Support.
Perhaps the time is ripe for TELECOPS?
18 October 2012
UPDATE: Please note that comments go on to two pages.