Local authorities join initiative providing digital support to carers
By Integrated Care Journal
1 million carers across England are benefiting from tech-powered support, as 1 in 4 (25 per cent) local authorities across the country have joined an initiative providing essential, digital services for all those who look after loved ones in their communities over the course of this year.
Nine local authorities across Cheshire and Merseyside have become the latest to join a new initiative aiming to provide digital support to carers. The service is being delivered by carer-led digital community, Mobilise, and can be accessed remotely via Mobilise’s online hub by anyone caring for a loved one in regions where local authorities are participating in the initiative.
Under the Care Act 2014, local authorities have a duty to promote and provide services to unpaid carers in their area, to put support the wellbeing of carers and reduce the risk of carer burnout.
The digital support services include:
An online peer community of thousands of fellow carers from across the UK – with the chance to share advice and experiences through a community forum and during regular events, such as the ‘virtual cuppa’
Easy-to-use, self-service tools outlining the different forms of support which carers may be entitled to – including Carer’s Allowance – and guidance on how to navigate eligibility criteria and access various benefits
Tailor-made support guides on everything from how to balance caring with full-time work, to managing personal health and wellbeing while looking after someone else
Information on carers’ rights and relevant social care law, in line with the latest government guidance
An AI-powered ‘assistant’ is also available to help carers quickly and easily find the specific information, resources or support that they need.
Cheshire and Merseyside is home to some of the UK’s highest density areas of unpaid carers, with more than one in ten residents living in St Helens, Knowsley and Halton providing some form of unpaid care.
“It’s reassuring to know that my experience as an ‘unofficial’ carer for my husband is valued, and that there is support and advice available from Mobilise if and when I need it.”
Sheila Walsh, a carer in St. Helen’s
Chair of the Adults and Health Committee at Cheshire East Council, Councillor Jill Rhodes, said: “By joining this initiative, we’re taking a significant step towards recognising and supporting the invaluable contribution of our local carers. The Mobilise digital tool will empower unpaid carers to access the help they need, when they need it.”
Cheshire and Merseyside councils follow thirteen local authorities in the North East, who joined the same initiative earlier this year through a similar collaboration. This saw over a quarter of a million carers living in the North East alone gain access to additional digital support. The North East is home to the largest proportion of people supporting relatives or loved ones in any region across the UK.
With Cheshire and Merseyside onboard, a total of 38 local authorities across England have provided added support for carers so far this year as part of the tech-enabled initiative with Mobilise, on top of existing provision. The free on-demand services are aimed at supporting individuals across the UK with the day-to-day realities of caring.
Suzanne Bourne, Co-Founder and Head of Carer Support at Mobilise, commented: “It is amazing to see all nine local authorities across Cheshire and Merseyside coming together to harness the power of technology, and widen access to support for unpaid carers. They join many other local authorities across England in this mission. And, with Cheshire and Merseyside onboard, a quarter of all local authorities across England are now providing additional, digital support for carers. We can’t wait to see the impact for all those who provide care across Cheshire and Merseyside, and beyond.”
Councillor Del Arnall, Cabinet Member for Adult Social Care at Knowsley Council, said: “Through joining this initiative, carers in Knowsley can use Mobilise to easily access a range of support services on-demand and link in with their peers across the UK to share advice and reduce isolation.”
For more information about the support now available in Cheshire and Merseyside, see here. To start accessing support today, the Mobilise app can be downloaded via the Apple App Store or Google Play, with more information available on Mobilise’s website.
Reforming diabetes care in care homes: training, collaboration, and compassion
By Navodi Kuruppu
Navodi Kuruppu spoke with Lynne Reedman, Founder and Service Lead for DUET Diabetes, and Martin Scivier, diabetes patient and advocate, and #dedoc° member, to discuss the impact of Covid-19 on care home residents with diabetes, the importance of peer support, and the urgent need to prioritise care for vulnerable and older populations.
In 2020, the first wave of the Covid-19 pandemic had a devastating impact on care homes in England; with over 40 000 residents dying by the end of 2021, 97.8 per cent of whom were aged 65 and over. Numerous investigations and the ongoing Covid inquiry have already highlighted major shortfalls in care homes, including lack of testing and personal protective equipment (PPE) for residents and staff. [1][2]
Delivering quality care during the pandemic was an even bigger challenge for residents with long-term conditions like diabetes. A skill gap in diabetes care among staff and deficiencies in technologies resulted in a lack of clarity and coordination regarding who to contact for immediate help, which led to preventable hospital admissions and increased mortality.[3] However, these deficiencies were not the result of the pandemic, but rather pre-existing gaps in the system that the Covid-19 crisis exposed and exacerbated.
Training of staff in social care is fundamentally important says Lynne Reedman
At least one in four care home residents currently has diabetes, however, an estimated 13,500 care home residents live with undiagnosed diabetes.[4] By 2050 the number of people aged over 85 is estimated to exceed eight million in the UK, which is likely to place additional strain on the social and residential care sectors.[5]
Lynne Reedman founded DUET Diabetes in 2015 from a desire to improve the understanding and knowledge of those looking after adults with diabetes. Designed to improve the skills and confidence of carers, nurses and healthcare support workers and the standards of diabetes care they provide, DUET Diabetes seeks to address knowledge gaps that were brutally exposed during the pandemic. Lynne argues that to solve these challenges, social care must be guided by three key principles that DUET Diabetes champions: communication, collaboration and education.
The 2022 National Advisory Panel on Care Home Diabetes (NAPCHD) was established to address the root causes of inadequate diabetes treatment in care homes. Their report identified several issues, including a lack of knowledge of key principals of ethical diabetes care on the part of care home staff, diabetes care teams and social services; ethnicity-related challenges in clinical care; and the importance of residents’ emotional wellbeing – all of which led to poor management of diabetes complications.[6]
Lynne observes that many team members including nurses in care homes lack a basic knowledge of diabetes best practice, reiterating the fact that diabetes training is currently not mandatory for care home staff. She says, when you talk to [the staff], a lot of them don’t have much confidence or knowledge [of diabetes care].
Residents shouldn’t have to wait for a district nurse to come in and manage their diabetes. We need a care sector that knows and fully understands diabetes and knows how to support these people.
Lynne Reedman, Founder and Service Lead at DUET Diabetes
Lynne strongly advocates for the implementation of a basic diabetes awareness programme across the social care sector, coupled with extra training to enable staff to disseminate knowledge within their own organisations. The NHS Diabetes Prevention Programme (DPP), along with campaigns organised by Diabetes UK and other organisations around the country, has played a central role in raising awareness at both national and local levels. Lynne’s proposal is innovative, in that it considers the combined needs of diabetes and social care, with the aim of supporting an all-around prioritisation the condition that is necessary to bridge the gaps specifically found within social care. You have to treat a person as a whole in care homes, she insists, and the care has to be tailored to each resident.
The NAPCHD proposes a multi-disciplinary model, focusing on collaboration between care homes, community and specialist services, primary care, and other key stakeholders. Within this model, the resident with diabetes is placed at the centre, supported by a nurse-led facilitator from the GP-Primary Care Unit and adult social services. Local Primary Care Networks (PCNs) would play a key role in supporting this service, by deploying existing primary care nurses with diabetes experience into facilitator roles, following additional training. While funding for this model may require agreements across multiple agencies, health economic studies are anticipated to demonstrate its cost-effectiveness, showing reductions to hospital admissions, ambulance callouts, GP visits, and medication expenses.
Using insulin pens, checking expiry dates, monitoring technology devices, maintaining a good diet and level of physical activity – there is a lengthy list of a daily actions that diabetes patients must juggle. These challenges are compounded for older patients with diabetes, who may encounter more difficulty caring for themselves daily. Studies have shown that diabetes may decrease mobility and restrict activities of daily living (ADL) by approximately 50-80 per cent, with this decline becoming more pronounced with age.[7]
One important aspect that the review does not touch upon is the role of peer support in diabetes care for older patients. Whether in a care or nursing home, emotional support is just as important as physical care.
Martin Scivier, a diabetes advocate, fully recognises the power and value of peer support. Now 75, Martin was diagnosed with type 1 diabetes (T1D) in 1954. Seventy years later, he feels healthy and lucky, having experienced only a few diabetes-related complications. To give something back to the diabetes community, Martin started running his own blog, Martin Scivier’s Mellitus – Type 1 Diabetes, in 2022, documenting his journey and experiences with T1D.
When I go to the hospital for appointments, I just sit there in the corner and don’t talk to anybody, I keep myself to myself. And then I see the nurse, see the doctor, and then I go out and go home. But thanks to social media I have found this wonderful diabetes community and started to get involved. Thanks to peer support, I am not on my own
Martin Scivier, Diabetes Advocate and T1D Patient
In 2018, Martin joined social media, finding many self-help groups on Facebook, Twitter and WhatsApp, such as the #GBdoc hub. I never went to diabetes camps when I was younger, so I used to be very much on my own, recalled Martin, but now I have all these new friends. This peer support acted as a hugely important space for Martin to feel supported and comforted after his regular check-ups at the hospital.
Martin’s story is testament to the power of peer support and its capacity to provide a safe space where patients like him can find comfort in sharing their experiences, feel supported and be reassured they are not alone. Martin has an optimistic outlook on the future, which he aims to realise through his advocacy and engagement with organisations like PPP. However, he was quick to acknowledge that many others are not as fortunate as him.
Older people need and deserve more says Martin Scivier
The NAPCHD strategic document acknowledges that many care home residents are highly vulnerable, and their diabetes condition is often worsened by complications, including uncontrolled hyperglycaemia, hypoglycaemia, which can lead to eminently preventable hospital admissions. It is estimated that 75 per cent of people with diabetes die because of cardiovascular complications, many of which could be prevented.[8]We have lost too many people along the way because of complications [of diabetes], adds Martin.
However, the condition and complications are often compounded by another factor – loneliness. Age UK has reported that around 1.4 million older people often experience loneliness each year in the UK.[9] Another study has found that loneliness is a bigger risk factor for heart disease in patients with diabetes than diet, exercise, smoking and depression.[10] Loneliness can also lead to decreased daily activity, contributing to increased inflammation and blood pressure, cognitive and motor decline, anxiety and depression.[11] Healthcare systems and providers must recognise that loneliness is a significant risk factor, affecting both psychological and physiological health outcomes, as well as health-related behaviours of older adults with diabetes.[12]
Martin shares Lynne’s belief that better training leads to better care. He recalled the 2016 education model run by Benikent within Swale CCG to improve diabetes management in care homes.[13]
Through this model,unregistered practitioners in care homes were trained diabetes management to improve diabetes care and delegation of insulin, ultimately seeking to provide individualised care plans and appropriate diabetes-specific training for all staff in the care. [14] Martin argues that this proves to me 100 per cent that any training is better than no training. But compulsory training would be brilliant.
PPP’s Diabetes Care Programme seeks to bring different stakeholders to the table. Hearing the stories of patients with lived experience of diabetes, together with the perspectives of experienced professionals, makes clear the importance of person-centred diabetes care. This approach supports both the medical aspects of the condition, such as managing complications, reducing hospitalisations, and lowering mortality rates among the elderly, as well as the human elements of treating patients fairly. As described by Martin, patients deserve to be treated with dignity and respect.
An individual should be cared for with dignity and respect. Their rights should be paramount.
Martin Scivier, Diabetes Advocate and T1D Patient
To learn more about how to get involved in the 2025 Diabetes Care Programme, visit the website here.
Martin Scivier, Author and Diabetes Patient AdvocateLynne Reedman, Founder and Service Lead, DUET Diabetes
Accelerating remote monitoring innovation in social care
By Fiona Brown
With the number of people who will require at-home care set to increase, innovation to boost capacity and drive efficiencies in social care is desperately needed, writes Fiona Brown, Chief Care Officer at Lilli.
In the ever-evolving landscape of social care, the need for transformational system-wide change has become increasingly apparent. Capacity and demand are reaching a critical level, with 73 per cent of healthcare leaders saying a lack of social care capacity is having a significant impact on their ability to tackle the elective care backlog. This is where new proactive care technology emerges as a vital ally in addressing challenges like workforce shortages and access to services.
However, navigating this path to technology adoption amid a stretched workforce, bureaucratic hurdles and a lack of long-term solutions to social care capacity, presents its own set of challenges. Procurement processes, often burdened by strict and outdated internal controls, can create barriers to meaningful change. Instead of embracing a holistic approach to technology integration, these internal barriers can lead to the development of tenders with narrow specifications, overlooking the wider system impact.
Pilots, while valuable for testing and refining solutions, often fall short of achieving lasting impact due to insufficient time for advocacy or momentum building, unclear outcomes and an organisational requirement for quick financial returns. In addition, lack of early engagement with the market further complicates efforts to drive systemic change. As a result, pilot fatigue can set in across teams. To counteract this trend, there needs to be a shift towards long-term commitment to proven solutions to see real transformation.
Across the sector, central government has launched several types of competitive and highly sought-after technology funds for organisations to apply for, including the Adult Social Care Technology Fund and the Digitising Social Care Fund. Yet more recently a new type of fund has been launched directly from the technology sector. The Proactive Care Fund (PCF) aims to expedite the adoption of home monitoring technology by offering local authorities and integrated care boards (ICBs) up to £1 million of matched funds, ushering in a new era of efficiency and efficacy in care delivery.
Home monitoring technology that discreetly monitors patterns of behaviour and indicators of wellbeing has been proven to help to address many of the key challenges in the system – from staff shortages to shrinking budgets – by supporting carers to right-size care packages, keeping people living independently for longer.
The technology can empower carers to be on the front foot and proactively respond to signs of health decline before conditions become acute. Data from remote monitoring company, Lilli, for instance, shows that it can generate thousands of additional carer hours, and accelerate hospital discharge by up to 16 days. Moreover, for every £1 spent on the technology, £9 can be reallocated into the care budget.
The PCF provides the necessary support and resources for organisations to break free from the reactive delivery of care and adopt a proactive care model to explore and implement innovative technologies with confidence while realising the benefits of saving money, time and resources.
Central to this paradigm shift is the creation of a conducive procuring environment within the sector. The PCF addresses this need head-on by streamlining procurement processes and providing matched funding to alleviate financial pressures. By facilitating quick and easy access to transformative technologies, the PCF empowers organisations to embrace innovation quickly without undue burden. G Cloud contracts, committed to a minimum of 12 months, offer organisations the time and flexibility needed to realise the tangible benefits and assess the broader impact on the care ecosystem.
Last year, several organisations – including borough councils, county councils and ICBs – across the UK saw successful applications through the first PCF. These included Hillingdon Council, Medway Council, Oxfordshire County Council and North Central London ICB, who embraced the initiative to support a variety of adult social care services and enable their residents to live safely and independently.
According to the latest research, the number of people who will require publicly funded care at home in the UK is expected to grow by 36 per cent between 2024 and 2035, so it is crucial that transformation happens now to prevent further crisis in the future. The PCF represents a significant step towards accelerating the adoption of proactive models of care, while having a positive knock-on effect across the rest of the health ecosystem, reducing pressure on emergency services, reducing hospital admissions and speeding up hospital discharge. In current times, where central and local government are struggling to fund basic services, private sector initiatives, with a track record of savings and efficiencies, could prove to be part of the puzzle to help a sector in crisis.
To find out more about Lilli’s remote monitoring technology, please visit www.intelligentlilli.com.
Social care system in sustained crisis despite ‘record’ investment, report finds
By Integrated Care Journal
2023 Sector Pulse Check report describes the current situation in social care as “arguably more perilous than ever”.
Unsustainable financial and workforce pressures are forcing adult social care providers to turn down new admissions and close services, as government grants are not reaching the people who need them most, according to a new report commissioned by Care England and the learning disability charity, Hft.
Based on a large-scale survey of adult social care providers, the 2023 Sector Pulse Check report finds that despite the sector receiving a £7.5bn funding boost in Chancellor Jeremy Hunt’s 2022 Autumn Statement, there has been little progress in the key challenges facing social care.
In a statement, Care England described the current social care environment as “arguably more perilous than ever.”
Professor Martin Green OBE, Chief Executive of Care England, commented: “The narrative that social care is under pressure is not a new one. What’s disappointing is that we find ourselves in a worsening crisis amid the Government’s narrative of ‘record investment’ into the sector.
“While the Government did make substantial commitments in the 2022 Autumn Budget, the outcomes have not matched the ambition. The new money into the sector has not led to tangible change or any significant progress towards ‘fixing adult social care’.
The report highlights how headwinds facing the social care sector include rapid and dramatic energy cost increases and unfunded rises in the National Living Wage, which contributed to 40 per cent of adult social care providers ending 2023 in deficit, the report says.
Recent funding initiatives from the government, such as the Market Sustainability and Improvement Fund and the International Recruitment Fund, have failed to mitigate funding concerns for the majority of providers, the report states; 84 per cent of care providers surveyed said that these measures made no difference to their organisation’s overall financial sustainability over the past year.
This has resulted in a reduced capacity for the sector to deliver care across providers, and the report finds that:
43 per cent of providers closed services or handed back contracts;
18 per cent offered care to fewer people;
39 per cent considered exiting the market altogether.
Workforce challenges remain widespread
The findings are concerning for a sector already facing deep-rooted and systemic challenges, particularly around workforce retention and recruitment. Despite a recent rise in international recruitment, staffing shortages remain widespread across the sector, with approximately one in 10 posts vacant in 2023/23. Nearly half (44 per cent) of organisations had to turn down admissions due to a lack of staff in 2023, the report finds.
Care England’s statement argues that the government’s approach to mitigate workforce are not working, and cites the recent tightening of overseas care staff and growing concern over the state of local government finances. Hft and Care England are calling on the government to implement immediate measures to support the care sector, including improving commissioning practice, revising VAT arrangements and removing barriers to ethical international recruitment.
Professor Martin Green OBE added: “It’s clear that the way our system is funded needs a rethink. For years, adult social care providers have absorbed increased costs and inflationary pressures without corresponding funding. When money is made available it simply isn’t cutting through. Recent changes to immigration rules and an insufficient Local Government Finance Settlement this year further suggest a government that is heading in the wrong direction. The sector’s needs are now on red alert.
“Our long-term vision remains one of a sustainable sector that is financially viable and an attractive destination for staff. While this may seem a distant reality, there are a range of policies at the Government’s disposal that would help turn the tide and put us on the path towards a sustainable future. As we count down to a general election, the Government must now make good on their promise to fix our sector.”
Steve Veevers, Chief Executive of Hft, said: “It is difficult to offer words of hope and motivation when the past 12 months have seen the adult social care sector engulfed in a sustained state of crisis.
“Despite moving away from the immediate challenges posed by the COVID-19 pandemic, there has been little respite from the fundamental financial and workforce pressures that have faced our sector for many years. The fact that 43% of providers told us they closed a part of their organisation or handed back contracts last year is testament to this.
“Our report provides several realistic, practical and impactful suggestions – including reforming VAT, revisiting the new visa laws for international workers and establishment of national commissioning standards – which we shouldn’t delay in implementing if we want to see real change from the next Government.”
Speaking to ICJ at the launch event, Veevers argued that ICSs, with their remit for joining local services, present an ideal avenue through which to improve access to social care. However, in line with recommendation area four in this year’s Sector Pulse report, he stressed that social care representation on integrated care boards and integrated care partnerships needs to increase in order to adequately reform the sector.
RIVIAM Digital Care’s Hospital Discharge: ready for NHSE’s Care Traffic Control Centre roll out
By Claire Hopkins, RIVIAM Digital Care
Delayed discharge cost the NHS an estimated £1.7 billion in 2022/23. RIVIAM’s Hospital Discharge service connects third sector partners and NHS trusts with the data they need, speeding up discharge, reducing readmission rates and supporting system-wide efficiency.
In 2023, RIVIAM introduced its Hospital Discharge service which is currently being piloted at the Royal United Hospitals Bath NHS Foundation Trust (RUH). Following the pilot, the service will be available on all wards to fast-track patient hospital discharge. The service enables RUH ward teams to make patient referrals simultaneously to multiple community, housing and voluntary sector services working together using RIVIAM at the Community Wellbeing Hub (CWH) in Bath and North East Somerset.1
Staff at the RUH can then see the status of the care in real time via RIVIAM’s Care Control Dashboard. NHS England plans to expand such Care Traffic Control Centres across England to boostcapacity and improve patient flow.2 RIVIAM’s Hospital Discharge service is a ready-made digital solution to support this ambition.
The challenge
According to NHS England, there are “more than 12,000 patients every day in hospital despite being medically fit for discharge.”3 Data from The King’s Fund also suggests that discharge delays in England increased throughout 2022 and that the cost of delays in 2022/2023 was at least £1.7 billion, at a time when the NHS is pushing to find cost savings.4 For patients, being stuck in hospital when they are fit enough to leave is also upsetting.
One of the challenges with reducing delayed discharges is how to access capacity in the care system provided by social care, community, housing and voluntary sector organisations. To make and coordinate discharge dependent referrals to these services often means multiple different referral routes and phone calls – this takes time that hinders patient flow and could be better spent delivering care.
For community, housing and voluntary sector services receiving referrals, it’s hard to access the latest patient information and to co-ordinate referrals for the best follow up care.
RIVIAM’s Solution
With RIVIAM’s Hospital Discharge service, ward teams at the RUH complete an Onward Admission Referral form giving them one place to refer a patient to a wide range of available community, housing and voluntary sector services at the CWH. This includes commissioned discharge dependent services which cross local authority boundaries.
Immediately reducing admin burden, the referral process is quick and seamless. RIVIAM also auto checks the patient’s details against the NHS Spine Mini service ensuring a high level of data accuracy is captured during the referral process.
Ward teams then use a Care Control Dashboard to see in real time what’s happening regarding the care they have requested for a person. Status updates and useful information are easily accessible. Online communication reduces the need for phone calls and emails which introduce time delays to a patient’s discharge.
A view of the dashboard is also available for the 20 different partners at the CWH so staff can easily see the person’s most recent ward, their expected discharge date and the different services requested.
Integration with the hospital’s Electronic Health Record (EHR), Cerner Millennium®, means that the dashboard data is seamlessly updated in near real time providing timely visibility of this critical information.
For CWH partners, RIVIAM makes it easy to co-ordinate care for a person with each other, reducing duplication, providing efficiencies, and improving the person’s experience.
Benefits of using RIVIAM’s Hospital Discharge service:
Improves patient care and prevents readmission. People leave hospital as soon as they are medically fit with the right support in place.
Frees up beds. Patient flow of those who are Clinically Ready for Discharge is improved, relieving pressure on hospital beds.
Utilises community and voluntary sector capacity. People can recover from a hospital visit at home, with access to local services.
Increases team productivity through data-driven decision making. There is one place for ward staff to see the latest information about the community care lined up for a person, communicate with them more easily and make quick decisions about discharge.
Delivers integrated care. Health, social care and voluntary sector providers can receive, manage and co-ordinate and care delivery and communicate with hospital ward teams.
Greater system-wide efficiency. Real time integration with electronic health records (EHR) provides seamless information flows and insights to reduce time delays, duplication and enable improved care.
“The impact of this digital transformation is plain to see. For ward staff, the ability to easily make referrals to multiple organisations at the click of a button is revolutionary. However, the ability for Discharge Co-ordinators to then easily see when support has been put in place gives much more assurance that a person can return home safely. This platform is not just a tool; it’s a conduit for change, enabling us to reach those who need us most,right when they need us.” – Simon Allen, CEO, Age UK Bath and North East Somerset
To find out how RIVIAM can support your organisation via hello@riviam.com or 01225 945020.
1 The CWH uses RIVIAM’s Multi-agency Referral Hub service to receive and manage referrals in Bath and North East Somerset for 20 social care, community, housing and voluntary sector organisations.
Recommendations from the report covered enabling DHSC to ease the burden of social care providers operating in multiple ICS footprints who deal with a variety of Shared Care Record formats, the support of digital inclusion among people receiving adult social care by local authorities and mandatory basic digital training for adult social care professionals.
The government has recently announced that £600 million is to be allocated to the adult social care sector to boost winter capacity, fund a research programme to determine future policies for social care, and follow through on commitments made in the Next Steps to Put People at the Heart of Care white paper. In order to achieve these goals, DHSC should not undermine the importance of investing in digital technologies within the social care sector, which will increase efficiencies and reduce pressure on frontline staff.
Examples of this type of technology are provided by The Access Group and include Access Assure and Oysta Technology – part of their Technology Enabled Care (TEC) solutions. The Health, Support and Care division (HSC), of which Access TEC is a part, works with more than 10,000 registered care providers, more than 200 local authority departments, and 50 NHS trusts, providing technology that helps these organisations deliver more efficient and personalised care.
Access Assure is a key pioneering technology supporting the adult social care sector by allowing vulnerable individuals to live independently for as long as possible and giving their loved ones peace of mind that they are safe, even when alone in their homes.
Alex Nash founded Alcuris – now Access Assure – in 2015 following his grandfather’s diagnosis with dementia, after noticing a lack of sufficient updates on his wellbeing. He developed a digital care solution that learns the behaviours of individuals and supports their independent living, while also providing the necessary information to the relevant health and care professionals.
The platform uses insights from social alarm and smart sensor technology to enable caregivers to provide proactive care by seeing where anomalies in data could be caused by health complications. These can include notifying carers if someone hasn’t been mobile, which could be due to a potential fall, or if they haven’t been going to the toilet regularly, which may be a symptom of a urinary tract infection (UTI), which is one of the biggest causes of hospital admissions for older people in the UK.
NHS East Lothian has been using the product since 2019 to review patient data and make decisions about the care of each individual. The system has enabled them to change care packages by identifying issues such as UTIs, making their delivery of care preventive of larger issues. By connecting direct costs in care to the use of Access Assure at NHS Lothian, it can be seen that each UTI avoided, or detected early on, produces a cost avoidance of around £3,000 per event.
A 2020 white paper titled Next Generation Telecare: The evidence to date, focusing on 29 family members users using Access Assure, also showed that 83 per cent of families felt it provided increased reassurance because even when not with their loved ones, they can still support them remotely and check-in.
Across the Access Assure customer base, staff have reported significant improvements to their work experience since using the technology. Tools embedded within the system have streamlined administration processes, helping staff cut admin time from 4 hours to a few minutes per individual, releasing time to care. Local authorities can also access the data to intervene swiftly, reducing the need for emergency care and improving quality of life for individuals. When the average wait time for an ambulance is 56 minutes and each callout costs the NHS around £252, the ability to pinpoint potential health complications early with platforms like Access Assure can prove significant in alleviating current pressures on emergency care.
Plus, the Access Assure dashboard, which has been developed over the last year, allows all Access Assure devices and their data to be pulled together into a single resource. Considering the insights provided by Access Assure, the Next Generation Telecare white paper also highlighted that over 40 per cent of care plans were amended after close interrogation of the data, resulting in better care for individuals and a reduction in hospital visits. The dashboard highlights information which can be saved as a PDF so that local authorities can quickly recognise any anomalies and spot where intervention may be needed.
Using Access Assure, patients can be supported to live independently for longer, and care providers and staff are able to drive care management forward. And collectively, with Access’ other technology enabled care solution, Oysta Technology, and wider HSC portfolio of technology, health and care professionals can take a more proactive and preventative approach to person-centred and participatory care. Access TEC supports NHS, local government and registered care organisation customers wishing to ensure service-users maintain and enhance their independence and confidence, while having dignity, security, and reassurance. These solutions also prevent, reduce or delay hospital admissions or the need to access care home settings and improve the quality of life for the cared for as well as family members and informal carers so that people are supported to stay safe, happy, and healthy in the communities they call home.
Protecting the dignity of vulnerable people through technology
By Gavin Bashar
Gavin Bashar, Managing Director at Tunstall Healthcare, discusses why it’s important to protect the dignity of vulnerable people and how technology can be used to achieve this while improving health and care outcomes.
As the health and care needs of our population change, it’s important to uphold the dignity and rights of those who use health, housing and social care services. There are a number of strategies and innovations that providers can implement to help them deliver high quality services that support the dignity of vulnerable people.
Protecting the dignity of vulnerable people
As the health and care needs of our population change and the number of older people increases, it is important that service providers understand why and how care provision can play a crucial role in protecting the dignity of vulnerable people.
Dignity can be defined as the state of being worthy of honour and respect. When it comes to health, housing and social care services, this particularly focuses on being able to provide care that is tailored to meet the needs of each individual, their circumstances and wishes.
Robust and integrated systems can be well placed to deliver improved outcomes for citizens, reducing their need for emergency and more extensive care, such as hospital admission. The longer that people are able to remain independent without the need for acute services, the more their dignity and quality of life will be protected.
The role of technology
One of the prime objectives for technology-based solutions is to put people at the heart of their own health and care needs, protect their independence and dignity, and achieve citizen-focused outcomes. With the right digital frameworks in place, services can become focused on engaging each individual with their own health and care support.
When technology is embedded seamlessly into care and support services, it can be transformative, helping people to live happy, fulfilled lives in their homes and communities. Digital tools can also be used to ensure timely and appropriate responses to emergency events, encourage greater engagement from citizens, and provide more person-centred care.
Developments in the provision, scale and quality of digital technology can support improvements in how care providers are able to collaborate and provide person centred care. The UK’s transition to a digital communications network brings a once-in-a-generation opportunity to modernise, improve and shift the sector and its thinking from a reactive, to a proactive delivery model. This in turn can improve health outcomes for citizens, deliver efficiencies, and enable people to live independently for as long as possible.
Investment in digital solutions will support health and social care providers in reconfiguring services to make them more agile and integrated, leading to better outcomes. Utilising data and technology to create a connected approach can also provide actionable insights to deliver more informed, and more effective care.
Importance of collaboration
Last year saw the introduction of integrated care systems (ICSs) across the UK. ICSs should help us to integrate services effectively and drive collaboration between service providers, such as care homes, GPs and hospitals. Collaboration across sectors is essential to keep people healthy, reduce inequalities, enhance productivity and value, and support economic and social development. ICSs will play a key role in enabling us to remove silos between health and social care providers, while increased collaboration will reduce duplication and fragmentation, disseminate best practice and progress in technology.
Through collaboration we can create a truly joined up approach where we listen to citizens, understand their everyday needs and work together to bridge gaps in our services. Building on ongoing collaborations will see a system begin to emerge that is better connected and user focused. The latest generation of digital solutions broaden the circle of care to engage families, friends and communities, and promote services that are connected and data-driven.
Strong relationships between health and care providers and end users is vital to ensure users feel both respected and protected. This in turn can lead to clearer communication, giving care providers the opportunity to deliver care that is targeted to the requirements of individuals.
The workplace and a cultural shift
The digital transition is an opportunity to create a clearer and consistent approach to care delivery. Collaboration is essential but to encourage this, a cultural shift must take place. While technology has sometimes previously been viewed as an additional aspect of service delivery, embedding digital solutions into services will contribute to the successful transformation of existing care models, and provide more intelligent insight to improve health outcomes and protect the dignity of vulnerable people.
Increasing system capacity and capability, as well as providing a foundation for future technological advancement, will see health and care services more able to effectively meet the changing demands of the population. There are compelling benefits for all stakeholders when it comes to technology, particularly from an economic and operational perspective. By driving education within the health and care landscape and building on an already shifting culture, we’ll see more professionals become open to the idea of using technology and transfer their skills, knowledge and experience to the people they care for, to create a digitised world.
A dignified future for care users
As people live longer, increased pressure is put on our care services. Technology has the ability to aid the management of this and potentially reduce pressure points. If successful and integrated digital services for citizens can be realised, the benefits flow will through the health and care system. If we get our approach right, citizens can live independently for longer and have more choice and control.
As we look to a more digital future, we must consider how we can best harness the power of the connected world and the value that can come from technology solutions. By committing to investment in more technological solutions, we will reform our services, improve outcomes and place users at the centre of care to protect their dignity.
Dire state of social care sector undermined pandemic response, study finds
By Integrated Care Journal
Structural weaknesses, unaddressed by successive governments, left social care struggling to provide the service and protection that people needed during the initial waves of Covid-19.
Lack of visibility of the sector, unclear accountability, insecure funding and poor workforce pay and conditions impacted the sector’s ability to implement protective measures in a timely way, according to a new report published by the Nuffield Trust.
The report is the result of a two-year joint study between the Nuffield Trust and the London School of Economics, and looks at issues which emerged with the Covid-19 response in the social care sector in England. Focusing on the initial four months of the pandemic response (February-May 2020), it found that the fragmented nature of the system and a shortage of civil servants working on social care contributed to confusion over who was responsible for decisions and implementation in the Covid response, which, for example, undermined the effective distribution of PPE and testing for care staff.
The study also concluded that successive governments failed to respond to concerns surrounding pandemic-preparedness identified by multiple cross-government planning exercises. Amid a poor understanding of the sector and its capabilities within government, many smaller care providers were unable to effectively accommodate infection control measures and adhere to the slew of ever-changing guidance and regulation, with disastrous consequences for the nearly 20,000 care home residents who died in England and Wales in spring 2020.
Natasha Curry, Deputy Director of Policy at the Nuffield Trust, commented: “What happened to social care at the start of the pandemic represents the consequences of letting one of our most important public services languish in constant crisis for years. Those early months exposed an array of weaknesses within social care that impacted the shape, speed and effectiveness of the response. Many of these difficult challenges could have been eased had warnings been heeded. Governments of all hues have failed to make social care and those who need it a priority.”
Drawing on interviews with sector experts, workshops with social care stakeholders (including people who use care), policy documents, and literature, the report identified areas that could put social care on a more resilient footing in the future.
The report found:
The government, NHS England and Public Health England missed opportunities to prepare the sector for a pandemic, or other crises, in the years immediately before Covid-19. They excluded social care from pandemic-planning exercises such as Exercise Alice. After exercises that did include the sector, such as Operation Cygnus, action was not taken to address the problems that were identified. Once infections took hold in England, the government did not sufficiently apply pre-existing knowledge of infection spread in care settings.
There had been no dedicated director general for social care in the Department of Health and Social Care (DHSC) since 2016. No adult social care representatives sat on the Scientific Advisory Group for Emergencies (SAGE) in the opening weeks of the pandemic. This meant social care leaders felt largely invisible, despite the critical role of the sector.
The wider Covid-19 response, which was perceived to be hospital-focused at the outset, caused many issues for social care staff because the structure of the workforce and what their jobs involved were not well understood. For example, a lack of access to Covid testing and sick pay had far-reaching consequences for staff when self-isolation policies were in place, especially for those on zero hours contracts.
The long-term tendency of governments to allocate funding to social care in the form of sporadic injections of cash limited the scope for strategic investment and had implications for how robust the sector, and its infrastructure, were when entering the pandemic. Many providers of care, which are often small businesses, entered the pandemic with little or no cash reserves.
During the pandemic, the succession of emergency funding pots offered to social care initially took a long time to reach the front line, and their short-term nature prevented strategic planning. While seen as a lifeline for care providers, extensions to the funding were frequently announced with only weeks, days or in one case hours before the end of the scheme and did not allow those on the front line to spend it to meet the needs they could see.
There was a lack of data and information about who uses and provides adult social care services and how to communicate with them. Covid-19 has accelerated efforts to collect data, and this is helping to lay the foundations of a robust source of standard data.
The government did not adequately consider the fragile state and the complexity of the adult social care infrastructure, in particular residential care buildings and equipment. Small organisations, that make up much of the sector, lacked the back office capacity to interpret continually updated guidance and outdated care home buildings struggled to isolate or group together infected residents and to accommodate wider infection control measures.
There has been some positive progress in learning from these problems, with the Department of Health and Social Care (DHSC) bolstering its social care capacity and expertise and the signaling of it as a priority area with the appointment not only of a specific director general but also a chief social care nurse.
Following the first four months of the Covid-19 response, progress was made to plan for ongoing outbreaks in the short to medium term, for instance with the establishment of the social care taskforce in June 2020 and the decision to continue to provide PPE purchased centrally. The smoother subsequent rollout of vaccinations in social care settings pointed to improved collaboration between the government and social care partners, and the prioritisation of carers in the vaccination rollout was widely regarded as a positive step forward.
Adelina Comas-Herrera, report co-author from the Care Policy and Evaluation Centre at the London School of Economics and Political Science, said: “The pandemic has had a tragic impact on people who use social care and those who provide care, unpaid and paid. This has been a shared experience internationally but the evidence suggests that some countries were able to cope better than others. Our research shows that social care in England needs a system-wide reform to be able to respond not just to emergencies, but to the implications of longevity and competition for workforce with other sectors.”
Care Minister, Helen Whately, said: “During the pandemic [the government] supported social care with £2.9bn in specific Covid funding, sent out more than 230m Covid tests to care homes and prioritised social care for Covid vaccinations. We are committed to learning lessons from the pandemic and are investing up to £7.5bn over the next two years to put social care on a stronger financial footing, help reduce waiting lists and alleviate workforce pressures.”
NW ADASS issues Data Security and Protection Toolkit support for commissioners
By Integrated Care Journal
The North West Association of Directors of Adult Social Services (NW ADASS) has published guidance to support Adult Social Care (ASC) Commissioners in increasing the implementation of the Data Security and Protection Toolkit (DSPT) across the ASC market.
The DSPT is an annual self-assessment that shows care providers what they need to do to keep people’s paper or digital information safe and protect their business from the risk of a data breach or a cyber-attack. It reassures everyone they work with, as well as their clients and families, that they are taking data security seriously and supports them in running a care service that people can trust.
The initiative is supported by Better Security, Better Care, a national and local support programme that assists adult social care providers to store and share information safely and raise awareness among providers of the importance of data and cyber security. It is led by a programme board whose members include, NHS Digital, NHS England and Improvement, the Local Government Association, the Association of Directors of Adult Social Services and Digital Social Care, which acts on behalf of care providers.
The new guidance provides:
Example wording of DSPT requirements for councils to adopt and adapt as ASC contracts are revised or renewed.
Guidance on monitoring provider adherence to DSPT requirements within contracts as part of the Better Security, Better Care programme.
Michelle Corrigan, Programme Director of Better Security, Better Care, the official programme of support that helps adult social care providers store and share information safely, said: “We are delighted that NW ADASS is providing this support to commissioners. The guide will help councils encourage adult social care providers to evaluate and improve their data security, whether they be digital or paper-based, by completing their DSPT. This is one of many ways local authorities can support implementation of the DSPT among adult social care providers.”
The document is available here and has been developed with input from colleagues at Wakefield, Tameside, Lancashire, and Blackburn with Darwen Councils.
For more information, contact:
Iris Steen, Communications Lead (Better Security, Better Care), Digital Social Care
State of social care and support provision has not improved, new report suggests
By Integrated Care Journal
Care England, as a member of the Care Provider Alliance, which brings together the main national associations that represent independent and voluntary adult social care providers in England, published a report on the current state of social care in England this week.
The Care Provider Alliance (CPA) published a briefing this week, The State of the Social Care and Support Provision in England, that highlights the key issues currently afflicting the social care sector. These issues include, but are not limited to:
· The rising cost of living
· Lack of funding to Local Authorities to adequately raise fee rates for social care
· Impact of financial pressures and uncertainty
· Unmet need is unacceptably high and rising
The key message from the report is that immediate government investment into social care is needed now. Without substantial reform and investment to support that reform, achieving long-term sustainability is impossible in the current economic climate. The implication of continued governmental inaction is continued market instability. Provider failure will impact significantly on both the NHS and Local Authorities, who will be unable to commission care and support packages from providers. Lack of action now will also prevent care providers from enabling those who rely on care support to enjoy their rights to live purposeful lives, as active members of families and communities.
Professor Martin Green, Chief Executive of Care England, said: “We require a 1948 moment for adult social care to establish a long-term and sustainable future that will be to the benefit of all citizens and the economy. It is clear that the reforms introduced under the Johnson administration are a starting point but are by no means going to ‘fix social care’ and the current reform proposals may well be kicked into the long grass again.
“The sector stands ready and willing to support the delivery of a much-needed reform agenda that will deliver a clear funding strategy for social care, whilst also developing a range of careers and opportunities that will provide high-quality care and support local economic development. The health of the UK economy cannot be separated from the health of the social care sector, the two are fundamentally linked.”
The report comes after Care England accused Ofgem of predatory pricing by charging “horrendous and financially crippling rates” in an open letter. Care England, the country’s largest representative body for independent providers of adult social care in England, is calling on the government to launch an investigation into the matter.
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