How telecare can defuse chronic conditions timebomb

Walsall is making telecare a default component of care packages to boost independence for people with chronic conditions and manage the rising costs of supporting this group, says council adult social care and inclusion director Paul Davies (pictured).

The challenge

Walsall has approximately 37,000 patients with long-term conditions of whom 3,300 created 4,000 emergency hospital admissions in 2009-10, at a cost of £12.9m.

Combined with improved life expectancy, the increasing number of people living with long-term conditions means local health resources will continue to grow at an unsustainable rate. Walsall Council and NHS Walsall wanted to find a solution that would meet these growing needs and support people in living fulfilled lives, whilst making the best use of local resources.

In the past, money has been used ineffectively through providing labour-intensive, inappropriate and low-quality care services to people who didn’t benefit from them.

By providing clients with telehealth and telecare as standard, we hope to allow people to live independently for as long as possible, safe in the knowledge that help is at hand whenever necessary.

The project

Our decision follows a pilot involving the monitoring of patients with chronic obstructive pulmonary disease, in partnership with telehealth and telecare provider Tunstall.

Patient selection was predominately the responsibility of community matrons, who selected patients based on their suitability for the project.

Patients were placed on monitors that measured their heart rate, blood pressure, oxygen saturation and weight. The data were then sent through a secure line to the triage station, where specialists reviewed it for any abnormalities. When the vital signs fell outside set parameters, the community matrons were informed, preventing or delaying unnecessary hospital admissions.

Universal offer

Following the pilot, we decided to provide telecare as the default component of every care package. It is not just open to people who are assessed eligible for community care services but others who would benefit from a preventive service.

Service users are provided with a telecare package that includes a range of sensors suitable to their individual needs. The sensors, including bed sensors, smoke and fire detectors and flood sensors, send out alerts either automatically or at the press of a button, to a response centre where operators are on hand to advise the resident on the best course of action, or call emergency services in times of need.

The service can be particuarly beneficial for people with dementia, or those at high risk of fire or bogus calls, who can have access to support 24 hours a day.

Case study

Gentleman B lives in one of Walsall’s extra care schemes with his wife of 63 years, where they have been settled and happy for many years. However, when he developed dementia and began wandering out of his flat during the night, a great deal of stress was placed on him and his wife.

A telecare package incorporating a door exit sensor was discussed with the couple, their support team and their family and they decided to give the technology a go with tremendous results. The telecare package has allowed staff to respond much faster when gentleman B leaves his flat, thus minimising the risks to himself and the distress to his wife.

The cost of the telecare package totalled £390. This includes installation and is a stark contrast to the annual cost of residential care, which would have been in excess of £20,000.

Costs and benefits

There is a charge of £12.50 a month for telecare users, though no charge for telehealth. Walsall Council and NHS Walsall are investing £2.5m from a pooled budget in this service from 2011-12 to 2013-14 and aim to triple the return on this investment by 2017.

True personalisation requires the integration of all services around the individual in order to ensure that assistance is targeted and there is an economy of effort in their delivery. Co-ordinating the activity of multiple teams can be costly, which is why Walsall plans to redesign the community care and adult social care pathways with telecare as a foundation, co-ordinating health and social care services to ensure the right care can be delivered appropriately.

Next steps

The benefits of telehealth and telecare are far-reaching and could potentially reduce unplanned hospital admissions and support independent lifestyles. By catching a problem early, be it an issue with medication compliance, falling or general decline, professionals are able to take preventative action and improve outcomes.

By providing a telehealth or telecare package as standard, trusts and care providers can ensure that those vulnerable patients have appropriate care at home, allowing them to remain independent and reducing the number of people moving into residential care homes unnecessarily at great expense. 

In every other field of human endeavour since the availability of microprocessors, technology has changed everything that we do. Why would it be any different in care? I believe technology is at the heart of an integrated system, it’s an unlocker, and an enabler and over time, the people of Walsall will reap the rewards.

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