Agenda item

Report ACH21-049

The Committee received a presentation providing an update on the Assistive Technology (AT) / Telecare Project.

The AT Project Manager informed Members that AT and Telecare services often sat within Occupational Therapy (OT), as they provided objective data to support the assessment of function and need. Bromley was a local Carelink operator that needed developing and transforming – the aim was to design and develop an Assistive Technology Transformation Workstream that was integrated and aligned with the Council’s Digital Transformation Strategy and the One Bromley Vision.

AT was the connected/digital technologies that had emerged in recent years as having the potential to transform the way that people were supported. There were four pillars of AT: home adaptations, portable devices, functional aids and digital communication systems. It was noted that identifying problems that arose before they become an emergency would play a bigger part in Telecare. The AT Project Manager highlighted that AT was vast, and they had firstly been required to narrow their focus. Progress to date included:

-  Mapping the existing AT/telecare offer, including the completion of a staff survey across organisations to ascertain the current understanding of AT.

-  A key stakeholder forum had been undertaken.

-  Small scale trials of new devices to support hospital discharge and community-based residents.

-  The scope of AT had been identified as an enabling tool to promote independence, health and wellbeing, create savings and cost avoidance in care packages.

-  Immediate opportunities identified to improve the operation and potential of the local AT and telecare services.

The first workstream of the project was the enhanced care pathway. Activity monitoring systems had been installed within 24-48 hours post hospital discharge for selected clients as part of the assessment to establish a comprehensive 24-hour picture of need. The use of these devices ensured that proportional care was established, and 24-hour behaviour analytics provided considerable reassurance to families when establishing the appropriate care required. The trial had progressed to include 13 residents with the following efficiencies to be achieved during the remainder of the current financial year:

-  £3k of immediate savings to the NHS with the potential for much more with further investigations.

-  £19k savings to LBB in the reduction of care packages.

-  £29k cost avoidance to LBB in prevention and avoidance of long-term residential care.

A Member enquired as to how residents had been selected for this trial. The AT Project Manager advised that discussions had taken place with the discharge team to identify clients to trial the home support and they had also spoken with their families to set out the scope of the project. Part of the assessment process looked at how safe these clients were during the night and conversations had taken place around managing levels of risk. Huddles took place three times a week to ensure that a cohesive and collaborative approach was taken. It was highlighted that this part of the project had been a real success story. In response to a question from another Member, the Occupational Therapy Service Lead advised that once kit was purchased, it was reused for other clients. The AT Project Manager said that it was a one-off payment of £250 to purchase a single device, plus a subscription charge of £30 per month which provided the data for interpretation. It was suggested that the business case for the project could be circulated to Members to provide them with further information.

Another workstream of the project focused on clients with autism or learning disabilities (LD), and work was being undertaken with the Oxleas Adult LD team to identify clients to trial seizure detection technology. This could detect the onset of seizures and would support the reduction in unnecessary long-term 1-2-1 care and waking nights. In response to questions from Members, the AT Project Manager said that devices were being trialled for different types of epilepsy and seizures, and they were looking at different ways of providing support.

The Brain in Hand (BiH) app had also been identified to trial with clients. This would support decision making and increase confidence to self-manage activities of daily living or manage extreme anxiety and sensory processing difficulties. A Member emphasised the need to ensure that the relevant level of support was in place to assist clients using these apps. The Occupational Therapy Service Lead advised that these apps were currently being trialled and had not yet been launched. The team had worked closely with the social workers of the clients involved in trialling the apps. This would continue to be monitored to ensure that the right people were using the right technology.

There would be further exploration of new technologies to support higher functioning individuals as they transitioned from children’s services to adults, which could often be long-term and expensive. It was noted that the next pilot studies would use more advanced technology – using home sensors, health devices, and a smartwatch to provide companionship, health and activity insights, and peace of mind.

A further workstream focused on continued scoping with King’s in the newly established COVID assessment clinics to provide strategies for those with ongoing symptoms – 7 ORCHA (the Organisation for the Review of Care and Health Applications) rated apps had been identified for trial in the self-management of long covid symptoms (e.g. brain fog, insomnia, depression and fatigue). Cross sector working was also taking place with King’s/Bromley Healthcare’s Physical Persistent Symptoms clinic to gather user feedback on selected and trialled products to inform the sector on possible solutions to streamline the service moving forwards.

A Member noted that this work was relying more on technology and questioned what would happen if the technology failed. The Occupational Therapy Service Lead responded that they were already relying on technology with the use of devices such as pendant alarms. This was a valid point, which had been discussed – however the technology was currently just being trialled and they would be mindful of this going forward.

The long-term goal of the project was a transformation that used data to predict risks and changing patterns in behaviour, to provide a proactive, preventative support network. Bromley was currently between stage 1 and 2 (detection/monitoring) but the aspiration was to reach stage 5 intervention – proposing actions that would prevent emergencies or slow down the decline in function that were increasing risk of accident of ill-health. In response to a question, the Occupational Therapy Service Lead said it was recognised that it would take time to reach their ambition of stage 5, with the period of transformation and change expected to take 3 to 5 years. The long-term aim was to develop Carelink as the cornerstone to a fully integrated digital care system. The AT Project Manager highlighted that technology could not always replace support. However imbedding a change in culture from a reactive to a proactive service by adopting AT and implementing it at the forefront of assessment would empower health and social care workers to enhance an individual’s wellbeing.

The Occupational Therapy Service Lead said that this had been a really exciting project which involved trialling new pieces of equipment. As this was a relatively new market the expertise of Dr Kevin Doughty (T-Cubed and Visiting Professor in the Digital Transformation of Care Services) had been extremely beneficial to help identify which companies to use.

The Chairman thanked the AT Project Manager and Occupational Therapy Service Lead for their excellent presentation.

RESOLVED that the presentation be noted.