Serious intervention is needed to help speed up government plans to rehabilitate health and social care. Mark Hindle, managing director of Tunstall UK and Ireland, tells us how telecare can help.
The soon to be published NHS 10-Year Plan will have prevention and in-community care at its core. Alongside it, the Casey Commission will address the social care system with a range of recommendations. And the government’s three shifts are now hugely familiar to all of us, moving from hospitals to community, from analogue to digital and from sickness to prevention.
But between the delayed 10-Year Plan and the Commission’s two-three year time-horizon, there are understandable concerns that investment will not meet the scale of urgent need. Even as the June spending review set out plans to invest £10bn in the modernisation of NHS technology, there are serious questions as to how far this funding will go. Meanwhile, demands on publicly funded adult social care are rising, increasing pressure on local authorities, carers and the NHS.
In parallel, the available technologies which support proactive and preventative care have advanced significantly over recent years. From the rise of wearable technology such as smart watches among the elderly, to ever-expanding potential for use of AI in health and social care, innovation is moving at pace. Telecare, or technology-enabled care, an often overlooked resource which bridges the divide between person-centred care and technology, is also evolving rapidly. Through remote monitoring, data collection, and early identification, telecare delays reliance on high cost services, reduces emergency interventions and supports independent living.
So why is progress in integrating these much-needed solutions so slow? Why is funding reform so challenging, and how can those of us in the telecare and social care sectors enable change while we wait for policy change?
A time to reflect
I am a relative newcomer to the telecare sector, having spent my career so far in digital health. This is a hugely exciting time to be moving into this area, with the next few years representing a key inflection point as we define our role in supporting an ageing population with increasingly complex conditions and manage the switchover from analogue to digital in early 2027.
We must define our role in this future, shifting from a focus on emergency support, telephones and alarms to an emphasis on outcomes, integration between health and care and truly proactive and preventative care.
This final piece of the puzzle strikes me as especially essential, and is fortunately recognised by the current government in their focus on sickness to prevention. Previously, we worked primarily in the sphere of reactive through to proactive support, from emergency response systems to triggers and sensors to detect issues and alert families and caregivers. Through personalised and predictive care, we can actively prevent incidents, avoid hospitalisations and save both health and care significant costs; all while ensuring greater quality of life for telecare users.
However, unlocking those cost savings requires investment. As the telecare sector evolves, how can we ensure that this understanding of the potential of prevention evolves with us?
Understanding the barriers to prevention
A significant barrier to the shift from sickness to prevention is the unequal distribution of costs and benefits. As it stands, social care bears much of the financial burden of installing the systems which enable prevention. However, the benefits accrue in health, through reduced hospitalisation and decreased need for emergency services. Of course, the solution is not simply to pass the financial burden across the arbitrary social-health care divide and leave it at that. Instead, we must see integration of these services as crucial, not only to unlocking operational efficiencies, but also prevention and long-term, independent living.
It is not just a lack of funding which has prevented this thus far. It is human nature to seek immediate solutions when faced with urgent needs or crises. This makes it difficult to allocate already limited budgets, raise taxes or incentivise personal investments for longer-term initiatives. However, when implemented, these prove successful. For example, when local authorities implement ‘invest to save’ models, evidence shows [CITE] that significant long-term dividends are achieved, both financially and in terms of patient outcomes.
We can look to Spain for a model of how this can be implemented effectively. Proactive care is well established and integrated with funding provided by government to local authorities. This has, in turn, fostered strong public and policymaker support for enhancing social care, enabling greater personalisation of services, effective risk-identification and as a result, more preventative services. Through initiatives such as Tunstall Spain’s Smarthabit programme, all-in-one sensors in the home can monitor routines and behaviour patterns, enabling the system to detect anomalies. Even in regions where circumstances such as low population density create specific challenges in accessing care, great strides have been made which demonstrate the potential for reform. For example, in Castilla-La Mancha, in over just 10 years, the local authority in partnership with Tunstall Spain, have achieved a 93% increase in Telecare users.
Recognising the role of bottom-up change
As we have shown, policy fragmentation and misaligned funding models are key challenges to implementing more effective prevention. But public understanding must also evolve. This requires more clarity on the concrete benefits of telecare, at an earlier stage, as well as important conversations about the stigma which may be associated with making use of telecare.
Generational shifts will inevitably support this change, as our level of comfort with technology in the home grows. It is my hope that as our sector reshapes our role to reflect this new reality, we can play our role in addressing remaining stigma and supporting more people to retain their independence.
There are important interconnections with funding here too; as telecare is often publicly funded, such as here in the UK, there is a disconnect between potential beneficiaries and service providers, mediated as this relationship is by over-stretched local authorities. As a result, potential users are not aware of the help telecare can provide as they have not been flagged in the system. If we are to effectively prevent incidents, collaborate with caregivers, and keep individuals independent at home for longer, we need to be able to have honest conversations about the benefits and potential of telecare solutions, earlier.
For social care, reducing the need for domiciliary and personal care services, and reducing the burden on those who do provide these services is a key benefit. Our research into the cost savings of this found that telecare can save approximately £4.5k per user annually in home care costs compared to a matched cohort without telecare. Post-discharge support through technology-enabled care is also a crucial area of cost-saving.
These benefits are not yet widely understood. But with the 10-Year Plan publication looming there are reasons to be hopeful, with the government and health secretary Wes Streeting placing a significant emphasis on the role of technology as well as prevention. With a better understanding of the barriers to effective prevention, and more active advocacy about our role in the solution, we can shape a new future where integrated and effective prevention is at the core of health and social care.
Tunstall Healthcare, which was founded in 1957, is a global provider of digital health and care solutions. Their main focus is helping older people live more independently.
Photo by Yamu_Jay via UnSplash and Mark Hindle
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