In 2021, Suffolk County Council launched Cassius, its technology-enabled care service for those aged 18+. Cassius provides a range of different devices and solutions in tandem with in-person care to support independence and well-being — and it’s been a big success.
For the new Social Care Today special report People First with AI & Tech-enabled Care, we spoke to Elissa Rospigliosi, Assistant Director for Strategy & Transformation within Adult Social Care at Suffolk County Council. Here is the full interview:
What issues were you trying to address in setting up Cassius?
The project began in 2020, in the immediate aftermath of Covid. As part of our response to Covid, we had deployed video care phones so that people living alone could be in contact with their friends and family networks. That got a really positive response from the community and we saw an opportunity to build on what we’d learned.
We also faced the same issues as most other local authorities: a rapidly ageing population, rising demand for care and for more complex care. That brought financial challenges.
But the main driver was to provide services in a better way to Suffolk residents. There’s been a shift in health and social care more widely in recent years to more proactive, technology-enabled support that helps people to live independently for as long as possible — which we know is so good for them.
We were thinking about ways to meet people’s needs, including complex care and support needs, in as creative and person-centred as way as possible. We wanted to complement traditional social care provision — not replace it — and work with our care providers to evolve that model together.
Elissa Rospigliosi, Assistant Director for Strategy & Transformation within Adult Social Care, photo courtesy of Suffolk County Council
Once you’d decided to invest in technology, how did you pay for it?
Cassius has been funded through a combination of money from the council budget and support from NHS England’s Better Care Fund, particularly in opportunities to use digital technology to support people to leave hospital. That’s been a big pathway. We’ve also leveraged some investment from central government. More recently, we’ve been working with Suffolk and North East Essex Integrated Care Partnership on a funding stream called Digitising Social Care to pilot the use of sensors in care homes that provide discharges.
From the start, we made the business case in terms of direct benefits to people. Fundamentally, if people are more independent and remain at home longer, and we can prevent their needs from escalating, we avoid having to provide more expensive forms of care. We could demonstrate strong financial value through significant cost avoidance and other, broader economic benefits.
Have you seen that return on investment? What has this project cost?
Up to April 2025, Cassius has cost us £7.5m. Last year as a whole, we spent just over £3.2m in total on equipment and on our work with our partners, but the total return on investment in that year was £4.25m, or 31%.
Since 2021, the use of Cassius has led to £16.7m of budgeted financial savings and avoided an estimated £40m in care costs.
The really positive thing is that we’ve been able to reinvest those savings into care and support, continuing the digital offer and making sure it’s sustainable. That helps with the overall impact of increased demand for adult social care and lets us invest further in tech and keep improving our offer. We continue to innovate in the care we provide, with the aim of giving better outcomes. We managed to set up Cassius so that it covers its own costs but it is fundamentally about doing better things for people.
Was there much resistance to the idea of tech-enabled care when you started the programme?
Any change is challenging, especially given that everyone in this sector is so busy. Yes, I think there was a bit of resistance, even fear, about this kind of approach. But it really didn’t last. Generally, once you put this tech into people’s hands, they are keen to give it a go. With the right help and support, even people without a lot of exposure to digital can find it really exciting and see the benefits.
Practitioners want what’s best for people so we had to demonstrate that this works. From the start, we put in a lot of time and effort to ensure they were on side, investing in training so that they had confidence in the transformative power of using the right technology. That was critical because you only get the benefits from these devices if practitioners use them to fit the needs of the person. That’s still going on — we’re working in partnership with providers at the moment to embed care technology more systematically.
Early on, we also made sure in contracts that there was resource for proactive culture change, drawing on national expertise to help get our social work teams on side. Our care providers linked up with families and community groups to ensure people felt engaged in what we were trying to do and in helping to shape the offer. The main point to get across was that digital is complementary to traditional care models, it’s not replacing them. It’s still all about us working together to support the person.
Last but not least, we put in place some dedicated expertise. For example, we put a digital practice lead into each service. They worked closely with social work teams to make sure that the Cassius technology was closely integrated into normal ways of working. They were also someone to ask questions or bounce ideas off. We established a network of digital care champions to provide ongoing peer support, to keep up the energy and momentum.
How quickly could you see the programme was working?
It ramped up pretty quickly. By the end of the second year, we had 3,200 people being supported with care technology. Associated with that, we were forecasting nearly £13m in costs avoided and savings. I think we had a very big spike in interest in the second and third year as people adopted this technology at scale, after which it levelled off. But we’d had more than 12,000 referrals into the service and have 6,400 active customers across Suffolk. As I said, last year we saw a 31% net saving on investment against the cost savings.
It was actually amazing how quickly we started to get stories and case studies coming through to support what we were doing. There were great examples of innovative practice coming out of the programme.
Can you give an example of that?
One that stands out is a person who kept missing doctor’s appointments. The issue was that this person wasn’t literate so couldn’t read they letters they received from the doctor with the date and time.
Tackling something like would once have involved some really intensive, hands-on support from a carer or carers. But the practitioner who was working with this person gave them a literacy pen, a little simple device which you scan over text and it reads the words out loud. Suddenly, this person could manage the post they received and not miss more appointments. But they also discovered the joy of being able to read, and we found they were now doing bedtime stories for their nieces and nephews. That turned out to have a massive benefit in family connectedness. It was lovely.
How much has the technology and the way you use it developed since Cassius began?
It’s definitely evolving. One of the key opportunities we face across the sector — but also a big challenge — is how fast technology develops. As I said, we started with video care phones. Now we have a varied range of devices including fall alarms, home sensors, personalised devices like reading pens and ones you can carry while you’re out and about in the community. With those, a person with mobility issues or who is living with dementia and at risk of wandering can still go out, and their loved ones can have confidence that they won’t get lost or be unable to access help.
It’s not just the range of different devices. It’s also become fully integrated digital care, with devices connected through a central data platform that enables remote monitoring and helps us to tailor care delivery. Now we’re moving into using AI to interrogate the data these devices provide, which will enhance our ability to monitor capacity and expenditure in real time. That will also tell us more about people’s needs so we can create more effective support plans for them.
We’re already doing some development work on this with providers. We’re working with Spark Technology to develop a virtual reality product to support people living with dementia. They’ll be able to use a VR headset to access a range of immersive films, giving them experiences that they’ll find familiar — from their lives in Suffolk. It’s a really exciting project with a lot of potential.
How much does the council have to consider the wider impacts of this kind of technology? For example, AI tech depends on large data centres that need sizeable amounts of energy and clean water.
I don’t think Suffolk County Council will have much impact on environmental resources given the scale at which we’re working on this at present. We’re also in the early days of AI adoption. But yes, as the sector scales up the use of this technology we and other councils will have to balance our corporate priorities against environmental sustainability. It’s definitely something we’ll need to work through. Even at this scale, I think there are things we could probably do better in terms of environmental impact. That’s something we still need to test and learn from.
What advice can you give to other local authorities who might want to explore tech-enabled care? What do you wish you’d known when you started out?
Once we could see the impact of Cassius, the question we asked ourselves was, ‘Why didn’t we start sooner?’ It’s been a really positive journey for the council and our residents. But I’ve also talked with the team about what our key learning points would be.
First, you need to start with a clear and shared vision. I said before that we tried to be really clear about the potential positive outcomes for people and built strong relationships between partners across health and social care, as well as with service users.
Connected to that idea of good partnerships is the importance of co-production — with tech companies, care providers and end users. We aim to develop these new ways of working with our partners, it’s not something we just impose. That’s a core part of our strategy in Suffolk; we want co-production built into everything we do. It’s been critical in how we shaped the offer and the way it was communicated to ensure it really landed with people. That approach also ensured we were always focused on the right things. As I said, we built in a lot of engagement from the beginning, to get everybody on the same page while bringing their different perspectives to bear.
Something we learned along the way was the importance of sustainable growth and being able to keep up with demand. You’d be surprised how many people, when you ask them to try a technological solution, are keen to say ‘Yes!’ We had a job to keep up with referrals and target resources as effectively as possible, so that the people with greatest need got the solutions most quickly.
Our relationships with practitioners has been key to that, on an ongoing basis. We need to be able to provide them with tools and support but we also need to hear and respond to their experience. That’s what happened in the case of the reading pen I mentioned: the practitioner led that solution and it worked better than we could have expected.
Lastly, I think it’s been important to ensure that we have a range of devices and solutions so that we can tailor our response to a person’s individual needs. It’s not about ensuring everyone has a wearable alarm or the same remote sensors in their home. Maybe, for some people, technology isn’t the answer. Though that hasn’t been our experience so far!
Thank you very much.
The special report People First With AI and Tech-Enabled Care has been produced by Social Care Today and Healthcare Management (HM), in association with British Association of Social Workers (BASW), Digital Care Hub and Vantage.
In related news:
Interview: Reducing falls in care homes with Earzz acoustic monitoring
Interview: AR app ‘Dorothy’ helps people living with dementia
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