High-quality, long-term condition care need not cost the earth – and can improve lives
There are around two million people who live with long-term conditions in Scotland1 – conditions such as diabetes, dementia and heart conditions which cannot be cured but can be managed through medication and therapy. Over the next two decades the nation’s population is expected to fall while the proportion of older people will increase2.This will result in more people living with these conditions – and therefore increasing costs for healthcare providers. According to the Long Term Conditions Alliance Scotland (LTCAS), the Scottish economy will have to foot the bill for hundreds of millions, with mental health problems alone using up to nine per cent of the country’s GDP.
Providing the best possible care for people with long-term conditions, while also finding efficiency savings, sounds like trying to fit a square peg in a round hole. But it needn’t be with the right technology deployed alongside existing services. Telecare has a huge role to play in reducing costs while helping people live more independent lives.
As the UK Department of Health’s Whole System Demonstrator (WSD) interim findings have shown, telecare has led to a fall of 20 per cent of emergency admissions where trialled, while cutting visits to A&E by 15 per cent. Telecare also reduced mortality by 45 per cent when you compare those long-term patients who are receiving telecare and those who aren’t3. Paul Burstow, Minister of State for Care Services, has said this could lead to a saving of £1.2bn. So, while the debate rages about when full findings will be available from the WSD, it is clear that significant cost savings are likely.
This is good news for the health and social care sector, but what about the impact on the lives of people with long-term conditions? While it is great to know that they are less likely to be visiting A&E, how does telecare really help people to manage their long-term condition more effectively? All too often, the answer is that it gives them peace of mind and makes the home environment safer, but this in itself can be an issue.
Freedom to live life beyond the home
Only one per cent of telecare connections in the UK are mobile-based. The vast majority still rely on a fixed line, leaving many people with little choice when it comes to accessing support beyond the boundaries of their homes.
Yet for many people who are considering telecare services, being confined to their homes is no longer acceptable. They want to be able to go about their daily lives with the reassurance that help is quickly available should they need it.
This may be when a person with diabetes calls for help if their blood sugar is too low and they don’t have medication or food, or when someone with dementia can continue to go about life normally while knowing that help can be summoned if they find themselves in an unfamiliar place. Or even when mental health service users can be assured that the support structure that they rely on can travel with them, available at the press of a button.
For all these reasons, mobile telecare – which maximises the freedom provided by mobile networks – is one way in which the cost of care for people with long-term conditions can be reduced while also allowing people to live a fuller life. In a period of austerity when the health and social care system needs to make significant savings, it can free up time for caregivers and staff members and make rooms, beds and spaces available.
The result is that organisations get care to more people and focus their face-to-face time on those who need it most. For patients, it allows people the freedom to get out and about while staying connected to the people and support they depend upon for care. For families, mobile telecare provides the freedom to give loved ones – both young and old – more independence, and carers can rest assured that even in their absence, care and support is available.
Using mobile-enabled pendants or wristwatches – rather than the more traditional pull cords and land-line based technologies – users can leave the confines of their own homes and benefit from features such as fall-down detectors and GPS so a user’s location can be identified quickly if they call for help. Safe zones can also be defined; and if the individual moves out of this zone carers can be alerted.
Devon Partnership NHS Trust is one organisation that has been using mobile telecare to support mental health service users. The trust wanted to allow younger people to live their lives in the community – integrating their care in to their normal schedules. Specifically, the GPS tracking features on mobile telecare was used with those at risk from suicide. It allowed the trust to track movements of people and interact with them directly as they went outside the boundaries of specifically defined ‘safe zones’ into higher risk areas. The healthcare team at the trust were able to speak directly to people outside these areas to talk them through the decisions they were making before the situation escalated to something more serious.
Feedback from the trial highlighted that people experienced greater freedom with mobile telecare, feeling safer and more confident about leaving home whilst knowing they could access help when they needed it. Carers and family members also benefitted from lower levels of anxiety knowing their loved one was supported and traceable, whether they were at home or out and about.
Healthcare staff from the trust were also able to spend more time with people who required greater levels of face-to-face interaction, whilst still being able to manage those who don’t need so much contact time in a way that doesn’t leave them vulnerable or isolated. While this example in Devon is hundreds of miles away from Scotland, many of the issues faced by patients, carers and health and social care practitioners are the same across the border.
Trials such as the one undertaken in Devon have underlined that there has never been a greater need for mobile telecare. For too long, the power of the mobile networks has not been fully exploited to provide telecare users, care providers, the NHS, local authorities and carers with the benefits of real freedom and reassurance combined with cost savings and efficiencies.
Health and social care is changing, there are more people requiring longterm care, an ageing population, increasing demands on staff and fewer hospital beds and resources available to keep on top of this ever growing need. Mobile telecare can play a major role in addressing these challenges – and O2 Health is at the forefront of this revolution.