November 17, 2021 • 46 mins
Digital Care Futures
1. Commissioning differently: Evolving personalised care with technology
Traditionally most telecare, and now ‘technology enabled care services’ (TECS), focused on managing the risks associated with living in the community when people were older or requiring support. TECS helped people to ‘age in place’ at home when discharged from hospital or when living alone following a bereavement. These devices and services were often reactive, creating an alert in emergency situations, either relying on the person triggering an alarm or the system automatically detecting changes in the home environment. There is now a distinct shift in approach in the UK from reactive to proactive and preventative services. Technologies are becoming ‘smarter’ and better able to relay information captured through a wider array of sensors and ‘Internet of Things’ devices. The design of services around the technology is also developing, using data gathered in more predictive and preventative ways as well as shifting towards ‘proactive’, in-bound calling systems. There is also a growing interest in mainstream devices and the role they can play in supporting people to live well in their communities and homes.
Findings from the Sustainable Care programme research from the University of Sheffield and from the TSA’s experience of engaging with the sector highlighted examples of local authorities and councils exploring and investing in TECS for prevention, taking a proactive approach as well as being focused on the wellbeing of those receiving support. The TSA has also observed in the past 12 months a rapidly growing appetite for more proactive services, both from adult social care commissioners and also people receiving support and their carers. However, this has been met with varying levels of technical service maturity and challenges, including issues related to interoperability, workforce pressures and limited capacity for analysis of the vast amounts of data generated and evidence-based decision making.
In this first episode of the Sustainable Care and TSA 'Digital Care Futures' podcast, Kate Hamblin (University of Sheffield) and Nathan Downing (TSA) spoke to guests from two examples of services which take a proactive and preventative approach.
Our guests:
Rupert Lawrence, former head of amica24, now Operations Director for the TSA
Carla Dix, TEC Prevention Strategy Manager, Delta Wellbeing Ltd.
Learn more about Sustainable Care at our website: http://circle.group.shef.ac.uk/
---Intro/outro music: Ambient Cool by Sunsearcher is licensed under CC BY-SA 3.0 Gain/fade effects applied
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:06):
The Digital
Futures Podcast series is a collaborationbetween Sustainable Care Research program
funded by the Economicand Social Research Council
and the technologyand book Strategy Board.
TSA Industry, an advisory bodyfor the UK tech sector.
Each podcast
we invite expert guests to explore with uschallenges and opportunities.
Technology can bring care and caring.
(00:32):
Hello and welcome
to Another about sustainable careprogram and technology
enabled Care Services Association podcastsas part of a mini series.
And today we're talking about technologyenabled care services
and how they can deliverbeyond managing risks
to think about things like wellbeingprevention, proactive services.
(00:54):
And something that we found duringour research was
although it's traditionally telecareand technology enabled, care services
have focussed quite in quite riskaverse ways on supporting people
on discharge from hospital,supporting people when they live alone for
perhaps the first time after bereavement,we're seeing a bit of a shift.
We're seeing increasingly services,thinking a bit more
(01:16):
about those sorts of broader agendas,thinking about the spirit of the CARE Act
and the Social Servicesand Wellbeing Act in Wales
and how we can create servicesthat are delivering on wellbeing.
And I'd like to bring NathanDowning in now, who works for
the Technology Enabled Care ServicesAssociation, to talk about their work
and what they've observed in the sectorquite recently.
(01:38):
Thanks very much, Kate.
And it's always good to say today as well.
And just to be able to get more quickly,I think it's pretty clear
that we have seen over the last 12 months,
12 to 18 months, with certainly everythingthat's been going on
around the world with the COVID pandemic,we've seen a rapidly growing appetite
for those for commissioningand delivering more proactive services.
(01:59):
So clearly there's an appetite thereand to drive things forward.
There's an appetite from sonsand daughters
looking out for mum and dad and understand
how can they can remain connected,but also know that mum and Dad are safe
without necessarilyalways being able to be there.
But equally we have seen the challengesthat have come across from shifting
to a very much remote working modelover the last 12 months
(02:22):
that the technicaland there is a lack of interoperability.
The challenge aroundbringing our technical systems up to speed
with the requirements of services,
trying to be
more outcomes focussed and not be led byby the technology and being really clear
that it's the service wrapped around thesemaking these proactive services
far more effective for the end user,for the commissioners, etc..
(02:45):
We've always been rich in data
across the world of telecare technology,care, assistive technology,
but how do we use it froman intelligence point of view?
And that's been the challenge.
How do we take this forward
and be far more evidence basedin our decision making ahead of crisis
rather than being predominantlyfocusing on, Yes,
very important safety, critical services,but always being.
(03:06):
Reactive?
I think that's a really interesting pointas well around the user expectations.
And now increasingly people are purchasingand paying for the services themselves.
And something that we
observed in our research andthere was a lot of enthusiasm for among
not just commissioners of servicesand and technology enabled care
service providers,but also we spoke to people who access
(03:29):
care services and carers was aroundthe potential of Internet of Things
and mainstream devicesand the way people were using it in
quite creative waysto support things like their wellbeing
and their independence and commissionerssort of on I think waking up to that
as a potential means to deliveron some of these these aspirations.
(03:49):
But I think they were again,there are challenges there.
I think there are challengesaround the sort of safety standards
and datasharing and people being fully informed.
And it's a consumer relationshipwith a lot of these devices.
And you sort of put in a lot of the onusis it on the consumers to understand
how that data is being processedby human review and how it's being stored
(04:10):
and things like that?
So I think there are always opportunities,but there are always challenges
and I think there is work going on
where governments try and think about
how they're going to create standardsaround Internet of Things
and whether that adequately addressestheir use and care context.
I don't know.I think that remains to be seen.
I think it's important, I think
(04:32):
clearly and certainly from a tax and artssubsidiary quality, we will always talk
about the importance of qualityand standards of ethical practices.
And clearly there's a worldthat is rife with technology.
The technologies increasing,growing more intelligent every day.
But again, for me, it has to come backdown to it might say technology
enabled care, but it's the enabling partthat's the most important.
(04:54):
How can we use a blend of virtualand physical care to support people?
How can we use a blend of technologyand services?
Effective response Tapping into localcommunity assets and networks.
That's reallywhat's going to support people
to remain in their own homesand communities safely for longer.
From a technologypoint of view, let's be clear
there is not one technology supplierout there that can do all of this.
(05:17):
They are the technology suppliers out
there have to work more effectivelyand collaborate.
They have to be interoperable.
They have to understand how do they howthey part of the solution in partnership
with service providers and commissioners,
because frankly, people in their ownlives are using technology
that quite often is far in advance of whatwe may use in technology enabled care.
There are almost 15 millionsmart speakers in the UK.
(05:39):
People are voting with their feet.
Half the battle for them has always been
Where do I find these servicesand these solutions?
The services?
Hopefully we'll hear from todayand indeed the people
that we're working with acrossthe TSA really are at the leading edge.
But again, I'm sure they would all admitsnot everybody has the full
the full range, the gamut of servicesin place for those that are leading better
(06:00):
on using technology and data,they may well be struggling on benefits
realisation for thosethat have a very clear relationship.
The conditions are really havethat partnership working well.
They might notnecessarily have embedded practices in
social work and occupational therapyand people seeing enabling care services
just as they would seedomiciliary care or aides and adaptations.
(06:22):
Something
that Segways nicely into introducingour speakers today, our guests.
So I'd like to welcome our guests todaywho are Carl
Dix from Doubts Wellbeing,which is based in Carmarthenshire
and we parents from Amateur 24,which is in Worcestershire.
Welcome.
And maybe you'd like to startby introducing a bit more
about yourselvesand the organisations you work for.
(06:44):
College, you want to go first? Yeah.
So I'm Tech Venturesstrategy manager with Dr.
Wellbeing and be with themnow for about two and a half years really.
But I've been involved in techsince about 2005 and
I think the the company itself
is a local authority trading company,So it's unique in as much
(07:07):
as we're the only tech company in Walesto be to work in that sort of way.
So we are wholly owned by CarmarthenshireCounty Council and that was that
sort of happened a few years back nowreally where there were lots of pressures.
And I say from the Councilin terms of not meeting budgets
and as we're all aware, tech isn'tstatutory provision within within the UK.
(07:31):
So there are always challengeswhen we come to sort of
looking at those budgetsand how that can actually be funded.
So the director at the time,I don't think he'll mind me
saying it's a bit of a disruptorwhen it comes to these things.
Very innovative inis the way that he works.
It tends to push those boundaries really.
And and obviously it waswas very competitive
(07:53):
utilising the Social ServicesWellbeing Act and those changes
that we had from a legislativepoint of view to really drive forward
looking at a different wayof providing this service then really
and clearly championedthe proposal for Delta.
And I think
normally it's about 2 to 3 yearsfor these businesses to be set up
and I think it was largely withinabout nine months.
(08:15):
So you can see that it was very much
somethingthat they really wanted to drive forward.
You know, obviously it's very traditionalreceiving centre arts or
opportunities thought to just sort of pushthose boundaries, like I said, really.
So I think, you know,when we're talking about it
being a disruptor,I think it's more about the fact
that actually transformationis really difficult to do
(08:38):
and you really do have to pushto those boundaries
and to sort of get peopleto come along with you then I suppose.
But I think that there's lot saidabout the Academy
in terms of that preventative approachand opening those doors.
And and we all knowthat legislation to a degree can be
interpretedslightly differently by, by people.
(09:00):
But again, put straight to those edgesreally in terms of locked in.
And I think the director feltthat it was an opportunity then to sort of
try to sort of make that sort of wholesalechange really, and open up those doors.
It allows doubters to workwithin the commercial world as they come
away from some of the bureaucracythat is involved in local authority.
(09:20):
We still we still are involved in that.
But I think we are also a trusted partnerfor a lot of people because we
have that connection there.
But also on the flip side,
because we are brandedas a separate company, then
I think individuals, well,you know, end users, family
and and people that are involved withthose clients also see us
(09:43):
as an opportunityto be something different
than statutory service provision,because I think that is a lot of
not negativity,but people don't necessarily want to be
seen by your social workeror don't want to necessarily
be, you know, involved in that sortof statutory service provision.
So I think we've been in a position tohave the best of both worlds a little bit.
Then we did adopt thatand I think we've with the Social Services
(10:07):
Wellbeing Act as well, there's a dutythat being placed on local authorities
to provide that information,advice and assistance at the front door.
And Delta actually providedthat foot and mouth to council.
So actually we are Roxanne's conduitthen in that person in between.
So when somebody does fallthat front door,
we are able to look for solutionsthat don't necessarily involve lock step
(10:29):
into statutory care and support themin the community for a bit longer.
And certainlyover the last couple of years
and with the projectthe public more to discuss now
with Connect we're hit a sort of a 25 30%preventative outcome at the front door,
which is significantly morethan it was pre-COVID,
but also pre the Connect project.
So I think clearly with hopefully
(10:52):
you know, with our eye to see, we'veprobably got significant integration.
I mean I comefrom a different local authority
and although we work quite closelywith our health board,
I'd say certainly within our regionalpartnership area in West Wales,
we've got quite a lot of integrationwith health, social care on towns in
I think within that sort ofa good position then to sort of coordinate
(11:14):
between them then.
And that said, with the mentioned the factthat we've got this sort of very data
rich sort of environmentwithin the tech world,
and I think we've got to lookat opportunities
to be able to share that informationappropriately
because at the end of the day, clientsare not interested in telling their story
15, 20 channels to the same peoplethat have probably supported them
(11:35):
somewhere along the line, you know what?
So I think that as a company,we we've managed to sort of
push those boundariesand I think we are probably at that sort
of cutting edge of that andthe opportunities are quite significant
then to to try and push forwardfrom an off point of view.
That's really interesting.
I think that sort of embedded, connectedapproach I think is is is really valuable
(11:58):
and great that you want to talka little bit with her and how it operates.
Yeah.
So for the last six years been leading.
I'm 24 and when I started that very
traditional teletext serviceand a pretty typical experience
within the local area of telecom models
(12:20):
and what could be done with thoseand what the experience was.
So it's actually been
quite a negative experiencefor a lot of people that
and that was somethingthat we really wanted to, to overcome
and we're quitewell placed as as the third
party organisation,part of a housing association.
(12:41):
We were able to bethat kind of independent advisor and,
and essentially a disruptor in the endbecause we came in with different ideas
and different models for how a serviceusing assistive technology could work.
And that was justa really very powerful thing.
Once we started to really highlightwhat the benefits of assistive technology
(13:07):
could be, how you couldactually demonstrate the outcomes
for for people and for families and carers
and other stakeholders across the piece,that that was a game changer.
And this is what we really needto highlight across the UK.
We need to really highlightwhat the service models are in
that whole wraparound,because until you start getting
(13:28):
to the actual outcomes, improving thoseand really showing those and creating buy
in from all of the parties,you won't actually get anywhere nice.
And we're talking by the technologyand the need for interoperability things.
Absolutely. Yeah.
I thought that is an absolute must.
But until you actually getto the service model
(13:50):
and getting the key stakeholdersall involved and bought into that process,
you're really going to struggle
to create an effective technologyenabled care service.
And I keep talking about technologyand aged care
through lots of the conversations I have.
And I keep coming back to an ideathat I'm really passionate by,
which is technology enabled health care,
(14:11):
because I think that'swhere it needs to go.
And I think the pandemichas just absolutely highlighted
that now everybodybeing more acutely aware of their health.
I think that's that's been my experience.
And we've certainly seen itthrough the service that we've been
that we operate,you know, that real kind of concern
(14:34):
for people's healthand indeed their wellbeing as well.
The effects of lockdown,the effects of isolation and loneliness
has really been brought to the forefrontof a lot of people's thinking.
And I think that that's a key thingfor us to grasp in this industry.
And I think it's a key thingfor commissioners to grasp as well.
(14:55):
We're not going to realise the benefitsof assistive technology
to the fullest extentuntil we start to really have
jointly commissioned technologyenabled care services.
And I think thatthat is where we need movement in the UK.
We need to have a real appreciation
of the benefits of technologyto everyday life, to everyday health,
(15:19):
to looking after that of vulnerable peopleand our communities.
Because, you know,the pandemic has really highlighted that,
that we need to have more effectivemodels of care
and health care into the communityand technology.
Assistive technology is a key facilitatorfor that.
And, you know, when we start to move onto the conversation
(15:41):
around the power of data, not wantingto tell your story to 14 different people,
this is really the key conduit for that.
And the assistive technologycan really wrap that up.
And we've got to overcomesome of the challenges
that Carla was talking aboutin terms of data and people's
(16:02):
obviously consent for for that things.
But these are all thingsthat can be achievable.
And if we get backing from healthcommissioners in particular,
we can overcome those together.
You know, this isthis is not insurmountable.
It's going to be easier to do that.
So these are the keykind of buying that we need to get.
But once you get to a servicethat is outcomes focussed
(16:27):
and you're looking at people'swellbeing indicators on the way
we use it all for health independenceand wellbeing I constructed
and it's fantastic because you're seeingwhat the impact of that technology
enabled care package is for that personand for the people around them as well.
You know, this is key to, to captureall of that, that feedback.
(16:49):
People are very
accepting of technology.
Now. I think that that that messageis getting completely smashed. Now.
The people,
especially olderpeople, don't want technology.
They do. They absolutely do.
They can use it.
They want to use itand they see the benefits of it.
And when you actually link that to theirwellbeing, it's really, really powerful.
(17:13):
These are the key things that we needto get to right across the UK.
I think.
I think both Tobyand I think it's refreshing to hear that.
Let's be honest, in both of your openingstatements or conversations,
the actual technologywas probably mentioned pretty minimally.
It's very much around the service andexactly where we need things to be going.
(17:35):
Yes, technology
suppliers need to play a role in that,but I'd like to think we can support
all of those suppliers of solutionsand services to think differently around
understanding the language,understanding the needs of individuals
and services and commissionersand the technology.
But I mean, to flippantshould be the use of it.
Clearly,there's you know, there's new new apps,
(17:55):
new devices coming out every 5 minutesand we know there's a large piece of
of ongoing work for servicesand commissions
to be doing around the shiftfrom analogue to digital solutions.
And I know in other podcaststhere'll be more discussion around that.
So I don't want to
and plus, I'm not technical enoughto be able to talk through that.
But I do think seeing digitalas an opportunity to think differently
about services rather than seeing it as ajust a switch, you know, like,
(18:18):
like replacement of what you've got nowfor a digital version is crucial.
Understandingthat you cannot expect people
to leave their own devices behind
when you're in the home and say, Well,that's great.
That might supported
you and helped you with independence,but here's what we're offering you.
And similarly, technology enabled care isas you both said, is outcomes focussed.
So some of these outcomesto be able to get down to the shops,
(18:41):
how do we support them with technologysitting in the background
and whether that be peoplealmost with a plan in their pocket
to help them understand what's going onthrough their day and help them next?
So some new learnedvillages, accents, communities,
whether it's somebodywanting to connect with friends or knowing
where the local sit down yoga club isor gardening clubs or what it may be.
That's part of the service offer,that's part of the ongoing signposting.
(19:04):
Hopefully we'll be able to come on toin terms of the service wraparound.
So that's the goal.
I know I'm kind of pushing onon our suppliers, but it's out to them
to really understandthe use case for the services
rather than being ledby a piece of technology.
Now when people said.
Yeah, I think you're absolutely rightthat often it is tech.
Tech first, you know, it's very,you know, exciting.
(19:27):
The technology
inherently new bits of kit are exciting,but we can't get led away by that.
And it's actually the servicein the reference, as you say, colleague.
Let's talk a bitabout the Connect projects and how that is
very much embedded in the workyou're doing.
Yeah, absolutely.
So this isthis is my I've lived and breathed connect
(19:48):
to the last couple of years,to be honest with you,
and probablycould have a whole podcast about it
because I do tend to go on a little bit,but I will tell you so Connect really
has come from a transformation programmethat Welsh Government
provided supportacross our regional partnership board.
So again, I suppose
it's a little bit different in Walesthan it is across across borders.
(20:09):
So we have our health boardsand they work then
quite closely with the local authoritieswithin that health board footprint.
So we've got Mark in Japan, LakshmanKendig on and I have a
the health board that we work within.
I suppose there's
there's an element of that's perhaps whythings are a little bit more integrated
for us in terms of the factthat they suppose they've sort of been
(20:32):
forced to work together a little bit,seeing those budgets being pooled,
albeit it's a, you know,
a grant award as opposed to budgetstruly being pulled them, I suppose.
But it gives us the opportunitythen to to actually, you know,
get that sort of proof of concept outthere then really and make things work.
So Connectcertainly does focus on prevention
(20:53):
and being proactive in the delivery.
Nathan's already touched on the factthat actually Tech really
is just a facilitator in thisand it isn't the main focus
of what we do inand it's the additional wraparound
and enhanced
service provision that Connect provides,which is probably where the success lies
in in. James, what's going on?
It's been adapted from thethe Barcelona model which anybody
(21:16):
that's lived in tech world for the lasthowever many years is probably aware of.
But I believe that we've actually we spenta lot of time really adapting that model
and making it fit for purposefor our customers and clients.
And that's not having anything negative.
But what what the Spanish model is.
But it is a completely differentsort of world
(21:36):
that we live inand they have in the statutory world
what their biggest sort of differencewith a non-stop tutoring.
So I would say support is of the nextiteration from a UK sort of perspective.
Then in terms of that modeland you know, the core functionality,
as I said, is about that tech being thereand everybody has a lifeline and,
and we are looking at other opportunitiesas we get to that sort of digital world
(21:59):
sort of work a bit differently and be moreinnovative in what we're providing.
But we provide them
that whole wraparound service,which is very bespoke to an individual.
You know,
we link in with our social serviceswellbeing assessment in terms of the ethos
around it, the person centred, what can,what are their strengths, how,
how are they coping,how are they managing?
(22:20):
And then we will look at then those areaswhere they want to improve things.
They may want to make some changesand what we are trying to do with our
community wellbeing officers supportand is a bit like a key work event.
So you know, not social workers,
but would a step back in termsof that community support.
We then empower coach mentoring individual
(22:41):
to sort of move them,I suppose in terms of their wellbeing
and trying to achieve the thingsthat perhaps they feel that they can't do.
So we've obviously got the remit of peoplethat are fairly capable, able,
still ableto access things in the community,
probably very low level in terms of needright the way through to those
that are actually, you know, have got likepull care calls a day
(23:04):
and are cared for and,and perhaps have a limited in terms
of actually perhaps being able to get outand about the things.
But actually the serviceare covered across all areas.
We originally in the projecthad two years of service.
So our biggest fear was aboutthat sort of preventative group,
those that are not receiving statutoryservice provision, about 65% of people
(23:26):
that we deem to work with their 30%in that intermediate to perhaps
sort of dipping into sort of some sortof refurbishment services or distribution
and things of that.
And then 5% at the top tier.
And what we have foundand it may be a little bit of the COVID
sort of situation, but we are actuallyhitting about 15% in that top tier.
(23:48):
But I think that probably gives youand I feel it sort of suggests
that actually preventioncan actually still be used for individuals
that have got complex needs.
This is about maintaining themat that level
and still keeping them in the community,keeping them in their own homes
without having the need to go into that
sort of a residential placementor whatever.
(24:08):
So I think is quitethat's quite interesting
for us to understand sort of where we canpitch these sorts of things.
The Connect Project, I mean,there's lots of information out there
about it on our websiteand things like that.
So I'm not going to go into sort of aof detail, but the additional in-house
service provisionreally said, citing the tech
we have a digital pathway,so it is about connected individuals
(24:31):
that are digitally enabledto be able to sort of engage.
And we are finding thatwe are linking a lot more with health.
And also we've got a telehealth project
going on in the region as wellto try and pull those together
because invariably it'sthe same customer, people with long term
conditions that would benefitfrom attending health provision.
And actually
I'm sure we're all aware of the factthat I think telehealth is still not quite
(24:53):
got to where it needs to get and again,move back to as the sustainable condition
is within health, perhapsnot understanding the the true value
and benefit of actually supportingindividuals back in the community,
stopping them from going in and hittingthose services that they need to provide.
So our digital pathway is now looking atit's moved on a little bit and is linking,
(25:15):
I suppose, our social carefinance with our health clients as well
and actually trying to providethat wraparound.
So it's quite,
quite exciting because that's an adaptedpath of the model really for us.
It wasn't what the plan was knowinitially.
We've obviously got our communitybased pathways of support,
so we haven't changed any of those,those of things that are already there.
But we are analysing
(25:36):
and trying to understand whether or notthere are any other gaps in that provision
to make sure that actually if we've gotlike a high level of thought in going on,
then perhaps we need to then supportcommissioners of those sorts of services
to provide somethingto support those clients.
So again,we're not changing anything there.
We just utilise what's already in place.
(25:57):
But the biggest thing for ushas been the response to this.
And Nathan, you touchedon appropriate response in terms of that.
When I came into this in 2011,it was one of those things
when we need a response services tax,a bit of a blast, scratch it.
If you can't, if you've got to waitfour plus hours for an ambulance to come
when you're actually not injuredand I mean for being very generous
(26:19):
and I know we know of peoplethat are on the floor for ten plus.
I was waiting for something
because they are an injuredand it's not life threatening.
And we all know the consequences
long lives and those individualsand it sucked into the house
the social care systembecause you know the consequence of that
our community welfare response has beenand it's been a challenge.
(26:41):
It's been quite scaryon two occasions to me
because it's something newand in terms of that, but
it's been absolutely wonderful,the experience that we've had of being,
you know, you can you can see itthere, can't you, when you actually go in
and picking somebody upand making sure that they're comfortable,
whereas, you know,they would have been on the floor before
that was our staff have been brilliantall the way through COVID and again,
(27:04):
was quite a risky sort of situation,you know, mean to everybody.
And we're going to get intothe thick of it, really.
And they've been and actually well,they've been amazing media.
But one thing that we decided to dois to actually register
our response to this with the CareInspectorate Wales, which is it's a C, c
c I think in England is, isn't it,in terms of the Capital Code Commission.
(27:24):
So we the only response servicein, in Wales anyway
that has actually got the abilityto provide that personal care provision.
So we've got some response servicesthat are part of a domiciliary cat vision,
which is fine, but they tendto get clogged the scheduled calls.
So they're not reactiveand not responsive to that.
(27:45):
But that's also opened up doors in termsof adapting our model to be able to work
with our hospitals, workwith Welsh ambulance service trusts,
to be able to provideanother sort of bridge in service
provision in the hospitalsand also some opportunities for us
to actually take off of the stack
with Welsh Ambulance serviceto deal with those low level calls.
So I think, you know, we've
(28:07):
we've been very agile and flexibleand quite open minded
and although it's a projectand it's got quite significant in terms
of what it's outcomes should beand what we should be doing in Delta,
we've been able to sort of flexa little bit
really asthings are coming through with an app.
So I think I can sitand sort of gush about connect for a bit.
But you know, we've had some challenges.
(28:27):
It's been really sort of difficultin terms of trying to get it right.
And I think the key for us is continuelearning and changing and adapting.
So if something doesn't work,
okay, let's figure out what can work thenand try that then a little bit.
So and very much, although I don't like itvery much of the ethos of the whole Dr.
Pepper something,
you know, what's the worst that can happenreally, as long as you're
(28:49):
not doing anything illegal,then really give it a go.
Because actually our customers
are much more discerningand they want us to do something.
They are less risk aversethan we actually are.
And it is a challengefrom a health perspective, definitely,
about being sort of less risk averse,but we sometimes just get to go with it.
And that's what happened in government.
You know,we're hoping to see a lot of evidence
(29:11):
falling into the window during COVIDbecause you have to do something.
These people have to make a differenceand change the way that they worked.
And I think that's added to the successnot just of connect,
but I think a lot of the proactiveservices
across the UK that we seeand having success is that,
you know,we took those barriers down and were able
to actually achieve whatwe should be achieving for our clients.
(29:33):
And then I just hopethat we don't revert back
to sort of putting those barriersback up again, really, because it would be
it would be disappointing because we'veall probably been bagging our heads
up against a brick wall for a long timeabout, well, look, this is common sense.
We should just dothis. It's the right thing to do.
And this is what our customerswant us to do.
So let's sort of let's go with it, really,and so on.
(29:54):
So yeah, connect
being them being the reasonfor quite a lot of sleepless nights.
But actually it's it's heartwarming to seeand that those personal stories
that are coming through,you know is on a daily basis
and you clearly can see the differenceloss making.
Thank you call it RupertDid you want to come in and talk about it
24 and how you preventative approachand whether as as with so to wellbeing
(30:20):
did the pandemic for you opentake down some barriers
and drive things forwardor was it more challenging them.
It's been
a really, really interesting time tooto see how a proactive
technology enabled care service performswithin a pandemic environment.
(30:41):
And one of the key thingsthat I've taken from it was thank God
we had proactive preventative
technology in place in Worcestershirebefore the pandemic hit,
and I've had that feedback to mefrom commissioners.
I've had that feedback to mefrom lots of different stakeholders
(31:01):
within service, and that's
because we didn'thave to introduce that approach.
It was already embedded.
We were already looking at how we problemsolve and Carlo was talking
about how you need to evolveyour your service and things over time.
And we've very much done that.
And I think that I thinkwhat Carlos talked about was,
(31:23):
you know, you've got toyou've got to take some leaps of faith
with assistive technology and, you know,we always talk about
when we were coming up with the servicewas backed by the art of the possible.
Let's start looking at thingsin a more positive way.
So can we find a solutionto that individual's situation?
(31:44):
That's it.
That individual circumstances,you know, nice and talks by,
you know, enablingsomeone to go down to the shops?
Well, let's do that.
What technologycan we use to actually facilitate
that so that person and and I thinkduring the pandemic, we were, you know,
faced with a different setof circumstances, much more challenging.
(32:05):
And the team were absolutely fantasticin terms of getting out
and making sure that people had thosethose devices and solutions to
to help them to maintainthat health independence and wellbeing.
And, you know, it's reallycome into its own.
And one of the key thingsthat I think we need to take forwards
(32:26):
over the next year or sois this real focus on sustainability
because the pandemic changed everything
in terms of the way that health and careneeds to be delivered.
And we saw some really fantasticexamples, but
there are a whole set of other challengesthat we've got which we can't ignore.
You know, we're absolutely awareof our ageing population,
(32:49):
you know, the increasing prevalenceof long term conditions and disabilities,
you know, there's lotsand lots of demographic factors there
that we need to be aware ofand the shortage of carers as well.
You know, the workforce is under realpressure in terms of delivering tests.
When I was talkingabout the importance of response services,
(33:15):
absolutely.
You know, these solutions and packagescan really start
to helpwith that whole sustainability piece.
And you know,we're very fortunate in Worcestershire.
We have a full response serviceoperated by Platform Paisan,
which is a local organisationand it's fantastic.
(33:36):
You know, people getting a responsewhen they're
when they're simply on the floorand needing that help to get out.
The reassurance, kindness,the interaction, you know, that's,
that's really showed during the pandemicas well and a really cost
effective solutionto helping someone who who isn't injured
(33:59):
but is at risk and you're actually makinga positive intervention.
And when you look
at the grand scheme of things, it'sa much more sustainable approach.
You know, calling out an ambulancefor someone who's uninjured on the floor,
putting extra pressure on the ambulanceservice is not doing anybody any good.
(34:19):
And you see it within the results.
I think our record for an ambulance sue
to turn up at a propertyfor someone who had fallen.
It wasn't in Worcestershire actually,but it was 15 hours.
And when you're seeing that play outwithin an arc environment,
it was amazing because it actually wentover three different shifts, you know?
(34:43):
So you had this call post.
It's bonkers. It's absolutely.
And we must really promotethe use of response services
that really needs to be somethingthat goes up the agenda in the UK
because they make positive interventionsevery single day.
When you talk with thethe end user in the situation,
(35:06):
they much preferto have that response service
coming out to them and looking after them,doing all of the forward.
They onwards forwardsassessment work and things like that
and it just joins things togetherand this is
what has been central to the servicethat we've been operating in.
(35:27):
Worcestershire is, is by joining thingstogether, we crucially assess
people properly when we're designingthe technology enabled care packages,
the links that we've got with with adultsocial care
and the social workteams, the individual social workers
being part of the reflective practice
meetings and really engaging with themand being that
(35:53):
that expert advice for them
really, really paid dividends.
And it's not just a focus on
reducing care package costs,although that is one of the key
benefits that comes with our service.
But there's the whole preventionpiece as well, and you can calculate this,
(36:15):
you can use different insights from socialworkers, for example, to formulate that.
And that avoidance, it is very,very simple to show how you are going
to help someone to avoid going
into residential care unnecessarily.
People don't want that.
They don't want to go into itcentral care if they can avoid it.
(36:38):
And you can design solutionsthat are able to achieve that for people.
And, you know,I think that's the whole sustainability
angle onthis is absolutely crucial because,
you know, health needs to be involvedin that conversation.
They need to be involved in the commissionand the services
(37:00):
because you can really show kind
the costs and sustainability around care
and a person's journey through care.
Now we talk about life curveand you know, how
you can actually help someoneto manage their progression.
And these are the key thingsthat have been part of our service
(37:22):
and people have bought into it as well.
Been really fortunate.
We got great commissionersand which is a really,
you know, kind of grasp the concept.
You know, they've said, you know,we know this is a good idea.
You know, this is it's a bit of ano brainer.
You know, we know that assistivetechnologies is great
and that it helps people.
So we've got to do this.
(37:43):
And they made that leap of faith.
And, you know,
you're seeing it with with serviceslike Karlis and others around the country.
We just need to really progress this up,you know, make that leap of faith.
I would again, totally agreewith everything I got.
I can't find anything
to disagree with.
I think for me, how do we take thisfrom the two excellent examples
(38:06):
we've heard from so far todayinto the much wider
spectrum of enabling care servicesacross the UK?
You know, there are 175long receiving centres across the UK
service providers that some ofwhich provide the whole and train service,
some provide just in my response rateor the installation service.
And it's trying to raise the game
(38:27):
across the piece and not just thosewho supply services, but clearly those
that provide the solutionsand those the commission them.
This has to be a partnership approach.
It can't be the daysof a transactional relationship
asking somebodyto install a thousand alarms a year or
go and carry out in 2000batch of checks or whatever it may be.
It's got to be that partnership approach
and peopleunderstanding that common language.
(38:49):
I think Rupert put it clearly around that
this is when we're not looking for aone size fits all approach to attack.
You know, everybody that is over65 automatically gets three things.
It's got to be that trusted adviser role,putting your trust
in the hands of the service providersto be heard from today
based on referring into the servicearound outcomes
(39:10):
risks alongside professional practice,you know, positive risk taking,
just enough supportand those sorts of approaches
rather than I'm going to prescribethat you, you install
a few pendant,an alarm and a few other bits and pieces.
So it's giving the socialor just the confidence
that the service providersreally know what they're talking about
and they will go and find the solutions,They will go and innovate
(39:32):
and they will challenge the very suppliers
that that's actuallywhat you've got isn't good enough.
We need solutions that can do X, Y and Z.
So I do think the challenge commissionersto think differently around this model,
they believe they need towhen they talk about proactive services,
frankly, it isn't the same funding modelthey used to.
Let's be honest,you don't, you know, a proactive
and focussed call talking to their friendson a monthly basis about your exercise
(39:57):
routines or doing a video
visit to agreeto taking the medication and watch.
They're talking about a few questions,not necessarily totally scripted,
but again, around the things that we know
around actorsthat they living around wellbeing.
And that's a far different service.
That's not a 32nd call, get the phonedown, get ready for the next person.
So it needs to be an adult conversationabout what you expect
(40:19):
and how do you fund this and indeed,
how do you collectivelybetween the commissioner,
which tends to besocial care at the moment,
how do you take that conversationwith that commissioner to health
to lead to actually this is the benefits.
You explain the what's in it for meacross the piece,
I think we've talked to the staffabout reverting back to practices.
I know, I know there'll be a challenge,
particularly in the health spherepersonally, of, you know, massive
(40:41):
improvement in remote monitoring solutionsthat have been used the last 18 months.
But as we open up safely,
I'm not going back to saying,well, that's the crisis kit
that goes in the cupboard.
Now let's go back to the waywe normally did things.
And I guessfinally before I get my soapbox,
we are seeing far more activitiesnow in the world of the analogue
to digital shift.You know, we've had 12 months
of stabilisation and nothingand what do we do?
(41:02):
As you know, the TelecomsNetwork changes over the coming years
and already is happening.
It's not no point
just saying 2025 and think of a waituntil then to start looking at it.
So there's a lot of work to do.
There's a lot of work on suppliersto make sure they can maintain supply.
We know there's
a global microchip shortage that again,
I'm sure will be coveredin another podcast.
But equally from a planning point of view,almost not diverting
(41:23):
all your attention towards digital shiftand the technical aspects not losing
sight of what we've talked about today,
there is a danger that people say, Well,actually we only got so much in our heads.
We'll focusnow on the service on the technical side,
and we'll forget about allthe good learning and all the things
we have learnt during COVIDthat clearly, as you all said,
consumers, users and users, sonsand daughters, you know, Fred and Frida,
(41:45):
they all want a service that supports themto deliver their outcomes.
Let's not lose sight of that
by then thinking, okay,but now anything more technical?
And I do think that's our job in GSAto help share the benefits of this,
to help services really think differently,to help those commissioners
and those senior decision makersto understand that this isn't
almost the last thingon the list of service
(42:06):
you can choose from, which, frankly,it has been for a number of years.
This has got to be right up front.
And don't think of it as technology.
It's not number one priority.
And you can't see Rupertput his finger up on the screen.
But I okay, it's a number one priorityto see enabling solutions at the
at the heart of care and health supports
rather not an afterthought or notas an add on after review period.
(42:27):
And as I said, we've been led by consumersthat are telling us, you know,
some of the doors are telling usthis is what they want.
Let's not
let's not almost brush that offand actually go back to reverting to time.
Yeah, I think and it links really wellto the sort of sustainability and spread
thing and the benefits realisationand what we observed in the project
with lots of lots of pilots,very similar pilots being done
(42:49):
and not sustainable, not not scalablebecause every commissioner
wants to try it in their own context,not taking that leap of states.
It's Barcelona model,
taking what you can learn from itand adapt it to your specific context.
You can't just transformthings you to do it.
You have to think about context
and it's just, yeah,just the same pilots being done it again.
(43:10):
And then the results of those pilots,the commissioner, the person
with the ultimate decisionmaking power, that's very nice,
but it's a very small scale pilotthat's not persuasive to me.
You haven't given me the evidenceI need to invest in this.
And I think that is the challenge that wewe found in the project was prevention
being quite a challenging thing forsome people to find the evidence base on.
(43:31):
How do you proveboth doing X you prevented y.
I especially if Y is a health costand that budget is not joined,
where is the incentive there
for the Commissionerin adult social care to invest in that?
I think that's really good to hearfrom you, Rupert, that you all pushing
that sort of evidence baseand you are able to
and there are ways to do it.
You know, you can build ineconomic costing and you can work out with
(43:54):
with by engaging with peoplewith expertise in this sector.
What would happenif this hadn't been put in?
What was the likely scenario?What would then put a cost to that?
It can be done,and I think it's a question of finding
a way to share where good practiceshappen, share how could say savings with.
So it wasn't.That is quite a persuasive argument.
Share how you come to wellbeing outcomes,which again is a challenging thing
(44:16):
to capture because wellbeingis a very personal thing.
How do you standardise that?
How do you capture that?
How would you, you know,persuade a commissioner around that?
And I think it's an ongoing challenge,
but I think it's somethingthat as an academic, I have a role to play
and I think the TSA has a role to playand in sharing good practice.
And I think
when commissioners and service providersget it right, they can really, you know,
(44:41):
use every
opportunity to sort of make it loudand clear where it's going on.
Well,and hopefully other people can think about
applying similar models in their context.
I do think clearlywe are seeing far more interested
in investment from NHS X Department,Health and Social Care in
independent living at home.
How do we better support people
(45:02):
in care homes through technologyand enabling services?
We have a real opportunityto have a better discussion
with integrated care systemsas they are developed to ensure
it is at the heart of that thinkingthat it is an opportunity to champion
a collective voice across social care,housing and health
(45:23):
and not not be predominately health led.
And I think all of us, as as I said, iswe've got the ability
and the opportunityto start to tell the story around
how do you measure the benefits,how do you provide that,
What's in it for me for all servicesand not meet benefits?
Realisation almost in the toodifficult pile and and something we do
(45:45):
after the FTA, after the fact to go backto this really make a difference.
It has to be right up front in everyone'sthinking alongside all the stuff we
talked about today.
Thank you, Nathan,
and thank you for co-hosting today,and I'd really like to thank Kyler Murray
for being so inspiringand sharing their experiences
of delivering servicesthat go beyond that risk.
(46:06):
To think about preventionand proactive and well.
And thank you very muchfor your contributions,
and I hope you enjoyedlistening to this podcast.
The Digital
Futures Podcast series is a collaborationbetween Sustainable Care Research program
funded by the Economicand Social Research Council
and the technologyand book Strategy Board.
TSA Industry, an advisory bodyfor the UK tech sector.
Each podcast
we invite expert guests to explore with uschallenges and opportunities.
Technology can bring care and caring.
(00:32):
Hello and welcome
to Another about sustainable careprogram and technology
enabled Care Services Association podcastsas part of a mini series.
And today we're talking about technologyenabled care services
and how they can deliverbeyond managing risks
to think about things like wellbeingprevention, proactive services.
(00:54):
And something that we found duringour research was
although it's traditionally telecareand technology enabled, care services
have focussed quite in quite riskaverse ways on supporting people
on discharge from hospital,supporting people when they live alone for
perhaps the first time after bereavement,we're seeing a bit of a shift.
We're seeing increasingly services,thinking a bit more
(01:16):
about those sorts of broader agendas,thinking about the spirit of the CARE Act
and the Social Servicesand Wellbeing Act in Wales
and how we can create servicesthat are delivering on wellbeing.
And I'd like to bring NathanDowning in now, who works for
the Technology Enabled Care ServicesAssociation, to talk about their work
and what they've observed in the sectorquite recently.
(01:38):
Thanks very much, Kate.
And it's always good to say today as well.
And just to be able to get more quickly,I think it's pretty clear
that we have seen over the last 12 months,
12 to 18 months, with certainly everythingthat's been going on
around the world with the COVID pandemic,we've seen a rapidly growing appetite
for those for commissioningand delivering more proactive services.
(01:59):
So clearly there's an appetite thereand to drive things forward.
There's an appetite from sonsand daughters
looking out for mum and dad and understand
how can they can remain connected,but also know that mum and Dad are safe
without necessarilyalways being able to be there.
But equally we have seen the challengesthat have come across from shifting
to a very much remote working modelover the last 12 months
(02:22):
that the technicaland there is a lack of interoperability.
The challenge aroundbringing our technical systems up to speed
with the requirements of services,
trying to be
more outcomes focussed and not be led byby the technology and being really clear
that it's the service wrapped around thesemaking these proactive services
far more effective for the end user,for the commissioners, etc..
(02:45):
We've always been rich in data
across the world of telecare technology,care, assistive technology,
but how do we use it froman intelligence point of view?
And that's been the challenge.
How do we take this forward
and be far more evidence basedin our decision making ahead of crisis
rather than being predominantlyfocusing on, Yes,
very important safety, critical services,but always being.
(03:06):
Reactive?
I think that's a really interesting pointas well around the user expectations.
And now increasingly people are purchasingand paying for the services themselves.
And something that we
observed in our research andthere was a lot of enthusiasm for among
not just commissioners of servicesand and technology enabled care
service providers,but also we spoke to people who access
(03:29):
care services and carers was aroundthe potential of Internet of Things
and mainstream devicesand the way people were using it in
quite creative waysto support things like their wellbeing
and their independence and commissionerssort of on I think waking up to that
as a potential means to deliveron some of these these aspirations.
(03:49):
But I think they were again,there are challenges there.
I think there are challengesaround the sort of safety standards
and datasharing and people being fully informed.
And it's a consumer relationshipwith a lot of these devices.
And you sort of put in a lot of the onusis it on the consumers to understand
how that data is being processedby human review and how it's being stored
(04:10):
and things like that?
So I think there are always opportunities,but there are always challenges
and I think there is work going on
where governments try and think about
how they're going to create standardsaround Internet of Things
and whether that adequately addressestheir use and care context.
I don't know.I think that remains to be seen.
I think it's important, I think
(04:32):
clearly and certainly from a tax and artssubsidiary quality, we will always talk
about the importance of qualityand standards of ethical practices.
And clearly there's a worldthat is rife with technology.
The technologies increasing,growing more intelligent every day.
But again, for me, it has to come backdown to it might say technology
enabled care, but it's the enabling partthat's the most important.
(04:54):
How can we use a blend of virtualand physical care to support people?
How can we use a blend of technologyand services?
Effective response Tapping into localcommunity assets and networks.
That's reallywhat's going to support people
to remain in their own homesand communities safely for longer.
From a technologypoint of view, let's be clear
there is not one technology supplierout there that can do all of this.
(05:17):
They are the technology suppliers out
there have to work more effectivelyand collaborate.
They have to be interoperable.
They have to understand how do they howthey part of the solution in partnership
with service providers and commissioners,
because frankly, people in their ownlives are using technology
that quite often is far in advance of whatwe may use in technology enabled care.
There are almost 15 millionsmart speakers in the UK.
(05:39):
People are voting with their feet.
Half the battle for them has always been
Where do I find these servicesand these solutions?
The services?
Hopefully we'll hear from todayand indeed the people
that we're working with acrossthe TSA really are at the leading edge.
But again, I'm sure they would all admitsnot everybody has the full
the full range, the gamut of servicesin place for those that are leading better
(06:00):
on using technology and data,they may well be struggling on benefits
realisation for thosethat have a very clear relationship.
The conditions are really havethat partnership working well.
They might notnecessarily have embedded practices in
social work and occupational therapyand people seeing enabling care services
just as they would seedomiciliary care or aides and adaptations.
(06:22):
Something
that Segways nicely into introducingour speakers today, our guests.
So I'd like to welcome our guests todaywho are Carl
Dix from Doubts Wellbeing,which is based in Carmarthenshire
and we parents from Amateur 24,which is in Worcestershire.
Welcome.
And maybe you'd like to startby introducing a bit more
about yourselvesand the organisations you work for.
(06:44):
College, you want to go first? Yeah.
So I'm Tech Venturesstrategy manager with Dr.
Wellbeing and be with themnow for about two and a half years really.
But I've been involved in techsince about 2005 and
I think the the company itself
is a local authority trading company,So it's unique in as much
(07:07):
as we're the only tech company in Walesto be to work in that sort of way.
So we are wholly owned by CarmarthenshireCounty Council and that was that
sort of happened a few years back nowreally where there were lots of pressures.
And I say from the Councilin terms of not meeting budgets
and as we're all aware, tech isn'tstatutory provision within within the UK.
(07:31):
So there are always challengeswhen we come to sort of
looking at those budgetsand how that can actually be funded.
So the director at the time,I don't think he'll mind me
saying it's a bit of a disruptorwhen it comes to these things.
Very innovative inis the way that he works.
It tends to push those boundaries really.
And and obviously it waswas very competitive
(07:53):
utilising the Social ServicesWellbeing Act and those changes
that we had from a legislativepoint of view to really drive forward
looking at a different wayof providing this service then really
and clearly championedthe proposal for Delta.
And I think
normally it's about 2 to 3 yearsfor these businesses to be set up
and I think it was largely withinabout nine months.
(08:15):
So you can see that it was very much
somethingthat they really wanted to drive forward.
You know, obviously it's very traditionalreceiving centre arts or
opportunities thought to just sort of pushthose boundaries, like I said, really.
So I think, you know,when we're talking about it
being a disruptor,I think it's more about the fact
that actually transformationis really difficult to do
(08:38):
and you really do have to pushto those boundaries
and to sort of get peopleto come along with you then I suppose.
But I think that there's lot saidabout the Academy
in terms of that preventative approachand opening those doors.
And and we all knowthat legislation to a degree can be
interpretedslightly differently by, by people.
(09:00):
But again, put straight to those edgesreally in terms of locked in.
And I think the director feltthat it was an opportunity then to sort of
try to sort of make that sort of wholesalechange really, and open up those doors.
It allows doubters to workwithin the commercial world as they come
away from some of the bureaucracythat is involved in local authority.
(09:20):
We still we still are involved in that.
But I think we are also a trusted partnerfor a lot of people because we
have that connection there.
But also on the flip side,
because we are brandedas a separate company, then
I think individuals, well,you know, end users, family
and and people that are involved withthose clients also see us
(09:43):
as an opportunityto be something different
than statutory service provision,because I think that is a lot of
not negativity,but people don't necessarily want to be
seen by your social workeror don't want to necessarily
be, you know, involved in that sortof statutory service provision.
So I think we've been in a position tohave the best of both worlds a little bit.
Then we did adopt thatand I think we've with the Social Services
(10:07):
Wellbeing Act as well, there's a dutythat being placed on local authorities
to provide that information,advice and assistance at the front door.
And Delta actually providedthat foot and mouth to council.
So actually we are Roxanne's conduitthen in that person in between.
So when somebody does fallthat front door,
we are able to look for solutionsthat don't necessarily involve lock step
(10:29):
into statutory care and support themin the community for a bit longer.
And certainlyover the last couple of years
and with the projectthe public more to discuss now
with Connect we're hit a sort of a 25 30%preventative outcome at the front door,
which is significantly morethan it was pre-COVID,
but also pre the Connect project.
So I think clearly with hopefully
(10:52):
you know, with our eye to see, we'veprobably got significant integration.
I mean I comefrom a different local authority
and although we work quite closelywith our health board,
I'd say certainly within our regionalpartnership area in West Wales,
we've got quite a lot of integrationwith health, social care on towns in
I think within that sort ofa good position then to sort of coordinate
(11:14):
between them then.
And that said, with the mentioned the factthat we've got this sort of very data
rich sort of environmentwithin the tech world,
and I think we've got to lookat opportunities
to be able to share that informationappropriately
because at the end of the day, clientsare not interested in telling their story
15, 20 channels to the same peoplethat have probably supported them
(11:35):
somewhere along the line, you know what?
So I think that as a company,we we've managed to sort of
push those boundariesand I think we are probably at that sort
of cutting edge of that andthe opportunities are quite significant
then to to try and push forwardfrom an off point of view.
That's really interesting.
I think that sort of embedded, connectedapproach I think is is is really valuable
(11:58):
and great that you want to talka little bit with her and how it operates.
Yeah.
So for the last six years been leading.
I'm 24 and when I started that very
traditional teletext serviceand a pretty typical experience
within the local area of telecom models
(12:20):
and what could be done with thoseand what the experience was.
So it's actually been
quite a negative experiencefor a lot of people that
and that was somethingthat we really wanted to, to overcome
and we're quitewell placed as as the third
party organisation,part of a housing association.
(12:41):
We were able to bethat kind of independent advisor and,
and essentially a disruptor in the endbecause we came in with different ideas
and different models for how a serviceusing assistive technology could work.
And that was justa really very powerful thing.
Once we started to really highlightwhat the benefits of assistive technology
(13:07):
could be, how you couldactually demonstrate the outcomes
for for people and for families and carers
and other stakeholders across the piece,that that was a game changer.
And this is what we really needto highlight across the UK.
We need to really highlightwhat the service models are in
that whole wraparound,because until you start getting
(13:28):
to the actual outcomes, improving thoseand really showing those and creating buy
in from all of the parties,you won't actually get anywhere nice.
And we're talking by the technologyand the need for interoperability things.
Absolutely. Yeah.
I thought that is an absolute must.
But until you actually getto the service model
(13:50):
and getting the key stakeholdersall involved and bought into that process,
you're really going to struggle
to create an effective technologyenabled care service.
And I keep talking about technologyand aged care
through lots of the conversations I have.
And I keep coming back to an ideathat I'm really passionate by,
which is technology enabled health care,
(14:11):
because I think that'swhere it needs to go.
And I think the pandemichas just absolutely highlighted
that now everybodybeing more acutely aware of their health.
I think that's that's been my experience.
And we've certainly seen itthrough the service that we've been
that we operate,you know, that real kind of concern
(14:34):
for people's healthand indeed their wellbeing as well.
The effects of lockdown,the effects of isolation and loneliness
has really been brought to the forefrontof a lot of people's thinking.
And I think that that's a key thingfor us to grasp in this industry.
And I think it's a key thingfor commissioners to grasp as well.
(14:55):
We're not going to realise the benefitsof assistive technology
to the fullest extentuntil we start to really have
jointly commissioned technologyenabled care services.
And I think thatthat is where we need movement in the UK.
We need to have a real appreciation
of the benefits of technologyto everyday life, to everyday health,
(15:19):
to looking after that of vulnerable peopleand our communities.
Because, you know,the pandemic has really highlighted that,
that we need to have more effectivemodels of care
and health care into the communityand technology.
Assistive technology is a key facilitatorfor that.
And, you know, when we start to move onto the conversation
(15:41):
around the power of data, not wantingto tell your story to 14 different people,
this is really the key conduit for that.
And the assistive technologycan really wrap that up.
And we've got to overcomesome of the challenges
that Carla was talking aboutin terms of data and people's
(16:02):
obviously consent for for that things.
But these are all thingsthat can be achievable.
And if we get backing from healthcommissioners in particular,
we can overcome those together.
You know, this isthis is not insurmountable.
It's going to be easier to do that.
So these are the keykind of buying that we need to get.
But once you get to a servicethat is outcomes focussed
(16:27):
and you're looking at people'swellbeing indicators on the way
we use it all for health independenceand wellbeing I constructed
and it's fantastic because you're seeingwhat the impact of that technology
enabled care package is for that personand for the people around them as well.
You know, this is key to, to captureall of that, that feedback.
(16:49):
People are very
accepting of technology.
Now. I think that that that messageis getting completely smashed. Now.
The people,
especially olderpeople, don't want technology.
They do. They absolutely do.
They can use it.
They want to use itand they see the benefits of it.
And when you actually link that to theirwellbeing, it's really, really powerful.
(17:13):
These are the key things that we needto get to right across the UK.
I think.
I think both Tobyand I think it's refreshing to hear that.
Let's be honest, in both of your openingstatements or conversations,
the actual technologywas probably mentioned pretty minimally.
It's very much around the service andexactly where we need things to be going.
(17:35):
Yes, technology
suppliers need to play a role in that,but I'd like to think we can support
all of those suppliers of solutionsand services to think differently around
understanding the language,understanding the needs of individuals
and services and commissionersand the technology.
But I mean, to flippantshould be the use of it.
Clearly,there's you know, there's new new apps,
(17:55):
new devices coming out every 5 minutesand we know there's a large piece of
of ongoing work for servicesand commissions
to be doing around the shiftfrom analogue to digital solutions.
And I know in other podcaststhere'll be more discussion around that.
So I don't want to
and plus, I'm not technical enoughto be able to talk through that.
But I do think seeing digitalas an opportunity to think differently
about services rather than seeing it as ajust a switch, you know, like,
(18:18):
like replacement of what you've got nowfor a digital version is crucial.
Understandingthat you cannot expect people
to leave their own devices behind
when you're in the home and say, Well,that's great.
That might supported
you and helped you with independence,but here's what we're offering you.
And similarly, technology enabled care isas you both said, is outcomes focussed.
So some of these outcomesto be able to get down to the shops,
(18:41):
how do we support them with technologysitting in the background
and whether that be peoplealmost with a plan in their pocket
to help them understand what's going onthrough their day and help them next?
So some new learnedvillages, accents, communities,
whether it's somebodywanting to connect with friends or knowing
where the local sit down yoga club isor gardening clubs or what it may be.
That's part of the service offer,that's part of the ongoing signposting.
(19:04):
Hopefully we'll be able to come on toin terms of the service wraparound.
So that's the goal.
I know I'm kind of pushing onon our suppliers, but it's out to them
to really understandthe use case for the services
rather than being ledby a piece of technology.
Now when people said.
Yeah, I think you're absolutely rightthat often it is tech.
Tech first, you know, it's very,you know, exciting.
(19:27):
The technology
inherently new bits of kit are exciting,but we can't get led away by that.
And it's actually the servicein the reference, as you say, colleague.
Let's talk a bitabout the Connect projects and how that is
very much embedded in the workyou're doing.
Yeah, absolutely.
So this isthis is my I've lived and breathed connect
(19:48):
to the last couple of years,to be honest with you,
and probablycould have a whole podcast about it
because I do tend to go on a little bit,but I will tell you so Connect really
has come from a transformation programmethat Welsh Government
provided supportacross our regional partnership board.
So again, I suppose
it's a little bit different in Walesthan it is across across borders.
(20:09):
So we have our health boardsand they work then
quite closely with the local authoritieswithin that health board footprint.
So we've got Mark in Japan, LakshmanKendig on and I have a
the health board that we work within.
I suppose there's
there's an element of that's perhaps whythings are a little bit more integrated
for us in terms of the factthat they suppose they've sort of been
(20:32):
forced to work together a little bit,seeing those budgets being pooled,
albeit it's a, you know,
a grant award as opposed to budgetstruly being pulled them, I suppose.
But it gives us the opportunitythen to to actually, you know,
get that sort of proof of concept outthere then really and make things work.
So Connectcertainly does focus on prevention
(20:53):
and being proactive in the delivery.
Nathan's already touched on the factthat actually Tech really
is just a facilitator in thisand it isn't the main focus
of what we do inand it's the additional wraparound
and enhanced
service provision that Connect provides,which is probably where the success lies
in in. James, what's going on?
It's been adapted from thethe Barcelona model which anybody
(21:16):
that's lived in tech world for the lasthowever many years is probably aware of.
But I believe that we've actually we spenta lot of time really adapting that model
and making it fit for purposefor our customers and clients.
And that's not having anything negative.
But what what the Spanish model is.
But it is a completely differentsort of world
(21:36):
that we live inand they have in the statutory world
what their biggest sort of differencewith a non-stop tutoring.
So I would say support is of the nextiteration from a UK sort of perspective.
Then in terms of that modeland you know, the core functionality,
as I said, is about that tech being thereand everybody has a lifeline and,
and we are looking at other opportunitiesas we get to that sort of digital world
(21:59):
sort of work a bit differently and be moreinnovative in what we're providing.
But we provide them
that whole wraparound service,which is very bespoke to an individual.
You know,
we link in with our social serviceswellbeing assessment in terms of the ethos
around it, the person centred, what can,what are their strengths, how,
how are they coping,how are they managing?
(22:20):
And then we will look at then those areaswhere they want to improve things.
They may want to make some changesand what we are trying to do with our
community wellbeing officers supportand is a bit like a key work event.
So you know, not social workers,
but would a step back in termsof that community support.
We then empower coach mentoring individual
(22:41):
to sort of move them,I suppose in terms of their wellbeing
and trying to achieve the thingsthat perhaps they feel that they can't do.
So we've obviously got the remit of peoplethat are fairly capable, able,
still ableto access things in the community,
probably very low level in terms of needright the way through to those
that are actually, you know, have got likepull care calls a day
(23:04):
and are cared for and,and perhaps have a limited in terms
of actually perhaps being able to get outand about the things.
But actually the serviceare covered across all areas.
We originally in the projecthad two years of service.
So our biggest fear was aboutthat sort of preventative group,
those that are not receiving statutoryservice provision, about 65% of people
(23:26):
that we deem to work with their 30%in that intermediate to perhaps
sort of dipping into sort of some sortof refurbishment services or distribution
and things of that.
And then 5% at the top tier.
And what we have foundand it may be a little bit of the COVID
sort of situation, but we are actuallyhitting about 15% in that top tier.
(23:48):
But I think that probably gives youand I feel it sort of suggests
that actually preventioncan actually still be used for individuals
that have got complex needs.
This is about maintaining themat that level
and still keeping them in the community,keeping them in their own homes
without having the need to go into that
sort of a residential placementor whatever.
(24:08):
So I think is quitethat's quite interesting
for us to understand sort of where we canpitch these sorts of things.
The Connect Project, I mean,there's lots of information out there
about it on our websiteand things like that.
So I'm not going to go into sort of aof detail, but the additional in-house
service provisionreally said, citing the tech
we have a digital pathway,so it is about connected individuals
(24:31):
that are digitally enabledto be able to sort of engage.
And we are finding thatwe are linking a lot more with health.
And also we've got a telehealth project
going on in the region as wellto try and pull those together
because invariably it'sthe same customer, people with long term
conditions that would benefitfrom attending health provision.
And actually
I'm sure we're all aware of the factthat I think telehealth is still not quite
(24:53):
got to where it needs to get and again,move back to as the sustainable condition
is within health, perhapsnot understanding the the true value
and benefit of actually supportingindividuals back in the community,
stopping them from going in and hittingthose services that they need to provide.
So our digital pathway is now looking atit's moved on a little bit and is linking,
(25:15):
I suppose, our social carefinance with our health clients as well
and actually trying to providethat wraparound.
So it's quite,
quite exciting because that's an adaptedpath of the model really for us.
It wasn't what the plan was knowinitially.
We've obviously got our communitybased pathways of support,
so we haven't changed any of those,those of things that are already there.
But we are analysing
(25:36):
and trying to understand whether or notthere are any other gaps in that provision
to make sure that actually if we've gotlike a high level of thought in going on,
then perhaps we need to then supportcommissioners of those sorts of services
to provide somethingto support those clients.
So again,we're not changing anything there.
We just utilise what's already in place.
(25:57):
But the biggest thing for ushas been the response to this.
And Nathan, you touchedon appropriate response in terms of that.
When I came into this in 2011,it was one of those things
when we need a response services tax,a bit of a blast, scratch it.
If you can't, if you've got to waitfour plus hours for an ambulance to come
when you're actually not injuredand I mean for being very generous
(26:19):
and I know we know of peoplethat are on the floor for ten plus.
I was waiting for something
because they are an injuredand it's not life threatening.
And we all know the consequences
long lives and those individualsand it sucked into the house
the social care systembecause you know the consequence of that
our community welfare response has beenand it's been a challenge.
(26:41):
It's been quite scaryon two occasions to me
because it's something newand in terms of that, but
it's been absolutely wonderful,the experience that we've had of being,
you know, you can you can see itthere, can't you, when you actually go in
and picking somebody upand making sure that they're comfortable,
whereas, you know,they would have been on the floor before
that was our staff have been brilliantall the way through COVID and again,
(27:04):
was quite a risky sort of situation,you know, mean to everybody.
And we're going to get intothe thick of it, really.
And they've been and actually well,they've been amazing media.
But one thing that we decided to dois to actually register
our response to this with the CareInspectorate Wales, which is it's a C, c
c I think in England is, isn't it,in terms of the Capital Code Commission.
(27:24):
So we the only response servicein, in Wales anyway
that has actually got the abilityto provide that personal care provision.
So we've got some response servicesthat are part of a domiciliary cat vision,
which is fine, but they tendto get clogged the scheduled calls.
So they're not reactiveand not responsive to that.
(27:45):
But that's also opened up doors in termsof adapting our model to be able to work
with our hospitals, workwith Welsh ambulance service trusts,
to be able to provideanother sort of bridge in service
provision in the hospitalsand also some opportunities for us
to actually take off of the stack
with Welsh Ambulance serviceto deal with those low level calls.
So I think, you know, we've
(28:07):
we've been very agile and flexibleand quite open minded
and although it's a projectand it's got quite significant in terms
of what it's outcomes should beand what we should be doing in Delta,
we've been able to sort of flexa little bit
really asthings are coming through with an app.
So I think I can sitand sort of gush about connect for a bit.
But you know, we've had some challenges.
(28:27):
It's been really sort of difficultin terms of trying to get it right.
And I think the key for us is continuelearning and changing and adapting.
So if something doesn't work,
okay, let's figure out what can work thenand try that then a little bit.
So and very much, although I don't like itvery much of the ethos of the whole Dr.
Pepper something,
you know, what's the worst that can happenreally, as long as you're
(28:49):
not doing anything illegal,then really give it a go.
Because actually our customers
are much more discerningand they want us to do something.
They are less risk aversethan we actually are.
And it is a challengefrom a health perspective, definitely,
about being sort of less risk averse,but we sometimes just get to go with it.
And that's what happened in government.
You know,we're hoping to see a lot of evidence
(29:11):
falling into the window during COVIDbecause you have to do something.
These people have to make a differenceand change the way that they worked.
And I think that's added to the successnot just of connect,
but I think a lot of the proactiveservices
across the UK that we seeand having success is that,
you know,we took those barriers down and were able
to actually achieve whatwe should be achieving for our clients.
(29:33):
And then I just hopethat we don't revert back
to sort of putting those barriersback up again, really, because it would be
it would be disappointing because we'veall probably been bagging our heads
up against a brick wall for a long timeabout, well, look, this is common sense.
We should just dothis. It's the right thing to do.
And this is what our customerswant us to do.
So let's sort of let's go with it, really,and so on.
(29:54):
So yeah, connect
being them being the reasonfor quite a lot of sleepless nights.
But actually it's it's heartwarming to seeand that those personal stories
that are coming through,you know is on a daily basis
and you clearly can see the differenceloss making.
Thank you call it RupertDid you want to come in and talk about it
24 and how you preventative approachand whether as as with so to wellbeing
(30:20):
did the pandemic for you opentake down some barriers
and drive things forwardor was it more challenging them.
It's been
a really, really interesting time tooto see how a proactive
technology enabled care service performswithin a pandemic environment.
(30:41):
And one of the key thingsthat I've taken from it was thank God
we had proactive preventative
technology in place in Worcestershirebefore the pandemic hit,
and I've had that feedback to mefrom commissioners.
I've had that feedback to mefrom lots of different stakeholders
(31:01):
within service, and that's
because we didn'thave to introduce that approach.
It was already embedded.
We were already looking at how we problemsolve and Carlo was talking
about how you need to evolveyour your service and things over time.
And we've very much done that.
And I think that I thinkwhat Carlos talked about was,
(31:23):
you know, you've got toyou've got to take some leaps of faith
with assistive technology and, you know,we always talk about
when we were coming up with the servicewas backed by the art of the possible.
Let's start looking at thingsin a more positive way.
So can we find a solutionto that individual's situation?
(31:44):
That's it.
That individual circumstances,you know, nice and talks by,
you know, enablingsomeone to go down to the shops?
Well, let's do that.
What technologycan we use to actually facilitate
that so that person and and I thinkduring the pandemic, we were, you know,
faced with a different setof circumstances, much more challenging.
(32:05):
And the team were absolutely fantasticin terms of getting out
and making sure that people had thosethose devices and solutions to
to help them to maintainthat health independence and wellbeing.
And, you know, it's reallycome into its own.
And one of the key thingsthat I think we need to take forwards
(32:26):
over the next year or sois this real focus on sustainability
because the pandemic changed everything
in terms of the way that health and careneeds to be delivered.
And we saw some really fantasticexamples, but
there are a whole set of other challengesthat we've got which we can't ignore.
You know, we're absolutely awareof our ageing population,
(32:49):
you know, the increasing prevalenceof long term conditions and disabilities,
you know, there's lotsand lots of demographic factors there
that we need to be aware ofand the shortage of carers as well.
You know, the workforce is under realpressure in terms of delivering tests.
When I was talkingabout the importance of response services,
(33:15):
absolutely.
You know, these solutions and packagescan really start
to helpwith that whole sustainability piece.
And you know,we're very fortunate in Worcestershire.
We have a full response serviceoperated by Platform Paisan,
which is a local organisationand it's fantastic.
(33:36):
You know, people getting a responsewhen they're
when they're simply on the floorand needing that help to get out.
The reassurance, kindness,the interaction, you know, that's,
that's really showed during the pandemicas well and a really cost
effective solutionto helping someone who who isn't injured
(33:59):
but is at risk and you're actually makinga positive intervention.
And when you look
at the grand scheme of things, it'sa much more sustainable approach.
You know, calling out an ambulancefor someone who's uninjured on the floor,
putting extra pressure on the ambulanceservice is not doing anybody any good.
(34:19):
And you see it within the results.
I think our record for an ambulance sue
to turn up at a propertyfor someone who had fallen.
It wasn't in Worcestershire actually,but it was 15 hours.
And when you're seeing that play outwithin an arc environment,
it was amazing because it actually wentover three different shifts, you know?
(34:43):
So you had this call post.
It's bonkers. It's absolutely.
And we must really promotethe use of response services
that really needs to be somethingthat goes up the agenda in the UK
because they make positive interventionsevery single day.
When you talk with thethe end user in the situation,
(35:06):
they much preferto have that response service
coming out to them and looking after them,doing all of the forward.
They onwards forwardsassessment work and things like that
and it just joins things togetherand this is
what has been central to the servicethat we've been operating in.
(35:27):
Worcestershire is, is by joining thingstogether, we crucially assess
people properly when we're designingthe technology enabled care packages,
the links that we've got with with adultsocial care
and the social workteams, the individual social workers
being part of the reflective practice
meetings and really engaging with themand being that
(35:53):
that expert advice for them
really, really paid dividends.
And it's not just a focus on
reducing care package costs,although that is one of the key
benefits that comes with our service.
But there's the whole preventionpiece as well, and you can calculate this,
(36:15):
you can use different insights from socialworkers, for example, to formulate that.
And that avoidance, it is very,very simple to show how you are going
to help someone to avoid going
into residential care unnecessarily.
People don't want that.
They don't want to go into itcentral care if they can avoid it.
(36:38):
And you can design solutionsthat are able to achieve that for people.
And, you know,I think that's the whole sustainability
angle onthis is absolutely crucial because,
you know, health needs to be involvedin that conversation.
They need to be involved in the commissionand the services
(37:00):
because you can really show kind
the costs and sustainability around care
and a person's journey through care.
Now we talk about life curveand you know, how
you can actually help someoneto manage their progression.
And these are the key thingsthat have been part of our service
(37:22):
and people have bought into it as well.
Been really fortunate.
We got great commissionersand which is a really,
you know, kind of grasp the concept.
You know, they've said, you know,we know this is a good idea.
You know, this is it's a bit of ano brainer.
You know, we know that assistivetechnologies is great
and that it helps people.
So we've got to do this.
(37:43):
And they made that leap of faith.
And, you know,
you're seeing it with with serviceslike Karlis and others around the country.
We just need to really progress this up,you know, make that leap of faith.
I would again, totally agreewith everything I got.
I can't find anything
to disagree with.
I think for me, how do we take thisfrom the two excellent examples
(38:06):
we've heard from so far todayinto the much wider
spectrum of enabling care servicesacross the UK?
You know, there are 175long receiving centres across the UK
service providers that some ofwhich provide the whole and train service,
some provide just in my response rateor the installation service.
And it's trying to raise the game
(38:27):
across the piece and not just thosewho supply services, but clearly those
that provide the solutionsand those the commission them.
This has to be a partnership approach.
It can't be the daysof a transactional relationship
asking somebodyto install a thousand alarms a year or
go and carry out in 2000batch of checks or whatever it may be.
It's got to be that partnership approach
and peopleunderstanding that common language.
(38:49):
I think Rupert put it clearly around that
this is when we're not looking for aone size fits all approach to attack.
You know, everybody that is over65 automatically gets three things.
It's got to be that trusted adviser role,putting your trust
in the hands of the service providersto be heard from today
based on referring into the servicearound outcomes
(39:10):
risks alongside professional practice,you know, positive risk taking,
just enough supportand those sorts of approaches
rather than I'm going to prescribethat you, you install
a few pendant,an alarm and a few other bits and pieces.
So it's giving the socialor just the confidence
that the service providersreally know what they're talking about
and they will go and find the solutions,They will go and innovate
(39:32):
and they will challenge the very suppliers
that that's actuallywhat you've got isn't good enough.
We need solutions that can do X, Y and Z.
So I do think the challenge commissionersto think differently around this model,
they believe they need towhen they talk about proactive services,
frankly, it isn't the same funding modelthey used to.
Let's be honest,you don't, you know, a proactive
and focussed call talking to their friendson a monthly basis about your exercise
(39:57):
routines or doing a video
visit to agreeto taking the medication and watch.
They're talking about a few questions,not necessarily totally scripted,
but again, around the things that we know
around actorsthat they living around wellbeing.
And that's a far different service.
That's not a 32nd call, get the phonedown, get ready for the next person.
So it needs to be an adult conversationabout what you expect
(40:19):
and how do you fund this and indeed,
how do you collectivelybetween the commissioner,
which tends to besocial care at the moment,
how do you take that conversationwith that commissioner to health
to lead to actually this is the benefits.
You explain the what's in it for meacross the piece,
I think we've talked to the staffabout reverting back to practices.
I know, I know there'll be a challenge,
particularly in the health spherepersonally, of, you know, massive
(40:41):
improvement in remote monitoring solutionsthat have been used the last 18 months.
But as we open up safely,
I'm not going back to saying,well, that's the crisis kit
that goes in the cupboard.
Now let's go back to the waywe normally did things.
And I guessfinally before I get my soapbox,
we are seeing far more activitiesnow in the world of the analogue
to digital shift.You know, we've had 12 months
of stabilisation and nothingand what do we do?
(41:02):
As you know, the TelecomsNetwork changes over the coming years
and already is happening.
It's not no point
just saying 2025 and think of a waituntil then to start looking at it.
So there's a lot of work to do.
There's a lot of work on suppliersto make sure they can maintain supply.
We know there's
a global microchip shortage that again,
I'm sure will be coveredin another podcast.
But equally from a planning point of view,almost not diverting
(41:23):
all your attention towards digital shiftand the technical aspects not losing
sight of what we've talked about today,
there is a danger that people say, Well,actually we only got so much in our heads.
We'll focusnow on the service on the technical side,
and we'll forget about allthe good learning and all the things
we have learnt during COVIDthat clearly, as you all said,
consumers, users and users, sonsand daughters, you know, Fred and Frida,
(41:45):
they all want a service that supports themto deliver their outcomes.
Let's not lose sight of that
by then thinking, okay,but now anything more technical?
And I do think that's our job in GSAto help share the benefits of this,
to help services really think differently,to help those commissioners
and those senior decision makersto understand that this isn't
almost the last thingon the list of service
(42:06):
you can choose from, which, frankly,it has been for a number of years.
This has got to be right up front.
And don't think of it as technology.
It's not number one priority.
And you can't see Rupertput his finger up on the screen.
But I okay, it's a number one priorityto see enabling solutions at the
at the heart of care and health supports
rather not an afterthought or notas an add on after review period.
(42:27):
And as I said, we've been led by consumersthat are telling us, you know,
some of the doors are telling usthis is what they want.
Let's not
let's not almost brush that offand actually go back to reverting to time.
Yeah, I think and it links really wellto the sort of sustainability and spread
thing and the benefits realisationand what we observed in the project
with lots of lots of pilots,very similar pilots being done
(42:49):
and not sustainable, not not scalablebecause every commissioner
wants to try it in their own context,not taking that leap of states.
It's Barcelona model,
taking what you can learn from itand adapt it to your specific context.
You can't just transformthings you to do it.
You have to think about context
and it's just, yeah,just the same pilots being done it again.
(43:10):
And then the results of those pilots,the commissioner, the person
with the ultimate decisionmaking power, that's very nice,
but it's a very small scale pilotthat's not persuasive to me.
You haven't given me the evidenceI need to invest in this.
And I think that is the challenge that wewe found in the project was prevention
being quite a challenging thing forsome people to find the evidence base on.
(43:31):
How do you proveboth doing X you prevented y.
I especially if Y is a health costand that budget is not joined,
where is the incentive there
for the Commissionerin adult social care to invest in that?
I think that's really good to hearfrom you, Rupert, that you all pushing
that sort of evidence baseand you are able to
and there are ways to do it.
You know, you can build ineconomic costing and you can work out with
(43:54):
with by engaging with peoplewith expertise in this sector.
What would happenif this hadn't been put in?
What was the likely scenario?What would then put a cost to that?
It can be done,and I think it's a question of finding
a way to share where good practiceshappen, share how could say savings with.
So it wasn't.That is quite a persuasive argument.
Share how you come to wellbeing outcomes,which again is a challenging thing
(44:16):
to capture because wellbeingis a very personal thing.
How do you standardise that?
How do you capture that?
How would you, you know,persuade a commissioner around that?
And I think it's an ongoing challenge,
but I think it's somethingthat as an academic, I have a role to play
and I think the TSA has a role to playand in sharing good practice.
And I think
when commissioners and service providersget it right, they can really, you know,
(44:41):
use every
opportunity to sort of make it loudand clear where it's going on.
Well,and hopefully other people can think about
applying similar models in their context.
I do think clearlywe are seeing far more interested
in investment from NHS X Department,Health and Social Care in
independent living at home.
How do we better support people
(45:02):
in care homes through technologyand enabling services?
We have a real opportunityto have a better discussion
with integrated care systemsas they are developed to ensure
it is at the heart of that thinkingthat it is an opportunity to champion
a collective voice across social care,housing and health
(45:23):
and not not be predominately health led.
And I think all of us, as as I said, iswe've got the ability
and the opportunityto start to tell the story around
how do you measure the benefits,how do you provide that,
What's in it for me for all servicesand not meet benefits?
Realisation almost in the toodifficult pile and and something we do
(45:45):
after the FTA, after the fact to go backto this really make a difference.
It has to be right up front in everyone'sthinking alongside all the stuff we
talked about today.
Thank you, Nathan,
and thank you for co-hosting today,and I'd really like to thank Kyler Murray
for being so inspiringand sharing their experiences
of delivering servicesthat go beyond that risk.
(46:06):
To think about preventionand proactive and well.
And thank you very muchfor your contributions,
and I hope you enjoyedlistening to this podcast.
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