Staying independent

We will help people to stay well and independent for as long as possible. To do this, we will:

  • provide better information and advice so people can make more informed choices about their care
  • support people to stay well for longer and prepare earlier for any care and support they need, rather than waiting until they reach a crisis point where they have fewer choices and often make rushed decisions
  • require local authorities to provide help earlier to try to prevent, delay or reduce people’s needs for care and support (as set out in the draft Care and Support Bill)
  • gather more evidence on how helping people earlier – and trying to prevent or delay them needing more formal and expensive care – can save money
  • continue to evaluate the benefits of telehealth and telecare
  • explore approaches such as Social Impact Bonds, which encourage more innovative use of resources to stimulate greater investment in preventive services

Telehealth and telecare

Telehealth and telecare are preventative services that allow people to stay at home for longer and be better prepared for the future. Telehealth is technology that allows health and care professionals to monitor someone’s condition or particular symptoms remotely.

The 3 Million Lives campaign is working to improve the lives of 3 million people over the next 5 years by making telehealth more widely available across health and social care. This follows the Whole Systems Demonstrator (WSD) programme, the world’s largest randomised control trial of telehealth and telecare services. The Department of Health published the WSD headline findings on telehealth in December 2011, showing that these services can substantially reduce mortality, reduce the need for admissions to hospital, lower the number of bed days spent in hospital and reduce the time spent in accident and emergency.

Telecare is the use of technology to allow people to live independently at home for longer. Electronic sensors and aids are used to make people safer at home. For example, some bed sensors can switch on a light automatically when someone gets out of bed, helping to prevent falls. Another type of bed sensor can send an alert to a call centre if someone doesn’t return to bed within a specified time, helping people to get help more quickly and hopefully be less seriously affected. The evidence on telecare from the WSD evaluation is expected soon.

Assistive technology, such as wheelchairs and grab rails in the home, can also make life easier for carers.

By gathering more evidence on preventative measures, and how effective and cost-effective these are, we hope to be able to save public money and help providers and commissioners provide a better service.

Strengthening support within communities

Strong and inclusive communities are a key part of the government’s vision for a reformed care and support system. We want to build on the large amount of good community work that’s already being done in care and support across the country.

During the ‘Caring for our future’ engagement, we heard that there is a lack of support for people trying to make decisions about the care they want and find out what is available in their communities.

We will support people, families and communities to come together to find their own solutions and make the most of their skills, resources and networks to support friends, family members and neighbours who need a bit of help to remain active and independent. We will do this by:

  • stimulating the development of time banks, time credits and other approaches that help people share their time, talents and skills with others in their community
  • supporting social workers to connect people at risk of being isolated to community groups and networks
  • encouraging communities to be involved in decisions on local health and care services

Social Impact Bonds (SIBs)

SIBs are a form of a payment-by-results contract, where interventions to improve social outcomes such as reduced hospital admissions are financed by private investors. Investors are then repaid on the investment depending on how much the outcomes have improved, and if outcomes don’t improve there is a risk that they don’t get a return on their investment. Investing in prevention through initiatives like SIBs means that the upfront funding can be provided for these inerventions at reduced risk for public sector commissioners.

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