New evidence to support telecare business cases

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The development of telecare services in the UK has, more often than not, been done on the basis of slim evidence from local trials or ‘on trust’ that spending a little you can save more. However, the just released report An Assessment of The Development of Telecare in Scotland 2006-2010 by Newhaven Research [for the Scottish Government, presumably, Ed Steve] which has realistic figures based on a large sample, will be a major boost to support business cases. This is very timely in this era when…

all public sector budgets will be under intense pressure. (TA item). The background is that in August 2006 a policy initiative to drive the adoption of telecare by Scottish social and health care service providers was launched, called the Telecare Development Programme (TDP).

To quote the Executive Summary “Over the period to March 2010, £16.35 million was made available by the Scottish Government under the programme. Of this sum, £2.55 million was used to fund an innovation programme, and meet research and administration costs, while £13.8 million was allocated directly to care partnerships to drive service expansion.

“Initial expectations regarding the likely outcomes and efficiencies that a dedicated funding programme would generate over the period to March 2010 were laid out in a telecare business case document, which argued that (initial) TDP funding (of £8.35 million) would generate outcomes and efficiencies worth around £43 million in gross terms by March 2010.”

The results did not quite meet those expectations, but the important thing is that savings were demonstrated from a large scale implementation and these figures can be used with considerable confidence in other business cases.

Key Findings (from the Executive Summary)

“Over 29,000 people began a telecare service through TDP funding over the period 2006-2010. Over the whole period around 7,300 subsequently stopped receiving a service.

“Over 2,000 people that received a TDP funded service are known to have been diagnosed with dementia, but the true figure is likely to be significantly higher.

“By 31st March 2010, approximately £10.4 million of TDP funding had been spent by local partnerships, and another £2.6 million as match funding.

“Around 1,500 hospital discharges were expedited as a result of TDP funding 2006-10 against a business plan expectation of about 1,800.

“At the same time around 6,600 unplanned hospital admissions were avoided against an expectation of around 3,800.

“Over 2,650 care home admissions were also avoided against an expectation of 3,025.

“By achieving the above outcomes, partnerships saved around:

  • 346,000 care home bed days (against an expected 188,000)
  • 65,000 hospital bed days through facilitated discharges and unplanned admissions avoided (against an expected 80,000)
  • 35,000, nights of sleepover/wakened night care (against an expected 55,000)
  • 411,000 home check visits savings were less than anticipated (against an expected 615,000)

“Overall, the gross value of TDP funded efficiencies over the period 2006-10 is approximately £48.4 million at current prices; the financial value of gross benefits achieved was fairly close to expectations, given the uncertainties necessarily involved in business planning.”

Unless I missed it, what the report does not seem to go into is whether the element of the funding for equipment was spent efficiently, or whether more robust purchasing could have effected more bangs for the Scottish bucks and have improved the case further. However, I think that the equipment spend was a relatively small part of the complete cost.

Like the Kent telehealth evaluation document this report is well worth taking time out to read and to reference when making business cases. An Assessment of The Development of Telecare in Scotland 2006-2010 (PDF, 33 pages)