Partnership case study: ‘Assistive technology’ by Nottingham City Homes

We seek to use assistive technology as an early intervention/prevention strategy. We promote independence by helping people live in their own home for longer. It also helps towards reducing demand on key front line services.

Our challenge

The demand on primary and secondary health care services is increasing. Meanwhile, the number of GP’s is falling. Delayed hospital discharge is an issue which is expensive and causes bed blocking. Our Assisted Technology project is aimed to tackle some of these challenges.

The community alarms and telecare element of our initiative is targeted towards older people and those with disabilities. Our telehealth services are targeted at those with a health condition which requires self-monitoring.

We aim to promote independent living so that people remain in their own homes for longer, in turn reducing demand for more critical adult care services.

Our solution                

Assistive Technology is used to prevent admissions/readmissions into hospital through the provision of appropriate technology. The installation of technology can hasten a hospital discharge and ensure that the appropriate care package is in place to help support the individual to remain in or return to their own home. It can also prevent re-admission into hospital and ensure that independence can be sustained for longer.  It reduces demand for primary and secondary care services.  A mobile response service has the impact of reducing the number of ambulance call outs and the resulting hospital admissions.

The service has recently been extended to include the provision of telehealth services which allow patients to monitor their own health conditions at home, thereby reducing demand on GPs and primary health care services.  It acts as an early alert to changes in a patient’s health conditions allowing more timely, often life-saving treatment to be administered.

Through training and reorganising the existing telecare and telehealth teams, our initiative has been re-structured to operate as a flexible Assistive Technology (AT) programme. This has seen all 38 members of staff within the initiative trained to carry out multiple functions within the organisation including assessing, installing, maintaining, monitoring and crucially responding to individuals with specific needs and support, 24 hours a day, 365 days a year.

This means that our initiative is well-placed placed to handle over 330,000 calls per year that come into the monitoring centre as well as installing over one thousand pieces of AT equipment.

Our impact

We have recently undertaken research to measure social isolation for those in receipt of Assistive Technology (AT) through our scheme. We have identified that 92% of people feel that the support of AT in their home makes them feel less isolated.

Without our support, just under a third report that they would rely on other services more, and a small proportion would have to move. This suggests that if our initiative were not available, up to 475 people would need a higher level of home care, with an associated cost of up to £4.9m per year. In addition, around 66 would consider moving into supported care accommodation, at a cost of £1.9m per year.

There is also a saving of £300 on each ambulance call out.  It is estimated we prevent around 500 call outs annually, which amounts to approximately £150,000 in savings.

For the Telehealth side of the AT initiative:

  • 67% of clinicians felt the Telehealth equipment was very easy or easy enough for their patients to use;
  • 100% of clinicians felt Telehealth was of benefit for their patients – reducing visits, increased confidence for patients in managing their health, picking up early signs of exacerbations in chronic conditions;
  • Some clinicians stated the Telehealth had, possibly had or was likely to have reduced hospital admissions and avoided clinician visits.

Our partners

The telehealth project is funded by our CCG.

Telecare is funded through the Better care Fund, and commissioned through the Health and Wellbeing commissioning group.

The community alarm service is funded through Housing-related Support grant from Nottingham City Council, the Housing Revenue Account, charges to private customers and selling services to other registered social housing providers.

The service has developed a marketing strategy and a business plan which looks to develop new business opportunities to reduce the reliance on external funding.

The service is championed by partner organisations which promote independent living, such as the Signposting Service.

Our role

We run our initiative working closely with other teams within our organisation and other registered social landlords. This includes the Independent Living team which provides accommodation at over 60 schemes within the area. With appropriate needs and risk assessments undertaken, Assistive Technology (AT) can be supported and used to ensure that independence is maintained.

Through the ‘Hospital to Home’ programme AT can form an integrated programme to allow tenants and wider housing residents to be successfully discharged to their home with the appropriate packages of support at whatever time of day.

Linking in with the Signposting Service, individual customers can be referred for other services such as fall preventions and aids and adaptations.

The Telehealth project has created stronger links with health colleagues and enables us to refer people to health services much more effectively, and vice versa.

Our contribution to improving health

Assistive Technology (AT) helps in enhancing the quality of life for people with long-term conditions, which includes dementia and those with mental illnesses as set out in the NHS Outcomes Framework.

The initiative we adopt installs a range of 200 individual AT equipment devices within 48 hours of a referral by a clinician or GP each year. This demonstrates speed of response to ensure that individuals can return safely to their own home, with the care package they need.

The scheme also:

  • promotes independent living and allows people to remain in their own homes for longer
  • reduces demand for primary and secondary health care services
  • reduces demand for critical adult care services.