What are the prospects for using telecare for older people?

John WoolhamJohn Woolham is Senior Research Fellow at the Social Care Workforce Research Unit. (500 words)

On 9 March, I spoke in a webinar lecture for Oxford Academic Health Science Network. This network brings together universities, industry and the NHS throughout the Thames Valley region to improve health and prosperity in our region through rapid clinical innovation adoption. One strand of this network is devoted to a dementia clinical network and I was invited to speak by Dr Rupert McShane, a Consultant Old Age Psychiatrist at Oxfordshire and Buckinghamshire Mental Health NHS Foundation Trust, who leads this network.

The lecture explored whether there was a need for a clearer role for telecare in adult social care in England that will deliver better outcomes for older people. Telecare is still a comparatively new form of service provided by Adult Social Care Departments. It usually takes the form of devices that are installed in someone’s home that can either remind someone to do something (or not do something) or to monitor the home environment to keep people safe. It’s an important service. Faced with continual cuts to budgets, Adult Social Care Departments are continually trying to find ways to provide cost-effective ways of meeting ever increasing demandsEarly telecare project evaluations suggested telecare could deliver better outcomes that were cost-effective, and the Department of Health (DH) produced policy guidance a decade ago encouraging local authorities to develop telecare services. Many Adult Social Care Departments have invested significantly in telecare because they believe it will help reduce demand for more expensive forms of service such as residential care and help hard pressed NHS services by preventing avoidable admissions into hospital.

One major problem with all of this is that findings from the DH-funded Whole System Demonstrator Project—the best evidence we have to date for telecare’s impact—do not support the positive findings of early studies. The authors of this project are clear that telecare does not produced better outcomes for people who use it—at least over the 12 month period that their study ran.

I suspect this finding was as unexpected as it was unwelcome in some quarters, but it’s not one that can be ignored by anyone if they claim to have an evidence-informed approach. The authors don’t really offer any explanation for it. It wasn’t, at the end of the day, what their study was designed to do. But the really important thing is that the Whole System Demonstrator Project’s findings don’t seem to have led to any scaling back of local authority investment in, or commitment to, telecare. My presentation asked whether telecare might therefore be becoming an emergent policy problem, but also whether, if Adult Social Care Departments went about using telecare differently, this might lead to better outcomes for older people. I’ve been able to win research funding from the NIHR School for Social Care Research to look at this in more detail over the next year or so, and I will try to post updates about this work from time to time on this site for anyone who may be interested.

John Woolham is Senior Research Fellow at the Social Care Workforce Research Unit.