APPENDIX 1
TELECARE CAPITAL GRANT

GUIDANCE CIRCULAR NAFWC 08/2007

1.0Introduction and Background
1.1This circular sets out guidance for local authorities and local health boards on the Welsh Assembly Government’s objectives in providing capital grant funding for the purchase of telecare sensors and equipment, on the terms and conditions upon which grant is provided and the procedure for submitting evidence of compliance.

1.2As this is a capital grant local authorities will be unable to claim for revenue expenditure.

2.0Policy Intentions

2.1This grant has the aim of supporting 10,000 homes in Wales with

telecare sensors and equipment.

3.0Strategic Context

3.1The introduction of a Telecare service supports the Assembly Government’s strategic direction for Health and Social Services throughout Wales. The Review of Health and Social Care advised by Derek Wanless emphasised the importance of prevention and earlier intervention across health and social care.

3.2The opportunities arising from the wider development of telecare services, to maximise independence and support more domiciliary (rather than residential) care will feature prominently in the Social Services Direction Paper. It will advocate that telecare is seen as a new platform of service. It will stress the importance of addressing systematically the currently fragmented and inconsistent pattern of telecare service development across Wales.

3.3Designed for Life also identifies the need for improvements in telecare and as part of its plans to re-design health services in Wales it acknowledges that ‘greater use of technology… will reduce the need for hospital visits or residential care…. The results of these developments will give individuals greater control over their own quality of life’.

3.4The NSF for Older People in Wales promotes independence for older people and supports the aim to shift service provision towards the community, enabling people to remain within their own homes for longer. The NSF promotes the effective use of available technologies which support this aim. Telecare is beneficial, in particular, in managing the health of older people with long term and chronic conditions and those with dementia within their own homes.

3.5The prevalence of community alarm systems in Wales provides an infrastructure that telecare services are being built on. Many authorities in Wales are either already delivering telecare services or developing them in partnership with health and the voluntary sector. Telecare is a platform for the operation of existing community-based services aimed at supporting people and controlling the risks of living at home and to that extent it supports the re-modelling of existing services to meet the demands placed on social care service delivery.

4.0Grant Available

4.1The grant (totalling £8.92 million) will be paid at 100%, requiring no contribution from local authorities.
4.2The grant allocation payable to each local authority is set out in Annex B. The allocation made to each LA area will be dependent on evidence of partnership working and a commitment to support the Wales Telecare LIN.

4.3 Where an authority fails to meet these requirements, or where the application (see paragraph 9) does not meet the requirement to receive funding by the dates specified in the terms and conditions, the National Assembly for Wales may re-distribute the unspent allocation amongst those authorities who have made successful applications in line with the formula for distribution given in section 2 of the Terms and Conditions (section 6 of the Guidance Circular)"

5.0Conditions
5.1The conditions of grant are set out in, Annex A.
6.0Distribution
6.1The funding has allocated £8.92 million between the 22 local authorities using as a formula for allocation the elderly, residential and domiciliary care standard spending assessment (SSA), 2006-07 (Using 2004 mid-year population estimates).

7.0Defining Characteristics of a Telecare Service

7.1Telecare is a means by which care and support can be provided to people with or without other services, through telecommunication and technologies in the home. It is becoming an increasingly important element of care packages for people with support needs. Telecare typically employs sensors and automated devices that enable the well-being of an individual to be monitored remotely and contributes to people’s health, mobility, social well-being and security.

7.2Those who can benefit the most from telecare systems are:-

  • Older People
  • People with disabilities including cognitive difficulties and/or sensory impairments
  • People with mobility impairments

7.3The provision of a Telecare service is best carried out on a joint working basis encouraging local authorities, local health boards and the independent sector to work together in partnership to ensure an integrated approach. Telecare should be seen as an integral part of both new and existing patterns of service. It has the potential to absorb some of the unmet need and predicted pressures on social care services and reduce pressure on the NHS in the form of unplanned care.

8.0Eligible Expenditure

8.1The capital grant can be used to purchase Telecare and Telehealth Sensors and Equipment and associated Electronic Assistive Technology devices to support the development and operation of telecare and/or telehealth service delivery. The following definitions apply:

  • Telecare - the continuous, automatic and remote monitoring of real time emergencies and lifestyle changes over time in order to manage the risks associated with independent living by use of wireless device linked via a home gateway to a Monitoring and Response Centre or direct to carers.
  • Telehealth - the remote capture and exchange of physiological data between a patient at home and clinical and medical staff at hospital to assist in diagnosis and monitoring of their state of physical health. Information gathered in this manner can be presented to service users to aid self care, and/or go to primary care providers to maintain independent living and avoid multiple hospitalisations.
  • Electronic Assistive Technology Devices - are electronically powered devices that will automatically and continuously support a person to live independently but may not be linked to any external Monitoring and Response Centre (although where possible this should be capable of being linked to a telecare service to alert emergency situations). Such devices are likely to include memory aids (including medication dispensers, memo minders and other talking devices), remote control systems, safety controls (such as autoswitch off valves and cookerguads) and security devices (including video door-bells, electronic locks and electronic watchdogs).

8.2The capital cost of equipment comprises its purchase price and any costs directly attributable to bringing it into working condition for its intended use, such as installation costs.

8.3This Grant is not to be used to fund powered equipment traditionally provided through Community Equipment Stores (such as stair-lifts, bath hoists etc.) which have established funding streams.

8.4Authorities in receipt of the grant are welcome to discuss with the Welsh Assembly Government whether individual examples of equipment are eligible for funding from within the grant.

8.5The terms and conditions of the grant prevent local authorities from charging for provision of capital equipment in people’s homes provided through this scheme.

8.6Organisations involved in the commissioning, procurement and implementation of telecare and related services should now be turning their attention to the comprehensive range of items and services listed in the electronic catalogue called ‘NHS E-Cat’.

8.7All the suppliers, products and services on the NHS Purchasing and Supply Agency (NHS PASA) National Framework Agreement for Telecare (NFA) for Telecare have been competitively market tested via an OJEU/EU Public Procurement tendering exercise, eliminating the need for organisations accessing the agreement to undertake their own tendering exercises.

8.8Organisations authorised to access the national framework can make savings not only on product/service discounts and reduced terms but also by avoiding the need to undertake their own competitive tendering process. The framework agreement has been developed to support commissioners and those involved in telecare projects. It allows telecare service commissioners instant access to a full range of telecare equipment and services, ensuring that end users of telecare services are avoiding unnecessary delays and are receiving the benefit of telecare services quickly and effectively.

8.9The comprehensive range of equipment which includes environmental controls and telehealth should satisfy user needs for the short and medium term prior to the likely availability of integrated hub units and extended interoperability in 2008.

8.10Organisations involved in a range of telecare provision from primary care trusts to housing associations to district councils to third sector organisations can also use the agreement for their purchases.

8.11There is no charge for organisations seeking to use the NFA and registration to NHS E-Cat, to access the NFA and view the range of suppliers, products and services is simple. Further information on how to register is available at .

8.12NHS PASA contacts for the Telecare National Framework Agreement are included at

9.0Capital Grant Proposals

9.1Local authorities are required to submit a completed pro forma (Annex C) briefly outlining their proposals for the 2-year period (2006/07, 2007/08) to the National Assembly for Wales by 31January 2007. The proposal must comply with paragraph 23 of the terms and conditions.

9.2Each proposal must identify how the authority proposes to use the grant to support the delivery of a telecare service and demonstrate the capacity to deliver telecare services as described by the ‘Guidelines to Assist Local Authorities and Health Boards to develop local telecare strategies’ (published by the Welsh Assembly Government in October 2005).

9.3Those approved purposes may however be modified by prior agreement between the Welsh Assembly Government and the grantee.

10.0Auditing

10.1The authority is required to provide the National Assembly for Wales with audited information, for the duration of the grant scheme, in accordance with paragraphs 22 of the grant conditions. An appropriate form and instruction will be forwarded to each local authority in July 2008.

11.0Monitoring Compliance

11.1Local authorities are required to provide the National Assembly for Waleswith a report setting out the progress made in developing telecare services by 31st May, 2007 & 31st May, 2008. An appropriate form and instruction will be forwarded to each local authority in February 2007 & January 2008.

12.0Payment

12.135% of the allocation shall be paid in the year 2006-2007 with the remainder paid in 2007-2008. The firstyear’s allocation will be paid on receipt and acceptance of the proforma and acceptance of the terms and conditions.

12.2 The remaining allocations will be payable in quarterly instalments in advance on receipt by the National Assembly for Wales of a properly completed claim in a form to be specified by it.

13.0Recovery of Grant

13.1If a local authority fails to comply with the conditions set out in Annex A, the National Assembly for Wales may require the repayment of all or any part of the grant monies (see paragraph 23.0 of the terms and conditions).

14.0Annexes

A Terms and conditions of grant

B Indicative level of funding

C Application Form

Annex A

National Assembly for Wales

TELECARE CAPITAL GRANT

Under

Local Government Act 2003, Section 31

1.0Award of Grant

1.1The grantee shall ensure that it abides by the following conditions for the receipt of this grant.

1.2The purpose of this grant is to provide funds to purchase telecare sensors and equipment

1.3The effective use of this grant requires local authorities (LAs) and local health boards (LHBs) in their capacity as commissioners to define partnerships for the purpose providing telecare services. The voluntary sector also plays an important role in many areas. Although it will be for commissioners to define the partnerships it will be important to engage all stakeholders.

1.4To secure the funding local authorities would be required to demonstrate the capacity to deliver telecare services as described by the ‘Guidelines to Assist Local Authorities and Health Boards to develop local telecare strategies’ (published by the Welsh Assembly Government in October 2005), which encourages local authorities to develop telecare services in partnership with LHBs and other community partners.

1.5Local authorities will also need to commit to evaluating their telecare service delivery and communicating learning across Wales through the Telecare Learning and Improvement Network (LIN).

1.6As a condition of the grant local authorities will be required to become members of the Wales Telecare LIN.

1.7Failure to meet these requirements by the dates set herein will result in that particular authority’s allocation being made available for redistribution.

2.0Distribution

2.1The funding has allocated £8.92 million between the 22 local authorities using as a formula for allocation the elderly, residential and domiciliary care standard spending assessment (SSA), 2006-07 (Using 2004 mid-year population estimates).

3.0Use of Grant

3.1Subject to any provisions made in the National Assembly for Wales’ letter to an authority formally awarding grant aid, any grant aid paid under this scheme shall be used only in accordance with these conditions, which are to be read in light of the guidance circular NAFWC 08/2007 to which these conditions are annexed (“the approved purposes”). Those approved purposes may however be modified by agreement between the National Assembly for Wales and the grantee.

3.2Any misinterpretation of relevant information, including concealment or withholding of information, by the grantee in its submission of a proforma under condition 18 may be treated by the National Assembly for Wales as a failure to comply with these terms and conditions.

3.3Each partnership’s expenditure shall only relate to services provided or activities taking place pursuant to the proposal as approved under condition 18 during the period of award, and cannot be used in support of other services provided or activities taking place outside the period of the award. As this is a capital grant local authorities will be unable to claim for revenue expenditure.

3.4Local Authorities shall comply with their own standing orders and arrangements and procurement law in the purchase of goods and services under this grant scheme. However Organisations involved in the commissioning, procurement and implementation of telecare and related services should now be turning their attention to the comprehensive range of items and services listed in the electronic catalogue called ‘NHS E-Cat’.

3.5All the suppliers, products and services on the NHS Purchasing and Supply Agency (NHS PASA) National Framework Agreement (NFA) for Telecare have been competitively market tested via an OJEU/EU Public Procurement tendering exercise, eliminating the need for organisations accessing the agreement to undertake their own tendering exercises.

4.0Change of Use of Grant Aided Assets

4.1The prior approval of the National Assembly for Wales must be sought before any change of use of assets, which have been purchased using this grant aid.

5.0Period of Award

5.1The grant is awarded in respect of the period of two years ending on 31 March 2008. The award of this grant should not be taken to imply that a similar grant will be awarded for the following year.

5.2The National Assembly for Wales reserves the right to terminate payment of grant under this scheme at any time upon written notice to the grantee. Reasonable notice of termination would be given and arrangements for the transfer or cessation of the work would take account of the grantee’s contractual obligations. In the event of the termination, the grantee may be required to repay the National Assembly for Wales any grant, which has not at the date of termination been used for approved purposes.

6.0Insurance

6.1The grantee shall ensure that it takes all reasonable steps to insure against any risks which may arise in connection with the provision or use of the capital assets secured under the terms of this scheme. This implies to any property or assets funded in whole or part under this scheme. This also includes any loss or personal injury to, or other liability in respect of, staffs undertaking activities carried out using the assets provided in respect of this grant. The National Assembly for Wales reserves the right to require the grantee to submit for inspection any relevant documents relating to insurance policies. The National Assembly for Wales is not in any way liable for any contingency whatsoever arising from the use of grant aid; responsibility for any such contingencies shall lie entirely with the grantee, who should be covered for all eventualities, for example by taking out satisfactory insurance policies.

7.0Underspend of Grant

7.1The grantee shall notify the National Assembly for Wales as soon as it becomes apparent that an underspend of grant is likely to arise. The National Assembly for Wales may at its discretion and in accordance with the powers under which this grant is paid approve the use of the unspent amount for other beneficial purposes. Where such approval is refused the partnership must return the underspend to the National Assembly for Wales forthwith.

8.0Publicity

8.1In its publicity material, the grantee shall acknowledge the financial contribution made to its activities by the National Assembly for Wales under this scheme. It should be noted however that this capital grant funding cannot be used for procuring publicity itself.

9.0Party Political Purposes

9.1The grantee shall ensure that no part of the grant is used for party political purposes, and no aspect of the grant-aided activities shall be party political in intention, use or presentation.

10.0Equal Opportunities

10.1The National Assembly for Wales requires all recipients of grant aid to ensure that they apply a policy of equal opportunities as employers, as users of volunteers, and as providers of services, regardless of race, language, gender, sexual orientation, religion and any disability.

11.0Welsh Language

11.1The National Assembly for Walesis committed to impressing upon Welsh public authorities the importance of delivering services through the medium of Welsh in key service areas such as health and social care. It requires all recipients to ensure that the activities funded by this grant aid meet this objective and are conducted in a manner which is consistent with the recipient’s own Welsh Language Scheme.

12.0Restrictions on the Liability of the Welsh Assembly Government

12.1The grantee shall not (and shall ensure that its members, officers, staff and contractors do not) represent the organisation in a way that might lead persons to believe that the grantee is an agent of the National Assembly for Walesor that the National Assembly for Walesis responsible for any liability of the grantee. Nothing in these conditions of grant shall impose any liability on the National Assembly for Walesin respect of any liability incurred by the grantee.