TECHNOLOGY-ENABLED CARE PROGRAMME 2014-2016

Invitation for Expressions of Interest: Partnership Guidance

1.Introduction

1.1The 20:20 Vision for Health & Social Care provides the strategic context for technology-enabled care developments in Scotland. Technology-enabled care is vital to the successful delivery of this vision, and the importance of digital technology is both recognised in the Scottish Government’s Routemap to 2020 and in the wider public-service reform agenda with its sharp focus on improving performance through greater transparency, innovation and the use of digital technology.

1.2Specific activity is driven by the National Telehealth and Telecare Delivery Plan for Scotland to 2015, which set out our commitment to embed technology-enabled options in the redesign of our health, care and support services. Oversight and monitoring of the Delivery Plan is provided by the National Telehealth and Telecare Advisory Board (NTTAB), chaired by JIT, whose membership is drawn from a range of key stakeholders across primary care, secondary care, social care, third sector, housing sector, digital participation and user/carer organisations.

1.3Following advice from NTTAB (see Appendix 2 for a more detailed background), the Scottish Government has launched the Technology Enabled Care (TEC)Programmefor 2014-2016. NTTAB have established a Programme Board to support and drive delivery, and the Programme is supported with £10 million in funding from the overall £173.5 million Integrated Care Fund for 2015/16 (£100 million of which is being distributed directly to Partnerships).

1.4The TEC Programmeencompasses two elements: a TEC DevelopmentProgramme consisting of five priority but related workstreams, and the TEC Improvement SupportProgramme (Delivering Our Ambitions). This guidance focusses on the first element – the TEC Development Programme– and invites health, housing and social care partnerships, as well as other organisations supporting health and social care, to submit expressions of interest to participate in significantly extending and embedding the availability of technology-enabled care in Scotland.

1.5For the purposes of this programme Technology-Enabled Care is defined as: where the quality of cost-effective care and support to improve outcomes for individuals in home or community settings is enhanced through the application of technology[1] as an integral part of the care and support process.

1.6The initial Development Programme will have a focus on working with selected partnerships to develop our approach to scaling up technology-enabled care with the wider learning and knowledge exchange supported via the Improvement Support Programme. It is imperative that partnerships have access to support for more rapid development of skills, knowledge, experience and evidence together with shared learning and measurement of improvements across Scotland. Further details on the Improvement Support Programme are available on the JIT website (

2.Outcomes & Deliverables

2.1The Prescribed National Health & Wellbeing Outcomes have now been laid before the Scottish Parliament[2] and, once passed, will come into effect in December 2014. Therefore, this Programme should be seen in the context of these National Outcomes.

2.2The overall aim of the TEC Programme is aligned with the National Telehealth & Telecare Delivery Plan, and is:

To enable greater choice and control in health, care & wellbeing services for an additional 300,000[3] people by March 2016, enabling more of our citizens to remain at home and in their communities.

2.3By working towards this aim, the five workstreams outlined in Section 3 will collectively deliver the following by 2016:

  1. A 100% increase in the number of people receiving home health monitoring;
  2. An increase to 80,000 the number of people who are supported to self-manage via digital platforms;
  3. A marked increase in the number of people with dementia who are able to be effectively and safely supported through technology-enabled care;
  4. A marked increase in the number of people supported through the provision of telecare systems/services;
  5. An integrated VC service across health & social care in at least two geographic areas – including extending the network to the third sector, independent sector and into citizens own homes;
  6. A 100% increase in the number of technology-enabled clinical & care consultations;
  7. A developing national data monitoring repository/information support system and local use of TEC data as part of routine management & planning of services;
  8. A scalable service model for home health monitoring that is efficient from both a clinical and financial perspective. This will include improved patient targeting, triaging and monitoring arrangements and the introduction of more cost effective technologies;
  9. A detailed feasibility report will be available that sets out the costs, benefits and methods of moving from analogue to digital for Telecare devices and services;
  10. A sustainable funding model to support expansion of Living it Up across all of Scotland.

2.4These deliverables have been identified by the national partners; however there may be further deliverables and outcomes that are important to local partnerships and you are encouraged to identify these in your expression of interest.

2.5Ultimately, Technology-Enabled Care should be seen as a mainstream and integrated part of care planning at a strategic and operational level as evidenced through its inclusion in the Strategic Plans required during 2015-16.

3.Approach

3.1By working both at a national level and with a small number of partnerships, the TEC Development Programme aims to mainstream technology enabled care and thereby build evidence of the impact of TEC delivered at scale.

3.2To help address the National Health & Wellbeing Outcomes, the TEC Development Programme will focus on five key areas, namely

  1. Expansion of home health monitoring as part of integrated care plans to move beyond the small/medium scale initiatives that have been introduced in a small number of areas to substantial programmes across Scotland, building on the United4Health programme;
  2. Expanding the use of video conferencing through using the experience of the NHS video conferencing systems to enable partner organisations across all health and social care sectors to participate and benefit, as well as growing its use for clinical/practitioner consultations;
  3. Building on the emerging national digital platforms of Living it Up and ALISS to expand supported self-management information, products and services for Scottish citizens – this will include direct access to advice and assistance for the public through use of home and mobile technology as well as 'second line' support for clinicians/staff who need to use complementary technology and who access and share information from telehealth and telecare devices;
  4. Expanding the take up of Telecare, with a particular focus on upstream prevention, support for people at transitions points of care and people with dementia[4] and their carers;
  5. Exploring the scope and benefits of switching current provision of Telecare from analogue to digital telecare(this is initially likely to be a nationally-commissioned area of research and analysis however we would welcome expressions of interest from partnerships or organisations wishing to be connected to this work).

3.3It is important to recognise that the above five workstreams are inter-related and while it may be opportune for a partnership/organisation to focus on just one workstream there will be occasions when an expression of interest will cover several workstreams to offer a comprehensive and person centred approach. For example, proposals with a focus on dementia can apply across several workstreams and not just workstream IV. Both approaches are legitimate, depending on local circumstances.

3.4The £10 million will be used at national and local levels to address “essential requirements” (see Appendix 2) to drive widespread adoption. Some of these requirements can only be addressed by National actions – those relating to ensuring there is an infrastructure available across all of Scotland, while others will require a local drive to design and deliver operational arrangements that fit within local circumstances.

3.5The overall TEC Programme is led by JIT, working in collaboration with the Scottish Centre for Telehealth and Telecare (SCTT),Quality Efficiency and Support Team (QuEST) and eHealth. Activity isoverseen by a Programme Board (reporting to NTTAB), supported by an Executive Officer Group and a Programme Manager (see Appendix 1).

3.6The time table for getting started is in outline:

  • National Improvement Support Programme launched 23rd September 2014;
  • Seeking Expressions of Interest in Development Programme (Nov 2014);
  • Discussions with interested partnerships (Dec 2014/Jan 2015);
  • Selection of Partnerships (Jan 2015).

4.About the Programme

4.1While Scotland is currently at the forefront of implementing technology within health and care settings,through this programme we aim to build on this position to remain at the forefront of designing, developing and deploying TEC worldwide. We know there is still significant potential to reach more people, to offer more direct health/care support and to realise more benefits – it is imperative we continue to invest energy, imagination and resources to maintain our leading position. It is expected that this Programme will contribute in significant ways to improving personalised care, helping people to optimise their independence and wellbeing in their own home and provide more cost effective approaches.

4.2The Cabinet Secretary for Health & Wellbeing has previouslyset out the need to see technology enabled care contribute to avoiding unnecessary hospital admissions, reducing lengths of hospital stay and preventing delayed discharges from hospitals in all locations across Scotland. This includes seeing greater application of technology enabled care in remote and rural locations where the recruitment of health and care staff can present additional challenges.

4.3We have deliberately not allocated funding to each specific workstream as the funding will be flexible. Not only will the ability to move money from one project to another as the need arises be retained, but the initial funding allocations to local partnerships will be based on the strength and focus of partnerships’ expressions of interest and will include change management support and expert advice and practical support to local partnerships, with an element retained for the national initiatives. The workstreams themselves are very much interrelated; therefore there will be significant overlapping and mutually supportive activities that will ensure overall cohesion.

4.4A proportion of the total funding will be allocated towards central programme management; commissioning of feasibility/research work; monitoring and evaluation; shared learning and development opportunities and developing further external funding opportunities. There is also an expectation/presumption that partnerships will provide a degree of match funding for some of the work areas, with the £100 million available to partnerships through the Integrated Care Fund a good source.

4.5Integration Boards and Lead Agencies will be required to articulate within their Strategic Plans how they will extend and deliver Technology-Enabled Care within their overall care delivery arrangements. The guidance currently being prepared to support the preparation of the Strategic Plans will incorporate specific requirements regarding how Technology-Enabled Care will be embedded within community care provision, how it will contribute to a reduction in hospital admissions and timely discharge practice and the level of investment in the commissioning of this provision during the life of the Plan.

4.6Appendix 2 goes into more detail on the background to the programme, a number of essential requirements that must be met and the reasons behind choosing the five workstreams.

5.How the Programme will work

5.1Funding for this Programme has been drawn from the 2015/16 £173.5 million Integrated Care Fund. It has already been announced that £100 million from this Fund will be available to Partnerships during 2015/16. The Cabinet Secretary has set out the broad parameters for this Programme – the five workstreams and associated deliverables – but beyond this we want the development and delivery to be driven by local partnerships, supported by the national partners. Other Partnerships or agencies that consider they can make a significant impact on expanding the use of TEC across one or more of the themes are also encouraged to note an expression of interest: this may include some RSLs and other 3rd sector bodies. However, such bodies will require to work with one or more local health, housing and social care partnerships, and we expect that to be covered in the expression of interest.

5.2It is essential this Programme sits comfortably within local partnership strategic plans to ensure TEC forms a part of a coherent pattern of care services and supports. To this end it is anticipated that much of this development funding released to partnerships/organisations will be used as match funding to supplement budgets identified for TEC to support both an acceleration and an expansion in activity.

5.3Partnerships will need to be confident there are clear governance and oversight arrangements in place to ensure a focus and drive is maintained and accountability and transparency for the use of resources achieved. It is anticipated that these arrangements will form part of partnership governance and management arrangements.

5.4The National Programme Board is required to provide at least six-monthly progress reports to the Cabinet Secretary. This will necessitate participating partnerships providing the Board with progress updates.

5.5It is important that this programme generates good quality information regarding what works and what does not work. This is not a research project but rather an at scale deployment where information and evidence will be used to support the evolution and growth of proven service models. To this end the National Partners will commission monitoring and evaluation in a form that will support action learning by the participating partnerships as well as shared learning across Scottish partnerships. Participating local partnerships will be required to participate in this monitoring and evaluation work through allowing access to information and staff, contributing information, ideas and opinions and sharing openly with other participating partnerships the information and ideas generated through the monitoring and evaluation work.

5.6Funding associated with the priority project work streams will be made available on the basis of agreed deliverables, with initial funding available in 2014/5.

6.Selection Criteria

6.1While we anticipate most interest to be from local health, housing and social care partnerships, as noted above, we will also consider expressions of interest from other partnerships or organisations who consider they can develop and deliver growth in one or more of the five workstreams identified for this Programme, thus RSLs or other 3rd sector organisations may wish to indicate an expression of interest.

6.2Overall, we will be looking to work with local partnerships and organisations who already:

  • can evidence a commitment to technology enabled care, and embedding it as part of supported care models within core service delivery;
  • work inclusively with all key stakeholders, with a focus on scale and expansion of technology-enabled care; and
  • have good experience to draw on together with an enthusiasm to continue to grow, develop, innovate and lead.

6.3In addition to the above points, the key criteria against which expressions of interest will be assessed are that applicants can:

  • demonstrate a commitment to successfully deliver TEC as a part of their integrated care strategic planning and demonstrate where this initiative will sit within the draft Partnership Strategic Plan or agency strategies;
  • show how the additional funding will supplement core budgets (including the Integrated Care Fund) to increase the benefits achieved from TEC;
  • show how their governance, leadership and management will be achieved to keep a focus and drive on TEC;
  • set out how other stakeholders will be engaged (including 3rd sector, independent sector, users and carers, clinical/professional staff);
  • demonstrate how TEC sits with other care services and supports to achieve a coherent whole systems approach;
  • describe the reasoning behind the choice of theme or themes to be the focus of the expression of interest;
  • inform the development of specific impact measures for the programme, , and their specific contribution to overall aim and key deliverables identified in Section 2;
  • be actively involved in the Improvement Support Programme to share progress and learning across Scotland;
  • set out what are perceived to be the key critical challenges that will need to be addressed and initial thoughts on what and how these can be covered;
  • set out the main opportunities that exist locally to improve the prospects of success and how these can be exploited;
  • be clear on the main benefits and outcomes to citizens;
  • indicate the number of users per service that will benefit;
  • demonstrate long-term plans for sustainability.

6.4It is recognised that not all the above criteria will apply equally to all development proposals or to expressions of interest coming from non local health, housing and social care statutory partnerships. However, we would anticipate that non-statutory partnership/organisation submissions will need to demonstrate they have the support and commitment from those geographical areas where their activities will be focussed.

7.Notification of Expressions of Interest: the process

7.1As noted above, the first stage of this process is to seek expressions of interest from partnerships and other bodies. We ask that this is achieved through completion and submission of the template attached at Appendix 3. Templates to be submitted by 17:00 on Monday 24November2014.

7.2Following the submission of completed templates there may be discussion between the National Partners and the local partnership to expand, clarify amend/adapt the proposals and potentially to link Partnerships with similar proposals. The aim will be to agree the participating partnerships by the end of January 2015.

7.3For further information regarding this process, and to submit your completed templates, please contact Alistair Hodgson: ; 0131 244 3652.

7.4The success achieved to date in Scotland is in no small part due to a good balance between local and national leadership, collaboration between both parties and improvement and support to local partnerships. It is essential for this approach to be sustained going forward.

7.5A renewed focus is now required to accelerate the pace of deployment and application as an integral part of the Health and Social Care integration process. Technology-enabled care must move from being an adjunct to care (bolted on to some care packages as an additional feature), to being a core part of care delivery.