Feasibility study for the provision of universal telecare services of the over 75s Peter Lock November 2016
Project Context Number of over 75s in Scotland is increasing and emergency admissions from this cohort has been steadily rising year-on-year. Rising longevity brings with it increasingly complex and chronic health conditions placing substantial demand on health and social care services. 75% of people over 75 suffer from chronic disease with the incidence expected to double by 2020. Between 25% and 29% of all over 75s in Scotland in receipt of a telecare package. However there remains significant variations in service provision across Scotland. Telecare is often provided on a reactive basis rather than as a preventative service. The over 75s should at the very least have the offer of a service available. 2
Project Overview Identify best practice Undertake cost benefit analysis Set out target cohorts Define standard packages Conduct a feasibility study to examine what a national approach to the provision of telecare services for the over 75s would look like. Explore legal and ethical considerations Define next steps National Universal Telecare The outcome will be used by: by Scottish Government in considering policy development and further investment in the shift to more preventative services, to support health and social care integration. by local health & social care partnerships and housing associations to understand any lessons learned in terms of implementing this shift locally. by Scottish Government and local partnerships, to understand the most cost effective models, based on the cost-benefit analysis to support business planning. 3
Key issues the review will consider Fragmented Landscape The Telecare landscape in Scotland is very fragmented. Local authorities are starting from different positions. Cultural Shift The successful implementation of a national entitlement model will hinge on effective stakeholder collaboration. Ethical Considerations Ethical dilemma between balancing people s potential wishes to be independent and the pressures around the availability of person provided care. Technology A national model must remain cognisant of limitations of the demographics of the target market and the availability of appropriate connectivity and infrastructure. Implementation Costs A national entitlement model must be supported by a convincing business model which clearly demonstrates that the benefits will outweigh the associated costs. Funding Model Funding decisions are currently largely determined locally which risks the emergence of a postcode lottery as regards to access to telecare. 4
Our Approach November December January February March Local Area Survey Cost Benefit Analysis Reporting Project Kick-Off Stakeholder Engagement Option Definition Workshops TEC Programme Board Interim Update Final Report Local Authorities NHS Scotland Scottish Government Housing Association COSLA 5
Deloitte refers to one or more of Deloitte Touche Tohmatsu Limited ( DTTL ), a UK private company limited by guarantee, and its network of member firms, each of which is a legally separate and independent entity. Please see www.deloitte.co.uk/about for a detailed description of the legal structure of DTTL and its member firms. Deloitte MCS Limited is a subsidiary of Deloitte LLP, the United Kingdom member firm of DTTL. This publication has been written in general terms and therefore cannot be relied on to cover specific situations; application of the principles set out will depend upon the particular circumstances involved and we recommend that you obtain professional advice before acting or refraining from acting on any of the contents of this publication. Deloitte MCS Limited would be pleased to advise readers on how to apply the principles set out in this publication to their specific circumstances. Deloitte MCS Limited accepts no duty of care or liability for any loss occasioned to any person acting or refraining from action as a result of any material in this publication. 2016 Deloitte MCS Limited. All rights reserved. Registered office: Hill House, 1 Little New Street, London EC4A 3TR, United Kingdom. Registered in England No 3311052.