Website of the Department of Health

The least we deserve

Today, that generation looks forward to a future of enormous potential.  Exponential advances in technology, great changes in trade are creating the reality of a more productive economy and the prospect of actually living longer to enjoy it. 

So today and tomorrow many will be better off, better educated and with higher expectations of public services than any generation before them. And the over 60s of today will be the first cohort to have lived with the NHS all of their lives and that will almost certainly effect the way they view public services.

In June a journalist called Alexander Chandler wrote 'today's sixty year olds are uniquely blessed'.

Our goal as a government, is to help make sure that older people live out that promise to the full.  And today, we express our resolve to harness technology to make that promise real for 160,000 more people; by helping deliver what is actually one of the most precious gifts of all; peace of mind.

Is the future to be feared

Now, I opened my remarks by saying that our older people today have never had such a good future ahead of them.

But, there's probably not a single person in this room, who isn't thinking well, most older people that I know very often fret about the future.

They're worried about what care they will need. They're worried about how much it will cost. And they're worried about how their families will be able to support them.  And all of those fears are absolutely understandable.

But, this is precisely why today is so important.

Because it is simply not realistic to continue to deliver care and support services in the way we do at present. 

Because the truth is 90% of older people want to live in their own home. We know that approximately half a million older people live in residential/nursing care.   But we also know that as many as 35% of those people might want to be supported to live at home or in extra care housing schemes through the use of telecare. (1)

We know that there are nearly 17 million people in our country who live with long term conditions.

We know that today, this day, 8,000 older and frail people will fall - 70% of them will fall tonight; 1,600 will be so hurt they will have to go to A & E. 200 will be found to have broken a hip; tonight 15 will die from their injuries or the trauma.

We know that 50% of people end their lives in a hospital bed, a fifth at home and a large number in nursing and residential care or hospices.  Yet, surveys tell us that the majority of people would prefer to be supported at the end of their life in their own homes.

This is why telecare is so important; because it actually helps give people the confidence to live their lives in way they want - independently; on their own terms; and with the peace of mind that comes from knowing that if something goes wrong, help will be at hand.

And the irony is that in equipping people to live their lives in the way they want, is actually much less expensive.

In 2003/4 there were over 1.6 million emergency admissions for patients aged 65 years - average cost of £83 and over and with all the associated pain, stress and anxiety for those individuals and their families.  Telecare has huge potential to reduce those unnecessary  hospital admissions and  improve people's quality of life.

Now the industry estimates that night falls by older people could be reduced by around 30% with the introduction of telecare.

So lets explore what that means.  So lets assume for a moment that there are 480 falls a night saved. Lets assume for the sake of argument that each one saves one ambulance visit and one day in an acute care bed. There would be 175,000 fewer falls a year and the NHS would be saved in the order of £260 million per year.

If that were only half-true it would represent a massive reduction in individual suffering and it would represent a huge saving in financial terms to both health and social services, especially for those families and professionals living in remote rural communities.

Our responce

So, today is a turning point in Britain's investment in peace of mind for older people.

Thanks to the Chancellor, we have £80 million of investment to make in telecare through the Preventative Technology Grant.

This huge injection of resources will help commissioners I think transform the use of technology within health and social care services.

This funding is not simply intended to be spent on delivering services. It is an unprecedented opportunity to pump-prime the market and stimulate an industry which will be of huge benefit to our country.

So what is our policy? It is three-fold:

It is for this final purpose that we have developed the policy guidance and implementation support materials which I am delighted to be launching today.  Our policy on telecare has been developed following consultation with a very very wide range of stakeholders.  This included the large numbers of people who have freely given of their time, knowledge and expertise to be involved in the Telecare Policy Collaborative.  We just couldn't have done it without you. I'd like to take this opportunity to personally thank all those involved in the collaborative for their role in developing and moving this policy forward. I would like to extend that thanks to the Telecare Advisory Board for the input of their valuable advice and expertise.

This grant is a great step forward not just because of the scale of investment, but because it dovetails with big changes in social care and health - especially new incentives and opportunities for local government to work more closely with health - and together to work more effectively with the voluntary sector.

And so although the funding we are providing over the next 2 years is primarily aimed at supporting, older people we cannot ignore the potential of technology to support us at every stage in our lives.  From advanced baby alarms which include vital signs monitors  providing reassurance at home for parents of premature babies or those at risk of infant cot death to supporting people to complete their lives the way they lived them, in their own homes amongst their family and friends. 

Now, I suppose that you wouldn't expect me to write this cheque without a few words of caution:  don't spend it all at once.

The £80 million will go direct to councils with social services responsibilities.  It won't be ring-fenced because we trust local authorities to use the grant for its intended purpose, to help support individuals in the community and help an additional 160,000 older people to live at home in safety; reducing the number of avoidable admissions to residential/nursing care and hospital. 

But it is vital that we think creatively about how to ensure that the money is used to its maximum potential.  We are working with the Commission for Social Care Inspection to develop mechanisms by which we can measure the impact of the grant by local authority and there is no room for wastage.  It simply will not be acceptable for this funding, intended to benefit 160,000 older people, to be frittered away through hundreds of different tendering exercises. Procurement best practice must be followed and the opportunities to leverage driving down unit costs and seeking best value, provided through the through the power of purchasing consortia, must exploited

Early statutory planning of services will be crucial to enable the industry to gear up to meet demand as it builds. Both the statutory sector and industry must work closely to ensure that supply will meet demand.  That is why we are issuing guidance today -nine months before the grant actually becomes available -so that you have as much time as possible to put the appropriate plans in place.

Conclusion

I wanted to conclude with just a few observations that I drew talking to people up down and Britain who were providing telecare or using it.

They left a very clear impression on me.

As we move towards the future, there is no doubt that new technology will play an increasing role in all parts of our lives. But, we must guard against allowing technology to ever control or isolate us. 

We must not forget that as the world is changing rapidly around us, our basic humanity remains the same.  Some care services will always, and quite rightly, be delivered personally because human contact is vital to maintaining quality of life. 

And so as we embrace new possibilities and the promise the future brings, it becomes not less important but more important to hold on to our oldest values chief of which is dignity.

Last week, I met a couple in Sandwell. Husband and wife. The husband is 80 years old with severely impaired mobility linked to a history of falls. The wife is a similar age and provides much of the necessary care for her husband - especially during the night.

She had been caring for her husband for over ten years but had found the price of this devotion increasingly difficult and exhausting. They have separate rooms and he had frequently had falls at night.

They had been using a baby alarm, which allowed her to listen for cries of help. But the truth was, with the level of background noise she still needed to be at least semi-alert and had not had a proper night's sleep for a decade.  Sandwell BC then installed telecare equipment - a simple wrist band sensor, similar to a watch linked to a small receiver on the wife's bedside table. If something bad happens, the husband presses the button on the wrist band which will wake her so that she can assist him - no need for telephone cables or monitoring by any external alarm call centre. And actually since they have been using this system they have both noticed a huge improvement. She has had the best sleep she has had for a decade and he has not fallen once. 

This simple system had transformed their quality of life. And what they said to me in their living room really just summed it up for me. She said;

'After a life-time's work, all we want is just a little peace of mind.'

I think that our retired community has earned that peace of mind and I am delighted to say that today we are a big step closer to achieving it.

Thank you very much, this is a great project.

Footnotes

(1) Source: DH Research