Essex care technology service

Essex has an ageing and growing population with a higher proportion of people aged over 65 than the national average. Essex is also seeing growing demand and more complex demand among working age adults with learning and physical disabilities.

To help them address this challenge, on 1 July 2021 a new countywide care technology service was commissioned which supports two mission-critical areas in the adult social care business plan: prevention and early Intervention, and digital and technology. The original contract length was three years, this was extended earlier this year for a further four years.

The care technology service supports their vision to “enable people to live their life to the fullest” but also enhances other aspects of social care such as supporting carers, improving housing environments, enabling employment opportunities, improving technological and digital capability in the care market and developing social care practice.

Care technology is a key enabler to both Essex's vision and Home First commitment.

The care technology service is available to anyone over the age of 18 who is eligible under 'Prevent, reduce, delay' or full Care Act eligibility. The service is countywide across Essex, excluding Southend and Thurrock and is free of charge for the end user.

The service is delivered in partnership with Livity Life (formally Millbrook Healthcare) and Provide Community Interest Company (CIC). Millbrook support with the end to end technology offer including procurement, installation, maintenance, decommissioning and recycling of technology, alongside promoting innovation and culture change. Provide CIC carry out the monitoring and response to any monitored equipment provided as part of the service, this also includes a falls pick-up service and a proactive calling service.

Since 1 July 2021, the care technology programme has achieved £30.3 million of gross savings, with net savings (allowing for costs) of £4.2 million delivered in 2021/22 (£3.3 million above target), net savings of £5.9 million achieved in 2022/23, (£1 million above target) and net savings of £1.6 million achieved in 2023/24 (£1.2 million above target).

So far for 2024/25 we are delivering avoidable net savings of around £3.5 million (as at August 2024) against the MTRS target of £2.5 million and is scheduled to overachieve for the fourth year running.

Care technology is supporting 11,599 residents (as at August 2024). 

They’ve trained 2,130 internal and external individuals to prescribe care technology across Essex to support people to live more independently. The growth of the service has exceeded targets and expectations in terms of outcomes. The service will continue to grow, and it is estimated that there could be up to 18,000 individuals being supported with Care technology by March 2028 moving Essex to an ambition where every adult in receipt of adult social care has access to care technology to support them to be as independent as possible.

They have seen a return of around £10.36 million in Social Value within sustainable employment, training and employment of specific cohorts, supporting communities with green projects and reducing public service demand. For example, the service so far has enabled 957,500 miles of car travel to be avoided and has supported 53 Essex residents to gain employment.

The growth of the service has exceeded targets and expectations in terms of outcomes. The service will continue to grow, and it is estimated that there could be up to 18,000 individuals being supported with care technology by March 2028 moving Essex to an ambition where every adult in receipt of adult social care has access to care technology to support them to be as independent as possible.

We have seen a return of around £10.36 million in social value within sustainable employment, training and employment of specific cohorts, supporting communities with green projects and reducing public service demand. For example, the service so far has tnabled 957,500 miles of car travel to be avoided and has supported 53 Essex residents to gain employment.

The care technology service has innovation at the core of the contract which allows Essex to carry out test and learns to ensure residents have the best technology available to reach their outcomes. Some of the test and learns which they are currently undertaking are;

• Using short-term assessment kit to enable the rightsizing of packages and elevate family members concerns and trialling this in a Reablement pathway. The technology is installed at the beginning of the reablement service and the data is then used to help inform the assessment of progress and independence, and of ongoing care needs. This has the potential to enable to better inform the care workers on the ground and to speed-up, slow-down, increase or reduce the ongoing care support based on data-driven evidence.
• A scaling-up falls detection project across Mid and South Essex and North East Essex in Care Homes. Our project consists of rolling out technology to 435 people in Care Home settings with an aim to identify all types of falls and supports quicker response and reduce ambulance call outs and A&E admissions.
• Exploring the concept of “Hybrid care” with Domiciliary care providers to shape future contracting and charging. The existing long-term domciliary framework is set-up on a time and task basis which does not allow the flexibility to use Technology. They have seen the benefits technology can make on supporting independence and want to complement care delivery with technology where appropriate. The project is scoping what good looks like and work with the market to shape future costing of telephone or video calling or referral incentives through a gain share model. The learning will feed into future re-commissioning in 2025.
• The development of a social care app catalogue which can be used by frontline teams to promote apps which could benefit residents of Essex.

Essex is also looking at oredictive analytics utilising the care technology data alongside system data in a more predictive way:

• The first phase looked at individual’s journeys within our system, pulling data from Mosaic linked to placements, assessments, safeguarding, care packages and matching this with care technology interventions and data from daily living monitoring and alerts. This will show the type of equipment across Essex in geographical, age and cohort level data.
• The second phase was to match this data with our benefits realisation information to see where we are achieving best outcomes in terms of escalating costs and see long term trends and patterns of the impacts of technology.
• The final phase was to use this data to identify risk and changing needs alongside helping us to manage future demand by finding similar people in review and social care assessment wait lists and to target Essex residents who could also benefit from similar equipment. This data can also be used to support commissioning activity where there are gaps in a service.

Essex is now in the final phase of this work and are looking at how they can implement their findings into a test and learn for those on the review and assessment waitlist.

Many years of learning were undertaken before adult social care launched a countywide care technology service. This included:

• Learning from national best practice – they knew via LGA and County Councils Network that Hampshire County Council were consistently being highlighted as an exemplar for their care technology service (delivered with PA Consulting)
• To support the development of our thinking, they commissioned two research reports from SOCITM and PA Consulting support. SOCITM assisted them to understand the care technology landscape, explore what other councils were doing and some of the opportunities. PA Consulting supported with a diagnostic report on where Essex was in terms of adoption of technology and recommended a potential delivery model.
• In 2018, they took the proposed model from PA Consulting and carried out a test and learn in the south quadrant (delivered by PA Consulting) where they tested out the principles of a provider carrying out assessments and installing equipment. This pilot was valuable in creating a robust benefits realisation model and enabled them to identify what technology could be used.
• In 2020, they distributed 2,000 Video Carephone (Alcove tablets) to help people stay connected and supported during periods of lockdown. Vitally the carephone rollout gave us further learning in terms of culture change.
• Final procurement launched October 2020 where they shifted from traditional procurement to a focus on outcomes for service users and went out with a 100 per cent quality tender of which 20 per cent was social value. The new procurement approach enabled them to utilise a framework which enables them to explore opportunities with NHS partners, housing and children service during the lifetime of the contract.