Proposed decision:
Procure a Countywide Technology Enabled Care Service and delegate authority to the Corporate Director Adult Social Care and Health to take relevant actions, as required to facilitate procurement activity.
Background:
Technology Enabled Care is a key area of the Making a Difference Every Day; Our Strategy for Adult Social Care 2022 – 2027 and aligns with Framing Kent’s Future Strategy, which lays out four priorities, one of which is the delivery of new models of care and support.
Technology Enabled Care will contribute towards the delivery of the key ambition “we have real opportunities to improve the effectiveness and efficiency of our adult social care services by making full use of new technology and innovations that mean we can better manage demand and focus resources where they are most needed.”
Technology Enabled Care is a term to describe a range of personalised IT and digital solutions which can be used to support outcomes for people who draw on care and support and carers. Innovative technology solutions and data are allowing people to remain independent for longer, identifying risk, preventing incidents and ensuring quick and appropriate responses to avoidable events such as falls.
The data harnessed from these technologies will not only support people more effectively at an individual level, but over the long-term has the potential to support management of health and wellbeing at a population-level and provide insights which support future service planning.
Technology Enabled Care has been evidenced in other local authorities to improve outcomes for people and achieve significant financial and non-financial benefits. The objective of the Technology Enabled Care Service is to fully embrace the range of technology now available in the market and embed a technology-focused and data-led approach in Adult Social Care.
The aim is:
· To commission and deliver an innovative digital Technology Enabled Care offer that empowers a person and supports them to maintain or improve their independence, safety, and wellbeing.
· To transform Practice and the way care and support is delivered which will improve lives and make social care sustainable.
· The future service will bring together the existing KARA and Telecare contracts and the new technology provision in order to develop a transformational service offer that progresses our strategic objectives.
The procurement will start in December 2022 with the aim to award the contract in June 2023. It is proposed the contract will run for five years with a two-year contract extension option.
Options:
As part of the development of the Technology Enabled Care Service, several options have been considered and assessed against the following critical success factors:
· Develop a robust data evidence base which is used to proactively support independence, improve outcomes and generate insights about future service requirements and population-level need, and support a data-led approach to practice.
· A clear and innovative offer that empowers people, supports independent living and provides greater choice and control.
· Proactively considering assistive technology across the social care pathway, including but not limited to, at the first point of contact, care and support assessments and reviews and enablement support.
· A flexible model that enables Technology Enabled Care to develop over time and explore benefits of partnership working.
· To develop the private pay market, exploring options for promoting Technology Enabled Care to self-funders and commercial opportunities.
· Maximise efficiencies in Adult Social Care and embed digital technologies to manage demand. From the start ensuring systems in place to collate and report comprehensive and reliable data, that show the financial and non-financial benefits and impact of Technology Enabled Care.
A short list was then formulated as potential opportunities:
1. Do Minimum
This option represented the current situation and provided a baseline against which the other short-listed options were measured. Although this option will be cheaper to deliver, it failed to address the requirement for innovation and culture change which seeks to embed Technology Enabled Care. Therefore, with this option there is a risk that a service will be procured but not utilised.
2. Less Ambitious than Preferred
This option represented the desired level of service based on the minimum level of change. Although this option would meet the majority of the critical success factors, it failed to include the development of the private pay market. Additionally, there was limited-service development and culture change included in the scope, which means the maximum benefits of implementing Technology Enabled Care are unlikely to be realised and technology will not be fully embedded.
3. More Ambitious than Preferred
This option represented the desired level of service change based on the maximum level of change. Although this option had the ability to meet and/or exceed all of the Critical Success Factors. The timescales for the procurement of the Technology Enabled Care Service were for the entire service to go live from June 2023, these timescales are extremely tight and not viable to mobilise.
4. The Preferred Option
This option represents the desired level of service change:
· Scope: County-wide Technology Enabled Care Service which is outcome focused and device agnostic with a focus on embedding innovation and culture change through the development of practice and a data-led approach
· Service Solution: A Technology Enabled Care Partner that delivers core requirements: assessment and referrals, products, installation, monitoring, data dashboards and culture, change management.
· Delivery: The Technology Enabled Care Partner will work closely with Kent County Council (KCC) to implement the core service and embed the approach in adult social care, as well as exploring commercial opportunities including private pay offer and developing opportunities with partners.
· Implementation – A phased go-live enables the mobilisation of existing people drawing on Telecare, KARA and Build and Test services and full service go-live from September 2023.
This option is the preferred due to its ability to meet and/or exceed all of the Critical Success Factors. The partnership model outlined in this option will enabled KCC to benefit from the expertise to drive change and embed Technology Enabled Care, achieving benefits and ensure there are effective ways to measure and demonstrate the impact of Technology Enabled Care. The timescales for implementation are achievable.
Decision type: Key
Reason Key: Expenditure or savings of more than £1m;
Decision status: Recommendations Approved
Division affected: (All Division);
Notice of proposed decision first published: 27/10/2022
Decision due: Not before 1st Dec 2022 by Cabinet Member for Adult Social Care and Public Health
Lead member: Cabinet Member for Adult Social Care and Public Health
Lead director: Richard Smith
Department: Social Care, Health & Wellbeing
Contact: Helen Gillivan, Head of Business Delivery Unit Email: helen.gillivan@kent.gov.uk or 03000 418941.
Consultees
The proposed decision was considered and endorsed by the Adult Social Care Cabinet Committee on 17 November 2022.
Financial implications: Financial modelling has been undertaken based on extensive market consultation and engagement with local authorities who have implemented Technology Enabled Care services. The financial model assumes that a certain proportion of people will transfer from existing technology services into the new contract and explores a number of scenarios based on different service growth over the proposed life of the contract. The Technology Enabled Care Service will grow over the life of the contract so that 50% of people entering Adult Social Care will receive some form of Technology Enabled Care as part of their care and support package by Year 5 of the contract. The contract value of this option over a 5+2 year contract has been modelled as £27,585,392 (7 years). The entire cost is revenue cost, as under the proposed model KCC will lease technology devices from the provider rather than purchasing devices which potentially have a short lifecycle.
Legal implications: Technology Enabled Care will be a tool to support the Adult Social Care and Health directorate to deliver its requirements to promote wellbeing and preventing, delaying or reducing needs under the Care Act 2014, and support the delivery of Framing Kent’s Future. Legal implications have been identified in relation to data processing and data management across a range of technological devices and systems. Legal advice has been obtained to develop the DPIA and ensure the service will be compliant with the Data Protection Act 2018.
Equalities implications: Equalities implications: A full Equality Impact Assessment (EQIA) has been undertaken and has determined that the Technology Enabled Care Service is not expected to have a significant negative impact on any protected characteristic. The EQIA identified an action to ensure Technology Enabled Care is promoted widely and in a way that is accessible to all individuals and communities in Kent. The EQIA will be updated once a provider is appointed. Data Protection implications: A full Data Protection Impact Assessment (DPIA) has been developed following the completion of the initial screening. The DPIA has been informed by engagement with KCC’s Data Protection Office and the Adult Social Care Information Governance Lead. However, some of the mechanisms on how the data will be processed will not be known until the preferred provider is selected. The preferred provider will also be required to undertake DPIAs to manage any devices and systems delivered under sub-contracting arrangements.