Implementing Telecare
Identify and procure technology

The decisions the project team makes about the technology for the early implementation of the project can have a long-term impact, and so the selection process needs to be handled as systematically as possible – via an options appraisal preferably or formal tendering process if required. Whilst appropriate technology alone will not be sufficient for the project to succeed (other factors will also affect success), it is undoubtedly an essential component.

In the initial roll-out the technological issues may not be significant, but it is still worth setting up fairly formal processes, as they will be needed as / when the project is expanded. It also must be noted that telecare technology will undoubtedly change (as the use of it expands and new approaches develop) and these decisions may need to be revisited within the next 3 - 5 years.

Identifying the technology

While research analysis into the different types of technology available is a necessary step, it is in itself a cost – so ever-deeper analysis and investigation may cost more than it is worth.

The National Framework Agreement for Telecare was set up by the NHS Purchase and Supply Agency (PASA) in 2006 and 15 suppliers were selected to participate following a full EU/OJEU compliant tendering process. Each supplier provides a range of telecare equipment and/or services (including installation, maintenance, monitoring and response).

When researching the technology options available, project teams should investigate the range of telecare equipment available on the market. The PASA suppliers list is a good place to start this research process. See next page for PASA Suppliers List.

Currently, the suppliers participating in the National Framework Agreement are (list updated 6 November 2008):

A major benefit of an initial roll-out is that it is a practical way to gather information about how a particular type of technology works in practice – and it can then be replaced if it is unsatisfactory. The following steps should help a project team to reach robust decisions on which equipment to use:

Revisit the project vision and outcomes

• Establish how the technology will contribute to the project’s vision and outcomes. (This focus on outcomes helps to protect against tempting sales offers or attractive “state of the art” technologies – but which do not serve the outcomes).

Establish the budget available

• Determine how much funding / resources are available for the purchase of technology.
• Establish whether funding is only for initial purchase, or also for other inevitable costs – such as equipment installations, battery replacement and maintenance.
• If additional costs cannot be met from the budget available, identify how these will be funded.
• Establish whether funding is capital or revenue funding.

Specify technical requirements

• Set out clearly what the technology is expected to do.

Establish compatibility requirements

• What other equipment or systems does the proposed technology need to be compatible with?
• What is the capacity of the existing technology with which it may need to work, e.g. call handling systems?

Set criteria for choice (options appraisal)

Specify the criteria that will be used to compare choices. Some criteria against which to compare the possible options are:

• does it address the outcomes / service user focus?
• does it meet technical requirements?
• is it compatible with other equipment, i.e. what format does alert / data have?
• what are the full costs – initial purchase plus consequential costs over the product lifetime?
• does it meet quality requirements the project team has set?
• does it meet installation requirements – e.g. ease of installation, cost, etc?
• reliability – consider maintenance / repair history from suppliers and other authorities experience
• ease of maintenance / repair
• running costs to service user
• equipment lifespan – when does it need to be replaced – consider both hardware and back office software (including battery lifespan)
• volume required – whether bulk discounts are available for bulk purchases. Refer to the PASA National Framework Agreement for Telecare (Page 64) for information.

The project team needs to list the criteria it will use, and weight them – not all will be equally important.

Identify alternatives

• Research the market to see which suppliers are available. Refer to the PASA National Framework Agreement for Telecare (Page 64). (This is a time when gathering information from other Telecare users is essential, as their experience can provide valuable guidance).

Compare and choose

• Gather as much information as practicable, including that from reference sites, published evaluations and other users, focusing on the technology most likely to do the job.
• Consider reviews of performance against chosen selection criteria.

Who to involve?

• Consider carefully who to involve in the decision.
• Operational staff and carer/service user groups will have much to offer in terms of both the criteria to choose, and in how to weight them.
• Call monitoring centre staff
• Contracts / commissioning sections
• Finance section
• Senior management representation may also be important depending on the size of the contract sums involved.

Procurement

This is an area which frequently causes difficulty, as both legislative and local requirements shape the choices that the project team can make.

The project team should:

• establish the likely contract sum;
• seek advice and guidance from contracts / commissioning staff as early as possible in the project, to avoid delays later;
• ensure that the contracts section is aware of the nationally agreed PASA National Framework Agreement for Telecare (Page 64). Using this framework could save valuable time and funding due to the agreed contract rates from approved suppliers;
• provide the contracts section with an overview of the project’s requirements and determine whether there is a requirement to go out to tender;
• if yes, establish the tendering process to be followed;
• be wary of anti-competitive practices – try not to be influenced by any one particular supplier.