Supporting & Empowering Scotlands Citizens: National Action Plan for Technology Enabled Care

Actions for 2016 and 2017

Key Activity Areas

To effectively focus effort and maximise deliverables over this transition period, we have identified the following four activity areas:

1. Continuation of the funded TEC Development Programme
2. Innovation Activity
3. International Engagement
4. Cross Cutting Enablers

1. TEC Development Programme:

The Scottish Government will provide a continuing commitment to support the development and delivery of TEC in local health & social care partnerships, and their partners, through ongoing investment in the TEC Development Programme. This aims to inform and deliver technology enabled system redesign at scale and focuses on five key interconnected work areas:

• Home and Mobile Health Monitoring;
• Expansion of Video Enabled Services;
• Digital Services, including development of a Digital Platform framework;
• Telecare Expansion (including a shift from Analogue to Digital Telecare);
• Improvement and Support.

This Programme is the primary means of driving local activity, although there is an expectation that long-term sustainability is being led by local partnerships and integrated within strategic planning and service redesign. In year one of the programme (2015/16), self-reported outcomes from local areas show we have enabled close to an additional 25,000 Scottish citizens to have benefitted from TEC and laid firm foundations for the further expansion of TEC. For more details on the programme, see http://goo.gl/c6NJGf.

Example 4 - Technology Charter

One of the primary deliverables of the programme as a whole during its first year was a 'marked increase in the number of people with dementia who are able to be effectively and safely supported through technology-enabled care'.

Alzheimer Scotland is receiving funding to help promote the greater use of technology (in general) for people with dementia and to support a number of areas in their focused activity. Alzheimer Scotland worked with partners to develop the first ever Technology Charter for people living with dementia in Scotland which was launched at the Scottish Digital Health & Care Conference, Glasgow in Dec 2015 by well-known Scottish journalist, Sally Magnusson.

The Technology Charter is a call to action, calling for the delivery of health and social care to people with dementia to incorporate and promote the use of technology; helping people with the condition to live healthier, safer, more active and more confident lives as valued citizens. It also seeks to raise public and professional awareness of how technology can enhance lives, promote independent living and assist and complement care and support.

The Technology Charter has six key values:

• Practice and service provision is rights based, personalised and free from discrimination.
• Unpaid carers and families are recognised and valued as equal partners in care.
• Information and advice about technology is available in clear everyday language and in a variety of formats.
• Routes and access to technology are ethical, equitable, simple, understandable and user-friendly.
• Consideration of technology is embedded at all key points in the integrated dementia care pathway.
• Technology augments - but does not replace - human intervention.

The full charter can be found at http://www.alzscot.org/assets/0002/0289/Technology_Charter_for_People_with_Dementia_in_Scotland.pdf

2. Innovation

Scotland can do ^[9] is Scotland's shared statement of intent across all of the public sector towards Scotland becoming a world-leading entrepreneurial and innovative nation: a 'can do' place for business. It recognises that increasing collaboration within and beyond Scotland, and involving the public, private and third sectors working together, is key to success. The public sector has an important role in creating a supportive business environment for entrepreneurship and innovation; in being a role model for innovation; through novel approaches to procurement; and in seeking to stimulate both innovation and market demand.

Scotland provides a fertile environment for growth in innovation, given its already strong connections between industry, academia and service providers, and our record of accomplishment in telecare and telehealth. Growth will be enhanced by more effectively integrating our innovation pipeline with our wider development activity to optimise the benefits from public sector investment in this area.

Within digital health and care, the global market opportunities over the next few years are estimated to be anywhere between £40 billion and £200 billion, with over £5 billion invested in the US alone during 2015.

This presents a unique opportunity for Scotland to build a material economic sector and realise significant efficiency savings in the delivery of health and social care. This is especially true given the assets at our disposal, as already recognised by the motion passed in the Scottish Parliament in 2014:

"Innovation through technology is vital in delivering Scotland's 2020 Vision for health and social care, whereby everyone is able to live longer, healthier lives at home or in a homely setting … and recognises that Scotland has a clear opportunity to be a leader in the growing global digital health and care market."

Scottish Parliament Motion S4M-09222 ^[10]

Scotland is currently well positioned to exploit this opportunity through the creation of an environment to allow these new models to be crafted and thrive, leveraging the wealth of health & care data at our fingertips, the geography and combination of urban, rural, remote & island communities as well as the increasingly integrated Scottish public sector capability in a rapid, risk-free way. Business consortia formation can also be positioned to internationally commercialise successful solutions and models of health & care.

A number of key themes will be identified and these will be progressed by our lead innovation delivery partner, the Digital Health & Care Institute, working in collaboration with other partners such as the other Scottish Innovation Centres, the NHS Innovation Leads, the Open Innovation Programme, CivTech, the Farr Institute and the Improvement Service in Local Government.

3. International Engagement

The Scottish Government's Action Plan for EU Engagement set out the vision and work being taken forward in Scotland to develop strong relationships with partners in Europe to our mutual benefit. In 2012, the Scottish Government tasked NHS 24's Scottish Centre for Telehealth and Telecare ( SCTT), with leading on EU engagement activities related to the development of digital health and care.

Since 2012, Scotland's international engagement activities in relation to digital health and care have been predominantly focussed within Europe, however Commonwealth collaborations are emerging with stakeholders in Australia and New Zealand, as well as interest in our approaches from Asia and the Americas.

Example 5 - European Innovation Partnership on Active & Healthy Ageing - Reference Sites

The Innovation Partnership ( EIP AHA) is one of the European Commission's flagship initiatives designed to accelerate the spread of best practice in the innovative use of digital in the delivery of active and healthy ageing initiatives. Within that, Reference Sites are 'highly inspirational ecosystems, delivering creative and workable solutions that improve the lives and health of older people. These solutions can be scaled-up and replicated across the EU.'

A first call, published in 2012 by the European Commission, resulted in 32 regions being recognised as EIP on AHA Reference Sites. NHS 24 led the submission of an application, on behalf of Scotland, in the first 2012 call which resulted in Scotland being one of only 3 regions to be awarded 3-star Reference Site status (3-star status was the highest award level in the first call) - primarily for our work in telecare and risk stratification, in addition to a commendation for work on falls prevention and management..

NHS 24 again led Scotland's submission to the second call, launched in December 2015. Following the peer and expert review process, Scotland was awarded 4-star Reference Site status for our work on technology enabled care within an integrated health & care environment. Only 8 regions out of 74 have been awarded this highest award level status, cementing Scotland's reputation as a leader in Europe. The Reference Site status is granted to organisations that have demonstrated excellence in the development, adoption and scaling up of innovative practices for active and healthy ageing.

SCTT published its first European Engagement and Activity Overview in 2014, with progress and outcomes reported annually in SCTT's End of Year reports. ^[11] A new International Engagement Strategy for Digital Health & Care will be published in Autumn 2016 to support this Action Plan. This builds on our significant achievements to date, outlines the priority areas for action over the next three years to capitalise on emerging opportunities for wider international engagement, with the ultimate aim of supporting the delivery of the integrated Digital Health & Care Strategy. NHS 24, through SCTT, will remain our lead partner for international engagement activity.

4. Cross Cutting Enablers

The above key activity areas are necessarily supported by a number of cross cutting enablers:

• Awareness raising/knowledge transfer: benefits of using the technology must be clear to users/carers and clinicians/staff and result in more efficient and more effective care; and lessons learned should be captured and more proactively made available to partnerships throughout Scotland
• Research: to provide a robust evidence base of the societal, organisational, clinical and economic benefits of TEC
• Standards: drive the quality of TEC services, by identifying and implementing appropriate standards based approaches
• Horizon scanning: to identify new opportunities that will support investment, innovation and inclusive growth
• Evidencing Impacts/Benefits Realisation: Further impetus will only be achieved by demonstrating the benefits of this approach at scale.
• Workforce development/staff training: Development of workforce capability and capacity is essential to integrating use of technology into everyday work and learning. The Improvement and Support workstream within the TEC Programme (Workstream 5) includes a focus on local workforce development, building capacity for support around business planning, data analytics, service redesign, change management etc. We also need closer alignment with the priorities and work programmes of organisations such as NES and SSSC.