Telecare in Scotland Analogue to Digital Transition

Transcription

1 - Telecare in Scotland Analogue to Digital Transition Initial Implementation Roadmap February 2017 NHS 24, Scottish Centre for Telehealth and Telecare

2 Copyright 2017 FarrPoint Ltd has produced the information contained herein for NHS24. The ownership, use and disclosure of this information are subject to the Terms and Conditions contained in the contract between FarrPoint Ltd and NHS24, under which it was prepared. Revision Description Author Checked Reviewed Authorised Date 0.2 Draft issue for initial RP/AP AP AP RP 13/01/2017 comment 1.0 Updated following client RP/AP AP AP RP 26/01/2017 comments 1.1 Minor updates following RP/AP AP AP RP 08/02/2017 further comments. 1.2 Minor updates following further comments. RP/AP AP AP RP 09/02/2017

3 CONTENTS 1. Introduction Background Digital Telecare Roadmap Objectives Roadmap Overview Proof of Value Workstream Planning Initial Deployment Full Deployment Procurement Workstream Innovation Workstream External Factors Annex A Gantt Chart NHS24D6V1.2 Page 1 of 17 February 2017

4 1. Introduction 1.1 Background Workstream 5 of the Scottish Government s Technology Enabled Care (TEC) Programme aims to: Explore the scope and benefits of switching current provision of telecare from analogue to Digital Telecare. FarrPoint was responsible for completing the study into Digital Telecare and, as part of this work, has provided two deliverables detailing the potential benefits of Digital Telecare and a suggested implementation approach 1. The telecare studies define Digital Telecare as follows: A Telecare solution is considered to be Digital if it carries information end-toend, from sensor / monitor, to the Alarm Receiving Centre agent s workstation / telephone in a digital form without any conversion occurring. In technical terms, this means that data will be carried end-to-end using Internet Protocol (IP) format. A range of potential benefits associated with Digital Telecare were identified in the studies. These potential benefits fall into four main themes: Reliability Potential benefits relating to improving the reliability and quality of Telecare services, or ensuring the continuity of Telecare; Efficiency Potential benefits relating to improving the efficiency of Telecare. These relate both to efficiencies gained through improvements in delivery methods and utilising increased sharing of information/partnership working to broaden services; Additional Functionality Potential benefits obtained by using digital technology to deliver new Telecare functionality and services; Telehealth Potential benefits obtained by using digital Telecare technology to support the delivery of Telehealth services. 1 The FarrPoint reports can be found here: NHS24D6V1.2 Page 2 of 17 February 2017

5 Currently no Scottish public sector Alarm Receiving Centre meets the definition of Digital Telecare. The studies presented a high level approach for migrating Scotland s ~26 Alarm Receiving Centres and ~150,000 Telecare users to a digital solution. The timescales for completing this high level approach were defined by the existing position of providers in their Alarm Receiving Centre/Service procurement cycle. Also driving the timescales are the emerging plans for the decommissioning of analogue telephone services. Whilst firm timescales for this decommissioning are not yet available, information from Ofcom indicates that potentially BT could have completed this process by 2025, with other providers completing the rollout prior to this date. Given this, it has been currently assumed that any rollout of Digital Telecare needs to be complete by Digital Telecare Roadmap The definition and plans for Digital Telecare were presented at a number of engagement events to stakeholders, including telecare providers, housing providers, and industry. As a result of the feedback obtained from these events it was decided that detailed planning for initial deployment and a full implementation of Digital Telecare should be completed. This document provides a Roadmap for the implementation of Digital Telecare. This Roadmap builds on the outline implementation approach presented in the previous FarrPoint reports, and provides further details on the plan, tasks and timing for the implementation. This document is intended to provide an initial overview of the approach to implementing Digital Telecare. Many of the tasks detailed in the Roadmap will require individual detailed plans, these will be presented separately at a later point in the implementation, as required. NHS24D6V1.2 Page 3 of 17 February 2017

6 2. Objectives The objectives of the programme of work detailed in this Roadmap are to: Deliver initial implementations of Digital Telecare to provide a Proof of Value testbed for the technology. These initial implementations should: o Test both the in-house (on premise solutions, operated by public sector organisations and/or housing associations) and hosted (cloud based solutions delivered by private sector companies) service delivery approaches; o Be scalable to allow them to grow into larger-scale solutions; o Focus initially on the digital enablement of current telecare services, rather than any innovation/advanced services. (See below for separate workstream looking at innovation/advanced services); o Test the functionality and reliability of the Digital Telecare solution; o Ensure user safety throughout; o Develop and test the arrangements and processes required to support Alarm Receiving Centre (ARC) clustering; o Validate the benefits of Digital Telecare (from both a user and service provider perspective) and establish a business case for organisations considering the adoption of the technology; o Develop and test the operational and organisational processes associated with Digital Telecare; o Develop and test a recommended procurement approach for Digital Telecare; o Develop and test a recommended implementation approach for Digital Telecare. This should provide a plan for the safe and efficient migration of Scotland s 150,000 telecare users to the Digital solution. It is currently assumed that this needs to be completed by This timescale is based on assumed plans for the decommissioning of the UK s analogue telephone service, although this assumption needs to be updated once firm plans for this decommissioning becomes available; o All the above should be completed by the end of NHS24D6V1.2 Page 4 of 17 February 2017

7 Develop Scottish standards for Digital Telecare service offering, service levels, and reporting. Develop and implement a framework to support the development, testing and deployment of advanced/innovative Digital Telecare services. Develop and implement the required procurement arrangements to support the rollout of both standard and advanced/innovative Digital Telecare services. Put in place arrangements to support a full deployment of Digital Telecare in Scotland. Ensure that external factors influencing Digital Telecare are considered by the programme, including: o The development of European standards for Digital Telecare; o The plans for the switch-off of analogue telephony services; o The availability and development of fixed and mobile broadband services in Scotland; o Potential plans for a universal telecare service in Scotland; o Developments within the other Technology Enabled Care Workstreams; o Other developments within Local Government, ehealth and wider public/third sector IT; o UK and International Digital Telecare projects. The following overarching principles have also been applied when developing the Roadmap: The Roadmap should focus on delivering Digital Telecare at scale, not just piloting the technology; The role of the Programme is to provide advice and best-practice guidance to organisations implementing Digital Telecare, not to dictate an approach; Any advice should be neutral on the delivery approach for Digital Telecare (inhouse vs cloud model); Any advice should be neutral in terms of Telecare equipment manufacturer / service provider; Open / published standards should be used, where available. NHS24D6V1.2 Page 5 of 17 February 2017

8 3. Roadmap Overview Figure 1 presents an overview of the tasks that form the Roadmap. Figure 1: Roadmap Overview NHS24D6V1.2 Page 6 of 17 February 2017

9 Further details on each of the tasks in the figure are presented in the following sections of this document. Annex A contains a Gantt chart providing further details of tasks and their interdependencies. Note that a number of assumptions have been made in developing the plans presented in this document. These assumptions will be tested, and plans updated as required, as further information becomes available as the project matures. It is intended to manage the delivery of Digital Telecare as an Agile programme. The programme will align with the Government Digital Service guidelines for Agile project delivery 2 as well as the Scottish Government s Digital First Service Standard 3. Amongst other things, use of these Digital guidelines ensures that users are included in the process of defining and evaluating the services delivered. At this stage, it is anticipated that the tasks defined in the Roadmap will map to Agile phases as shown in Figure 2. Given the nature of the Agile approach, the project will be completed as a series of short learning cycles which develop the optimal approach to Digital Telecare in an iterative and controlled manner using the combined expertise of the project team and the learning gained as the cycles proceed. Agile Project Phase Discovery Phase: Alpha Phase: Beta Phase: Live Phase: Digital Telecare Roadmap Phase Planning Phase Initial Development Phase Early stages. (It is expected that this Phase will be short as the service will be based on commercial off the shelf equipment) Initial Development Phase Later stages. Full Deployment Phase. Figure 2: Agile and Roadmap Phase Alignment NHS24D6V1.2 Page 7 of 17 February 2017

10 4. Proof of Value Workstream The Proof of Value Workstream is responsible for establishing the initial deployments of Digital Telecare and for supporting the scaling of Digital Telecare nationally. Within the FarrPoint Digital Telecare reports this Workstream was referred to as Phase 1: Rollout - Deploy digital technology 4.1 Planning The Planning tasks will be completed over the period January March The first task, now complete, is to Develop this Roadmap. A process of stakeholder engagement will then be completed to Communicate the Roadmap and to Invite Applications to Participate in the initial deployments of Digital Telecare. Applications will be sought for organisations to: Participate in an initial deployment of Digital Telecare starting in April To meet these timescales organisations must have an existing in-house (public sector hosted) ARC solution capable of accepting natively digital connections and equipment without major re-engineering. The timescale associated with this requirement is likely to limit the number of organisations capable of participating, therefore a second invitation will be issued as detailed below. Participate in an initial deployment of Digital Telecare starting in late To apply organisations must expect to have, within this timeframe, an in-house (public sector hosted) ARC solution capable of accepting natively digital connections and equipment. Participate in an initial deployment of Digital Telecare as part of a cluster. These organisations will use telecare equipment and other facilities (TBA) that are hosted by another organisation. These organisations will support the development of the operational and organisational procedures required to support the clustered service delivery approach. Work with the programme during the procurement of a Digital Telecare solution (hosted or in-house) to assist with the development of procurement best practice. NHS24D6V1.2 Page 8 of 17 February 2017

11 Work with the programme to assist with the development of a specification, standards, and processes for Digital Telecare. These organisations will not participate directly in the initial Digital Telecare deployments, but will use information gathered from the deployments, and their existing telecare experience, to support the development of Digital Telecare standards, etc. Organisations will also be invited to participate in the Innovation Workstream. Further details of this work are presented in Section 6 of this document. The initial deployments of Digital Telecare will also include the use of a private sector hosted solution (as opposed to the in-house approach detailed above). There is an existing project being planned by a consortium of organisations in Scotland to develop and deploy a hosted Digital Telecare solution. Given this, it is assumed that this programme will not duplicate this work and will instead liaise closely with the consortium s project. Further details on this are presented in the next section. It is understood that the consortium s project is subject to an application for funding via Innovate UK and therefore the feasibility and timing of the project as currently planned is uncertain. If the project does not progress this programme will need to investigate ways of directly including a hosted solution in its scope. In parallel with the process to seek applications, a task will be completed to Agree the Resource and Governance and Arrangements for the programme and associated roles and responsibilities This work will include the development of a Communication Plan for the programme. Once initial deployment Participants are Identified, Initial Engagement is necessary to agree the initial technical solution, test approach, resources and procedures that will be used by the initial deployments. This work cannot be completed until the participants are identified as the solutions are dependent on participants existing arrangements. The solutions put in place initially are likely to develop during the period of the initial deployments as experience and information obtained supports service improvements. 4.2 Initial Deployment The Initial Deployment tasks will be completed over the period April December Several tasks will be completed in parallel during this phase, and it will be necessary to ensure that there is close co-ordination between the tasks. NHS24D6V1.2 Page 9 of 17 February 2017

12 The In-House Solution(s) will be Implemented and Trialled. At this stage it is anticipated that this will involve public sector hosted Digital Telecare solution(s) that: Provides Digital Telecare services to at least 100 users supported by the organisation hosting the telecare solution. Provides Digital Telecare services to at least 100 users from other organisation(s) participating as part of a clustered ARC approach. Uses mobile data as the preferred connectivity approach, but also trials other connectivity on a smaller scale. The private sector Hosted Solution will be Implemented and Trialled during this phase. It is currently assumed that the hosted solution will be provided by the consortium project (as outlined in the previous section). The feasibility and timing of this project is currently unclear given the outstanding Innovate UK funding application. Given this, the timings for the project in the Roadmap are assumptions that need to be updated once the plans for the project are finalised. Arrangements will be put in place to ensure a close working relationship between the Programme and the Hosted Solution project. This will include the sharing of information in both directions to ensure that the projects learn from each others experience and that the services being developed remain coordinated and use common service specifications and procedures. The in-house and hosted deployments will be used to Develop and Validate Telecare Standards and to Develop and Validate Operational Procedures for Digital Telecare. These standards and procedures will be applicable to both hosted and inhouse delivered solutions, and will be expected to also take account of: the clustering of ARCs; the impact of Digital Telecare on other services provided by Service Providers; data generated by Digital Telecare that may be of use to other health and care providers. This phase will also include a Procurement Trial. This will assist an organisation seeking to procure a Digital Telecare solution by providing best practice and advice on the specification and service standards to be sourced. It is likely that this procurement will be completed because an organisation s existing telecare solution becoming end- NHS24D6V1.2 Page 10 of 17 February 2017

13 of-life. This may not coincide with the start of this phase and so the timing of this task is still to be confirmed. A Business Case Validation & Checkpoint is included in the Roadmap following completion of all the above tasks. The business case validation will include a review of the benefits delivered by Digital Telecare, including their impact on the service provider, users, the NHS, and the wider public sector. It is expected that a Health Economist will be responsible for leading this element of work. The Checkpoint is included to provide an opportunity for a review and signoff of the business case for Digital Telecare prior to the Full Deployment Phase commencing. 4.3 Full Deployment The Full Deployment tasks will be completed over the estimated period The timescale for this work can only be estimated at this stage as it is dependent on telecare providers deciding if, when, and how to upgrade to Digital Telecare. There are two tasks defined within this Phase. These reflect the work required to support the different deployment approaches telecare providers may choose to take. The initial Digital Telecare deployments will be designed to scale to accommodate further organisations joining a cluster. The Support the Scaling of the Initial Deployment Solutions task will provide advice and support, as required, to organisations seeking to join one of the existing Digital Telecare solutions. The Support Organisations Procuring / Establishing New Deployments task will provide advice and support to organisations that do not wish to join an existing cluster and instead want to procure/establish their own Digital Telecare solution. 5. Procurement Workstream The Procurement Workstream is responsible for developing and establishing the procurement arrangements necessary to support Digital Telecare deployment. The Develop Procurement Strategy task is expected to be completed over the period March June The purpose of the task will be to determine the procurement approach that will be used for: The equipment and services required to support the initial deployments of NHS24D6V1.2 Page 11 of 17 February 2017

14 Digital Telecare; The equipment and services required for the full deployment of Digital Telecare; The equipment and services delivered as a result of the Innovation Workstream. The procurement strategy will need to take account of the telecare frameworks that are currently in place. The strategy will also need to take account of the differing value, timing, and supplier base associated with the three elements listed above. The procurement strategy will be implemented by the Procurement Frameworks Established task. The plan currently assumes that this task will be complete in time for the commencement of the Full Deployment of Digital Telecare and Telecare Innovation Deployments. However, the extent to which existing telecare frameworks will impact these timescales is currently unknown and so this timing is an assumption at this stage. 6. Innovation Workstream The Innovation Workstream is responsible for agreeing and establishing the arrangements that will support the development of Innovative Telecare services. Within the FarrPoint Digital Telecare reports this Workstream was referred to as Phase 2: Consolidation - Fully exploit digital technology The first task within this Workstream is to Agree a Development Framework for Telecare Innovation. The framework is not expected to attempt to define any technical solutions, but instead will focus on defining the arrangements that need to be put in place to allow innovative telecare solutions from a range of suppliers to be developed, tested, and deployed. This output of this task will also be used by the Procurement Workstream when defining the procurement arrangements that need to be put in place to support Telecare innovation. The above task is expected to be complete in Autumn 2017 to allow the necessary arrangements to be put in place and for Telecare Innovation Trials to commence in late These trials will be used to test new telecare services and to demonstrate their value. Those that deliver benefits will be included in Telecare Innovation Deployments. Both the Trial and Deployment tasks are on-going. It is expected that there will be constant development of new services and so these tasks will, in reality, become part of business as usual telecare development programme. NHS24D6V1.2 Page 12 of 17 February 2017

15 7. External Factors A number of external factors will influence the programme. An initial overview of some of the key factors is provided below. This list is not exhaustive and part of the responsibility of the programme will be to identify and monitor relevant external factors. The development of European standards for Digital Telecare. European technical standards for Digital Telecare are currently being developed. The timescales for the standards being finalised are currently unclear, but the development of the Scottish Telecare solution needs to take account of any draft and final standards. SCTT currently have a representative working with the standards committee and so liaison arrangements are already in place. The plans for the switch-off of analogue telephony services. The switch-off of analogue telephony services is already progressing. Telecoms providers are completing this work for commercial and service development reasons, with Ofcom involved from a regulatory and oversight perspective. The specific plan and timescales for the switch-off are not currently known. SCTT has an existing relationship with Ofcom representatives and this will be maintained throughout the programme. The availability and development of fixed and mobile broadband services in Scotland. Digital Telecare cannot be fully deployed in Scotland until reliable digital connectivity is in place to deliver it. Coverage in many remote / rural areas is not currently available. The commercial rollout of broadband continues to improve coverage levels. In addition, a number of Scottish Government projects are being completed to provide coverage in areas outside the commercial rollout, with a commitment to provide superfast broadband to 100% of premises by The programme will need to ensure that plans for the rollout of Digital Telecare are coordinated with the availability of digital connectivity. Potential plans for a universal telecare service in Scotland. Work is currently being completed on behalf of SCTT to investigate the scope and benefits of a potential universal entitlement to telecare in Scotland. The initial report on this is due to be delivered in Spring This work has potential to influence the definition, scope and rollout of Digital Telecare and so close liaison will be required with this workstream. Developments within the other Technology Enabled Care (TEC) Workstreams. As detailed in the previous Digital Telecare reports, it is expected that the deployment NHS24D6V1.2 Page 13 of 17 February 2017

16 of digital technology will see the lines between telecare and telehealth blur. Close liaison with the other workstreams within the Scottish Government s Technology Enabled Care programme will be required to ensure that opportunities for linking and improving services are identified. This is likely to be most relevant to the Innovation Workstream, as defined earlier in this report. Other developments within Local Government, ehealth and wider public/third sector IT. Digital developments are being completed in all areas of the public and third sectors. Many of these developments have potential to influence the development of Digital Telecare, and so arrangements should be put in place to ensure that developments are monitored and assessed for impact on the Programme. International Telecare Developments. A number of countries are currently planning a rollout of Digital Telecare. SCTT has existing relationships with many of these countries. The programme needs to ensure that international developments are identified and arrangements put in place to ensure the sharing of learning and best practice. UK Telecare Developments. The TSA is leading planning for the development and deployment of Digital Telecare services and standards in the rest of the UK. SCTT has existing relationships with the TSA and will maintain close liaison throughout the completion of the programmes to share of learning and best practice. NHS24D6V1.2 Page 14 of 17 February 2017

17 Annex A Gantt Chart Figure 3: Summary of Activities to be Completed Over the Next Three Months NHS24D6V1.2 Page 15 of 17 February 2017

18 Figure 4: Gantt Chart (Planning Stage) NHS24D6V1.2 Page 16 of 17 February 2017

19 Figure 5: Gantt Chart (Remainder of Programme) NHS24D6V1.2 Page 17 of 17 February 2017