Roy Lilley on the CECOPS Technology Enabled Care Code

Roy Lilley kindly provided a foreword for the new International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services, as follows. (Details about the Code can be found HERE)

“An outcomes-based Code of Practice for both commissioning and providing Technology Enabled Care Services, who’d have thought it? And it’s fabulous!

Commissioning; there is no great mystery to it. In plain English, it is buying stuff. In the more elegant language of healthcare, the right people providing the right services, in the right place for the right people. It is trickier than you’d think.

Healthcare is notoriously complicated. It is a whole-system. Fiddle with one bit and you disturb another bit. Change something and run the risk of making a mess someplace else. Commissioners have to regularly cope with this complexity. Quite how they do it, I will never know. An added dimension is a more recent addition to the commissioning repertoire: Technology Enabled Care Services, now commonly called TECS.

Technology is not a bolt-on or an addition. It is at the heart of modern health and care. This fabulously well-thought-through framework and Code of Practice puts the patient and service user at the heart of decision making and helps the commissioner, and the provider, through the complexity of it all.

I congratulate Brian Donnelly on his tireless work in this, often, Cinderella part of health and care. He moves it front and centre with ease. Pages of common sense, technical guidance, help and, the best part, all outcomes-focused.

Emphasising the involvement of stakeholders, users and carers, this is more than a Code of Practice; it is a map, a guide and a chaperone. It is thought-provoking and a source of inspiration.

Telehealth, telecare, apps, and digital technologies in health, social care and housing sectors have so much to offer patients, residents, relatives and carers. New approaches emerge, what seems like, every day. What works, what doesn’t? How will we know? What is essential and what is a gimmick? What might we dismiss and come to regret passing over?

This Code of Practice gives us the baseline for making assessments, a foundation for making decisions and it helps the commissioners and providers with the groundwork to get it right, first time.

To date, the lack of a reference point may have been a disincentive to put our faith into new technologies and, perhaps, contributed to a slow take up of and engagement with the tools, devices and equipment that may not only be of huge benefit to patients and residents, but also contribute to health and care organisations’ drive towards innovation and efficiencies.

This well-researched Code provides an end-to-end solution, from early planning to post-implementation, as well as a reassurance that innovative projects can be implemented on time and with success. It is a thorough and complete piece of work and advice that, I am sure, will become a welcome reference point for commissioners, providers and people receiving services.

If I were to sum up the Code in a couple of words, I would choose: quality and continuous improvement.

Congratulations on an outstanding contribution to the complex world of commissioning and providing Technology Enabled Care Services.”

Roy Lilley

Roy Lilley is a leading analyst, writer, broadcaster and commentator on health and social care in the UK.  Roy is the Founder of the Academy of Fabulous NHS Stuff, www.fabnhsstuff.net, a repository which has become a social movement and is seen as the change platform for the NHS and Social Care. Roy is also the publisher of an e-newsletter for NHS managers – see www.nhsmanagers.net.

To find out more about the work of CECOPS in the TECS space, view the latest newsletter HERE

Shaping the future of the digital health marketplace

I was recently asked to explain the digital health marketplace in the UK and how providers are supposed to access the market. This marketplace includes, for example, telehealth, telemedicine, eHealth and mHealth products, as well as telecare.

A marketplace is formed where there is demand for a product or service, and when this demand is supplied. Of course then, markets grow and evolve over a period of time.

Within the digital health space, on the supply side there is a vast range of products and services, but the demand side is unclear. The need is there, but organisations responsible for planning and commissioning services are often unsure of how best to engage with some of the technologies available and to procure these. What works? Where do we start? Is it cost effective? How can we assess service impact?

So we could reasonably conclude that the marketplace for digital health is not well defined and has not yet matured. This is discouraging for providers, especially SMEs, and there is confusion about the best approach for accessing the market. This could even cause a provider, particularly a smaller one, to ‘give up’. This would be a shame if they had an excellent product which they were struggling to sell.

It is important for those on the demand side to be clear about what it is that they want to procure or commission, and that they are ready for adopting the technologies and services. Organisational readiness is often an area overlooked; yet this is such an important issue to address to ensure the marketplace matures and thrives.

While there are some pockets of excellent working in getting products to segments of the market e.g. acceleration programmes, processes are not the same across different geographical areas and sectors. These issues are not limited to the UK. From conversations I am having with people overseas, the situation is pretty much the same internationally.

The imbalance between the supply and demand sides of the market cannot continue.

So, what can be done?

FIRST EVER INTERNATIONAL CODE OF PRACTICE FOR PLANNING, COMMISSIONING AND PROVIDING TECHNOLOGY ENABLED CARE SERVICES

 To help shape the marketplace, CECOPS has developed the first ever International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services. This is an outcomes-focused quality framework for procurement and provision of services. It offers an end-to-end solution which addresses all aspects of the marketplace.

This new framework for the first time provides structure to the marketplace and is set to become the recognised benchmark.

Working with the Code will help to create and shape a more balanced marketplace. Following it will also help to ensure an organisation’s readiness before engaging with digital health. The Code can also act as a framework to support providers coming into the space, so that they have a clearer understanding of what might be required of them.

Using the Code within tender specifications simplifies the procurement process. As the Code is outcomes-focused, it encourages providers to be innovative. It will also help to achieve sustainable economic growth in the space; as growth for some providers is currently minimal and short-lived.

As the standards and certification body for these services, CECOPS is also able to accredit services via an external assessment.

Some of the many benefits of this new approach include:

• Marketplace development and maturity
• Brokering improved relationships in the marketplace
• Accelerating organisations to a state of readiness
• Achieving sustainable economic growth for the sector
• Simplifying procurement, commissioning and contract management processes
• Better chance of realising benefits from providers’ products and services
• Saving time and cost (by providing a ready-made framework)
• Improved quality and performance
• Local, regional, national and international benchmark and platform for sharing good practice and having a community building approach
• Improved clinical, wellbeing and financial outcomes

Copies of the International Code are available from here. The Code is free to organisations registered with CECOPS.

To find out more about CECOPS accreditation scheme or the Code, please get in touch.

Brian

Brian Donnelly MSc, CEO, CECOPS CIC

E: brian@cecops.org.uk | +44 (0) 7511 667 330 | T: +44 (0) 1494 863398 | www.cecops.org.uk

Organisational readiness: Technology Enabled Care Services

Having previously worked in the public sector I have personally been guilty of procuring technologies without firstly giving a lot of consideration as to how ready the organisation was to use the technologies effectively. For example, does the organisation have the right skills, resource, capacity or information systems to benefit from such technologies and measure service impact?

Not considering organisational readiness appropriately means that it is likely the technologies will not meet their intended purpose, and neither will expected benefits be realised.

This oversight is something that happens regularly, especially within the public sector. We have all witnessed it with failed local and regional technology related projects, as well as national multi-million pound IT projects, for example.

I once knew someone who bought £500K of telecare ‘boxes’ for a local authority. After 6 months the ‘boxes’ were still in a store; no one knew how to deploy and use the contents of the ‘boxes’!

On a national or even international scale, the cost of investing in technologies without ever realising their full potential or improving care to patients and users must be colossal. This is a complete waste of public funds.

Organisational readiness: For too long the focus has been on the provider and supplier end of the market; whilst this has its place, time and consideration has to equally be given to the planning and commissioning end of the market. It is in the long term interest of good providers and suppliers of technology to provide their products, solutions and services into organisations that are ready.

Not only should organisations assess their own readiness prior to committing to acquiring technologies, there is a role also for providers and suppliers to help ensure organisations are ready.

So how can organisations make sure they are ready before taking a leap into the world of technology enabled care services? This is very important now that technologies are playing more of a role in health and social care provision.

Good News: We are glad to inform you that CECOPS has some new developments which will help!

First end-to-end outcome-based International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services

We have just developed the first ever end-to-end outcome-based International Code of Practice for Planning, Commissioning and Providing Technology Enabled Care Services. Following the sequential steps set out within this Code will help to ensure organisations are ready before engaging with technology enabled care services. It will also help to ensure any service implemented results in the best possible outcomes, and that the service is innovative and sustainable.

The new CECOPS Code is available from HERE. The Code is FREE to organisations working with CECOPS.

To supplement the Code, CECOPS has also developed a self-evaluation and continuous improvement tool for both planning and commissioning TECS, as well as service provision. This tool can also help with determining organisational readiness and implementing new services. There is a free trial available so you can see how it works. Details can be downloaded HERE

 

“..this is more than a Code of Practice; it is a map, a guide and a chaperone. It is thought provoking and a source of inspiration.” Roy Lilley, Health expert and analyst.

Brian Donnelly

Get in touch: If you would like to discuss any of the above issues please get in touch.

E: brian@cecops.org.uk | +44 (0) 7511 667 330 | T: +44 (0) 1494 863398 | www.cecops.org.uk

Technology enabled care services (TECS) see first International Code and support tools

The first ever Code of Practice and support tools covering all aspects of planning, commissioning and providing technology enabled care services (e.g. telehealth, telecare, eHealth, digital health) have been developed by CECOPS, the independent standards body in the UK for assistive technology services.

Uniquely, this new Code, which sets out standards covering every aspect of services, offers an end-to-end and whole-system approach, ranging from the early planning stages through to post-implementation of services. It can be looked at as a value-chain solution that interlinks those responsible for planning and commissioning services with service users, through the activities of clinicians and providers.

‘…this is more than a Code of Practice; it is a map, a guide and a chaperone. It is thought provoking and a source of inspiration.’

Roy Lilley, leading expert and analyst in healthcare

The Code is complemented by a unique and powerful self-evaluation and continuous improvement tool iCOPS®, which helps organisations to self-evaluate services, assess readiness before engaging with TECS and drive their own quality and performance agenda.

 It is anticipated the Code and support tools will encourage wider adoption of TECS and set the benchmark and framework for all organisations in the sector to work to.

 Following the Code enables the longstanding barriers to adopting TECS more widely to be overcome, ensuring projects and initiatives are delivered with the best possible outcomes, with the ability to measure their success and embed sustainability.

 These latest developments offer a quality framework for the procurement and provision of services, with the ability to assess, influence and improve outcomes, as well as streamlining the whole contract management process.

 The introduction of this Code means that CECOPS can now extend its accreditation scheme across all assistive technology related services (e.g. telecare, telehealth, wheelchairs, electronic assistive technology, disability equipment), nationally (UK) and internationally.

The new Code and iCOPS® tool incorporate the following subject areas:

PART ONE: PLANNING AND COMMISSIONING

1. Strategic Planning and Preliminary Considerations
2. Involvement of Stakeholders, Users and Carers
3. Partnerships, Joint Working and Integration
4. Governance, Ethics and Risk Management
5. Business Case Development
6. Investment and Funding
7. Procurement
8. Service Requirements and Specifications
9. Contractual Arrangements
10. Eligibility Criteria and Self-funding
11. Legal & Regulatory Obligations and Standards
12. Information Technology and Information Management
13. Marketing and Promotion
14. Implementation
15. Performance Management and Continuous Improvement
16. Measuring and Evaluating Service Impact

PART TWO: SERVICE PROVISION

1. Governance, Risk and Ethics
2. Legal & Regulatory Obligations and Compliance with Standards
3. Managing Referrals and Assessments
4. Procuring Technologies, Equipment and Services
5. Implementation of New Technologies and Services
6. Trialling, Assembling, Installing and Demonstrating Technologies and Equipment
7. Involving Patients/Service Users and Carers in Decision Making
8. Management of Medical Devices/Technologies
9. Management of Assets and Inventory
10. Monitoring and Alerts
11. Quality Management Systems
12. Health and Safety Management
13. Staff Competence
14. Information Technology, Management and Governance
15. Collaborative Working
16. Third Party Contractors
17. Marketing and Promotion
18. Contract and Performance Management, and Continuous Improvement
19. Measuring and Demonstrating Service Impact

The new Code is currently available to organisations working with the CECOPS scheme.

A published hard copy and eBook version of the Code will be available to purchase in the coming weeks.

The iCOPS® tool is available for purchase now. A FREE 30 day trial is available.

If you are interested in purchasing a copy of the Code, becoming CECOPS accredited or trying out the iCOPS® tool, please get in touch.

E: info@cecops.org.uk

T: 01494 863398

M: 07511 667 330

W: www.cecops.org.uk

Note to editors:

CECOPS CIC is a UK-based independent, not-for-profit, standards body for assistive technology services. CECOPS is widely supported by regulators and professional organisations. CECOPS is often cited as a requirement in tender specifications, and, although relatively new, is already working with approximately 80 organisations in the UK, with growing international interest.

Will Personal Health Budgets for wheelchairs fix the problems?

NHS England recently announced that to give people more choice and control about the care they receive, personal health budgets will be extended to cover wheelchairs from April 2017.

This move is intended to support the government’s target of enabling 100,000 people to benefit from greater control via personal health budgets by 2020/21.

It is proposed that Personal Health Budgets (PHBs) will replace the current wheelchair voucher scheme as part of efforts to improve services for over 1.2 million people that currently use wheelchairs.

NHS England claims the new personal health budget scheme will offer more choice over what wheelchair can be acquired, and will include a detailed care plan to help users make informed decisions about their wheelchair. They claim care plans will not only cover purchasing the chair, but will also include guidance on future maintenance, repair and replacement needs. Without a business case or impact assessment or relevant evidence, it is difficult to assess at this stage exactly how the model will work in practice.

NHS England has been reviewing wheelchair provision over the past 2.5 years, and introducing PHBs would appear to be in response to the findings of that review; however we sincerely hope that issuing PHBs for wheelchair users is not the only outcome of that review, as PHBs cannot possibly be a solution to the numerous problems associated with these services.

As the independent standards body in the UK for wheelchair services, CECOPS welcomes the move to extend personal health budgets to these services, and we have in fact already included the use of PHBs in our Code of Practice. The use of PHBs for wheelchairs will be an area which our assessment processes will cover, for organisations seeking accreditation with us.

Notwithstanding our support of measures to improve wheelchair services and user experience, we do have some concerns which we hope will be addressed before the introduction of PHBs for wheelchairs in April 2017.

We feel that if the areas of concern below are not sufficiently addressed, the roll-out of PHBs for wheelchairs will not achieve its well-intended aims. At this point it is unclear how PHBs will work better than the existing voucher scheme, and this is something we would like to hear more about from NHS England Personal Health Budget team.

Could PHBs exacerbate current difficulties associated with disjointed services?

Disabled people often require a range of assistive technology (AT) related services e.g. communication aids, posture equipment, adaptations. As the different AT services generally operate independently of each other, people usually undergo several different assessments to cover their various and holistic equipment needs.

The current model is costly and is far from being person-centred. Offering a PHB exclusively for one type of assistive technology (i.e. wheelchair) could potentially exacerbate the problem, and would appear to go against the direction of offering more holistic, personalised and person-centred care.

NHS England has indicated that it hopes to start off with PHBs for wheelchairs and then move on to other types of AT. However we feel it would be much better to offer PHBs for all AT needs at the commencement of the initiative; this would help stimulate the drive for more holistic and person-centred assessments, offering real benefits in terms of user experience, as well as improving clinical and financial outcomes.

The following quote from a service user clearly demonstrates current difficulties, and why offering PHBs exclusively for wheelchairs won’t help with wider issues:

“It was great that I eventually got an indoor/outdoor wheelchair, but I couldn’t get in or out of my home because the adaptation hadn’t been done. I was given a communication aid but no-one would agree to mount it to my wheelchair.”

Will PHBs address long waiting times?

One of the main problems associated with many wheelchair services is the waiting times. It is not uncommon for people to wait 18 months for a wheelchair.

PHBs won’t address waiting times, as they are not set up for that purpose. In fact, PHBs could even increase waiting times, for reasons explained below.

The main reason currently for long waiting times is lack of funds. PHBs won’t introduce any new money, and purchasing a wheelchair at retail price under a PHB rather than at bulk contract price will be more expensive. In addition, wheelchairs bought under a PHB belong to the user and will never come back into the wheelchair service to be reissued to another user. This could add significant pressure to current overstretched budgets and increase waiting times for all wheelchairs, whether under a PHB or not.

Will PHBs help people who need equipment urgently?

People with rapidly progressive conditions, such as motor neurone disease or some types of multiple sclerosis, require access to equipment urgently. Sadly, fast-tracking of services for these people is not generally in place.

Providing people with PHBs is not likely to address this serious problem. Presumably there will be a waiting list for accessing PHBs just as there is for loaned equipment, as without new money there will still be funding issues. We feel strongly that this area should be looked at as a priority; it is disgraceful that some people die whilst waiting to receive vital equipment.

One solution could be that the PHB scheme includes a fast-tracking arrangement so that eligible people have access to funds immediately to buy everything they need quickly. Obviously there would need to be clinical professionals involved to facilitate and advise.

Could PHBs for wheelchairs actually be more costly?

As previously mentioned most wheelchairs are purchased by the NHS or out-sourced provider under a bulk contract or framework, in some cases at significantly discounted prices. With PHBs, people will purchase equipment outside of these agreements from retailers at high street prices, which are very likely to be much higher than the prices currently paid by the NHS for wheelchairs. PHBs will have to be of sufficient value to cover the retail price of a wheelchair, otherwise people will not take them up! As this cost is likely to be higher than is currently paid by the wheelchair service, this could strain wheelchair budgets.

In addition, there are significant savings and cost avoidances under the current model where wheelchairs are reissued by wheelchair services. For example, a wheelchair costing £2000 issued 3 times over its life results in a cost avoidance of £4000; whereas 3 of the same wheelchairs purchased using PHBs will cost £6000. Equipment purchased using a PHB will not be recycled within the wheelchair service, and is in effect a sunk cost.

If PHBs for wheelchairs are widely taken up it could have a drastic effect on wheelchair service budgets.

Could wheelchair users be exploited?

There will need to be proper support and safeguards in place to ensure people using their PHBs to buy wheelchairs are not exploited by retailers i.e. being sold something they don’t actually need, or charged an excessive amount. It is recognised that people are consumers in other aspects of their lives, and should be able to make their own choices; however some buyers will be in a vulnerable position, making a large purchase in an unfamiliar market, which could leave them open to exploitation without appropriate guidance, safeguards or support.

When the Department of Health introduced the retail model several years ago for aids to daily living, there were cases reported of people being exploited by retailers, so this is a real concern. 

Could using a PHB compromise clinical needs being met?

A PHB for a wheelchair will only be for a limited amount, although it is currently unclear how this will be set. Wheelchair users will be able to top up from personal funds if they want a higher specification wheelchair. There is a risk that wheelchair users acquire an item which does not meet their clinically assessed needs.

This is a high risk area and it is vital that users get the right wheelchair to avoid problems associated with postural care and pressure, for example. It is difficult to see how it can be ensured that retailers are competent to advise on these matters, some of which require specialist clinical input.

Failure to address the above issue could mean people end up with equipment that doesn’t meet their clinical needs, resulting in further health problems such as a pressure ulcer.

PHBs and Training

As yet no guidance has been made available from NHS England Personal Health Budgets team on training for frontline staff with regards to PHBs for wheelchairs e.g. what training is needed, who needs to be trained, who would carry out the training and who pays for it. It could be a costly and timely exercise for local areas to formulate their own guidance on this, and deliver their own training, which could potentially be a barrier for wider adoption.

Conclusion

CECOPS hopes the above issues will be sufficiently addressed before commencement of this initiative in April 2017; we would be willing to work with the NHS Personal Health Budget team to work through possible solutions.

Many of the areas of concern can be addressed by following our Code of Practice and working with our accreditation framework, which is now formally approved by Care Quality Commission and being adopted by many wheelchair services across the country.

Brian Donnelly, CEO, CECOPS

NEW: CECOPS APPROVED SOFTWARE MARQUE

We are delighted to announce that we are now offering a CECOPS Approved Software marque as part of our scheme. This means IT companies providing management systems in the assistive technology space (e.g. disability equipment and wheelchair services, telecare, AAC) can now apply for their products to gain this prestigious status.

To gain CECOPS Approved Software status, software systems will have to clearly demonstrate that they meet certain criteria. These criteria are based on how software systems can help to meet the outcomes set out in CECOPS’ Code of Practice.

The CECOPS Approved Software marque is designed to help commissioners and equipment providers with procuring software systems for these services, and provide assurance that the system supports the CECOPS Code, the only available service specific standards for these services. It will also give IT providers the opportunity to demonstrate and showcase the suitability of their products beyond the technical capabilities and functions.

CECOPS’ CEO, Brian Donnelly, said,

“As more organisations are coming on board with CECOPS, it makes sense to have software systems that support our standards and framework. This new initiative will also make the process for procuring systems easier. Most importantly, it will help to ensure people in receipt of these services receive good outcomes.”

Kevin Clegg, the owner of BEST, the first software system in the UK to gain CECOPS Approved Software status, says,

“Now more than ever, we all need to identify and improve our service performance and use as many ways as possible to reduce costs as well as enhance service delivery and the customer experience.

Good standards ensure that these aims and objectives can be met and are not always mutually exclusive. It is possible to manage and maintain a high degree of consistent activity, firstly by setting these standards, then by measuring and meeting them, finally by exceeding them and then re-defining them to improve still further.

CECOPS now maps and sets out national standards we all should aspire to and build on. The CECOPS framework allows everyone involved in the delivery of a service to record and identify their strengths, highlight weaknesses and plan for constant and continuous improvement. Soft Options are proud to support, adopt, and promote these standards and welcome all the benefits realised because of them.

To find out how you can have your software approved, please go HERE or contact us: support@cecops.org.uk

-END-

Personal Health Budgets for Wheelchairs in England

NHS England recently announced that they are introducing personal health budgets for wheelchairs. This new approach to wheelchair commissioning will replace the current voucher scheme. According to NHS England, wheelchair users have found a number of challenges with the existing scheme, now 20 years old, including a lack of information and guidance around maintenance, repair and replacement as well as a limited number of providers where a voucher can be redeemed.

It is claimed that the new personal health budget scheme will offer more choice of where wheelchairs can be bought as well as a detailed care plan that will help users make informed decision about their wheelchair. The care plans will also go beyond purchasing the chair to also include guidance on future maintenance, repair and replacement needs.

It is also claimed that a wheelchair will form part of a person’s wider care, catering for their individual needs and ensuring a more joined-up approach, a key aim of NHS England’s Five Year Forward View. The new approach will also help NHS England collect meaningful data on wheelchair provision that will further help improve services and address variations in provision across the country.

CECOPS’ CEO, Brian Donnelly, says, “Offering personal health budgets for wheelchairs will be useful for some people. Although not a total solution, this will certainly increase choice and hopefully allow people to get access to the equipment they need more quickly.

 We included personal health budgets in our Code of Practice for Disability Equipment, Wheelchair and Seating Services last year.

 Following the Code will help commissioners, providers and clinicians and will ensure the necessary safeguards are in place where personal health budgets are used.

 We would hope to see personal health budgets eventually being used for all disability equipment so that the holistic needs of disabled and elderly people can be met more effectively.”

CECOPS: A New Outcomes Approach to Commissioning and Providing Disability Equipment, Wheelchair and Seating Services

Our innovative approach to commissioning and providing disability equipment, wheelchair and seating services is gaining popularity in the UK, and beyond.

Why is a new approach needed?

The process for commissioning and providing disability equipment, wheelchair and seating services in the UK has generally been the same for many years, very often involving detailed specifications written by commissioners, with which providers are expected to comply.

Stifling innovation and creativity: The process of commissioners writing specifications is time consuming and costly. It has also been found in many cases to be too prescriptive, which can fetter innovation and creativity of providers, and clinical and technical staff. It forces the provider into compliance mode, where they have to work to the exact requirements of the specification and nothing more, meaning that what is set out in the specification is what will be delivered for the duration of the contract.

This approach can prevent frontline staff from making suggestions for better ways to deliver services, making improvements, meeting changing policies, strategies or demands, and it does not often result in improved outcomes for people using the services.

Compliance, not continuous improvement: The current approach to commissioning services does not generally seek for, or encourage, continuous improvement, meaning that people receiving services often have to  settle for a ‘just good enough’ service for the duration of the contract. This is largely owing to the fact that the provider is commissioned and paid to comply with the requirements of the specification, and nothing more. This is an inherent weakness in the age long processes currently used.

Outputs, not outcomes: Furthermore, there is often an emphasis on measuring outputs including, for example, the number of activities related to the service. The overall performance of services is often assessed on these outputs, or data sets. Whilst important, outputs only capture one dimension of the service and do very little for influencing or improving quality-related outcomes for people using the services.

When services are commissioned and provided in this way, there is a certain inevitability about the mediocre levels of service that will ensue.

The New Approach

CECOPS and support tools: Recognising the need for change, CECOPS Community Interest Company (CIC), the independent standards body in the UK for disability equipment, wheelchair and seating services, has introduced a new model and support tools for assisting commissioners and providers to help improve services. Already, many health and care organisations are working with CECOPS.

CECOPS CIC has an officially recognised Code of Practice for these services, and offers a registration and accreditation scheme. CECOPS also offers a self-evaluation, compliance management and continuous improvement software tool, iCOPS®.

Outcome focus, not just outputs: The CECOPS Code is made up of forty seven outcome based standards. Some commissioners are already requiring providers and clinical teams to report against these outcomes, meaning that the provider, for the first time, now has the flexibility to choose how best to meet the outcomes, without being fettered or restricted by having to comply with a rigid and detailed service specification.

An outcomes based approach also helps service users to know what level of service to expect. It reduces the need for commissioners to write lengthy and detailed specifications, and ensures all aspects of service provision are comprehensively addressed.

The CECOPS outcomes are service related, and following them ensures the people receiving the service receive safe, good quality and effective care.

Continuous improvement, not just compliance: Whilst compliance with the requirements of a specification or standards could raise the bar in terms of service quality and performance, it can equally breed a culture of apathy i.e. just good enough. Neither should regulation be relied upon for improving quality and performance. Quality and performance management needs to be everyone’s responsibility, and providers should be in control of driving their own improvements. CECOPS has developed a tool, iCOPS®, which helps organisations to self-evaluate their own service, and it cultivates a continuous improvement focus with the view to delivering an outstanding service. This tool also supports compliance and regulatory obligations as it collects all supporting evidence in one place.

Improved contract management: Commissioning services involves a lot more than writing service specifications and tendering services; it includes the day-to-day management of contracts; this requires a lot of time and effort.

To help with this, the CECOPS model includes accreditation; this means that an assessment of the service is undertaken by CECOPS’ assessment team, DNV GL Healthcare (world leaders in quality and risk management).

Accreditation provides (external) assurance that the CECOPS outcome-based standards are being maintained. The assessments are risk rated and weighted, meaning that the commissioner will get a report highlighting any areas that need to be focussed on. This significantly reduces the time and effort of managing these large contracts.

Equally, providers can use accreditation as a means of managing contracts and making improvements.

The simplicity of the CECOPS model and how to get started: Commissioners can simply include CECOPS registration and accreditation in specifications, and require that the provider must evidence continuous improvement year on year using the iCOPS® tool.

Equally providers can directly seek to be registered or accredited and use the iCOPS® tool.

 “This is a small change in process, but results in significant change in outcomes. This pioneer approach to commissioning and providing these services is long overdue.” Brian Donnelly MSc, CEO, CECOPS CIC

For further information CECOPS can be contacted here:

T: 01494 863398 | E: info@cecops.org.uk | W: www.cecops.org.uk

NEW: Code of Practice for Planning & Commissioning Technology Enabled Care Services (TECS) coming soon.

 A new and unique Code of Practice for Planning and Commissioning TECS, an official CECOPS guide, is set to be published in the coming weeks.

The main reason for the guide is that, to date, other Codes of Practice for TECS have focussed exclusively on the service provision and supplier end of the market.

This new Code will help all those with responsibility for planning and commissioning TECS to overcome the many and longstanding barriers to adopting TECS more widely, and ensure projects and initiatives are delivered efficiently and effectively, with the ability to measure their success.

The Code acts as a risk, quality and performance framework. It takes organisations through sequential steps, allowing a readiness assessment check at every stage and promoting continuous improvements.

The Code can be used for all digital health and care technologies, in the health, housing and care sectors. Technologies covered by the Code include for example telehealth, telecare, telemedicine, telecoaching and self-care apps. It also has wider application for use when introducing any assistive technology or medical device related service.

The Code covers services as single entities e.g. a telecare control centre, or grouped together as digital health and care, or integrated with a wide range of assistive technology services.

This Code is supported by a self-evaluation and continuous improvement software tool, iCOPS® – see here for details: www.icops.co.uk

Whilst the Code is mainly aimed at the UK, the principles apply internationally.

It is anticipated that the Code will eventually fit in with the CECOPS registration and accreditation scheme, although it will also be available as a standalone guide.

The Code is made up of 16 Code Standards. These are supported by relevant outcomes and sub-clauses.

The 16 Code Standards are:

CODE STANDARD 1: Strategic planning and preliminary considerations

CODE STANDARD 2: Involvement of stakeholders, users and carers

CODE STANDARD 3: Partnerships, joint working and integration

CODE STANDARD 4: Governance and risk management

CODE STANDARD 5: Business case development

CODE STANDARD 6: Investment and funding

CODE STANDARD 7: Procurement

CODE STANDARD 8: Service requirements and specifications

CODE STANDARD 9: Contractual arrangements

CODE STANDARD 10: Eligibility criteria and self-funding

CODE STANDARD 11: Legal & regulatory obligations and standards

CODE STANDARD 12: Information technology and information management

CODE STANDARD 13: Marketing and promotion

CODE STANDARD 14: Implementation

CODE STANDARD 15: Performance management and continuous improvement

CODE STANDARD 16: Measuring and evaluating service impact

If you are interested in this new Code, please contact us and we will let you know when it is available.

T: 01494 863398

E: info@cecops.org.uk

Addressing the ‘care crisis’ by deploying Assistive Technology effectively

The growing elderly population is a global trend which, coupled with an increase in the number of people living with Long-Term Conditions (LTCs), increases demand for health and care services, with associated fiscal strains, in all societies.

Continuing with the same models of delivery is not going to be sustainable. New approaches and service delivery models need to be found that will deliver more efficient and effective care, whilst maintaining safe and good quality services.

People need to be equipped with the right products and services to help them become more independent and to be better supported in managing their own care. This includes disabled children and adults, to ensure they have the same life expectations, opportunities and outcomes as other citizens. Services also need to be geared toward prevention and early intervention to avoid unnecessary and costlier episodes of care later on.

One method to address some of the concerns above is the better deployment of assistive technologies – from orthotics, prosthetics, walking aids, beds, wheelchairs, and communication aids, through to more advanced electronic assistive technologies such as telecare products and telehealth equipment. If used strategically these can support health and care services significantly and meet a range of government policy aims.

Not only does effective provision of assistive technology improve outcomes for service users, including social inclusion and quality of life, but it can also reduce the burden on the state by enabling independent living, enhancing employment prospects and enabling individuals to take control of their own lives – all of which have a part to play in tackling the worldwide problem of funding longevity.

But a shift towards better deployment of all assistive technologies has not really happened at scale, for a variety of reasons. At strategic level, there is generally failure to appreciate the benefits of this equipment, and as a result there is no overall strategy or vision to integrate the many departments and bodies which currently issue it in such a piecemeal way.

Most assistive technology-related services operate completely separately and independently from one another, resulting in duplication, poor use of resources, and wastage, not to mention the effect on the service user of having to undergo multiple assessments.

One of the results of failing to provide assistive technologies and disability equipment effectively is significant unnecessary cost for the health and care economy, for example through delayed hospital discharges, and unnecessary hospital and care home admissions. Providing services inappropriately is always a false economy.

Incorporating assistive technologies into the delivery of health and care provision is a whole-systems responsibility. It starts with good planning, commissioning and governance. This inevitably flows through to good service provision and clinical involvement. Each of these service areas needs to be clear about their respective responsibilities. There also need to be measurable outcomes and standards in place.

The new UK-wide Code of Practice for Disability Equipment, Wheelchairs and Seating Services

The new UK-wide Code of Practice for Disability Equipment, Wheelchairs and Seating Services is designed to address this, and offers a template for commissioning and providing services; it includes clearly defined and specific standards and measurable outcomes.

Following the Code, in all its parts, will go a long way in overcoming many of the difficulties highlighted above and will significantly improve both clinical and financial outcomes. It will also help to identify where weaknesses are within the whole system and allow root causes to be traced. Following the Code will also enable any equipment-related strategies to be achieved.

The Code, in some or all its parts, relates mainly to disability equipment, wheelchair and seating services. It also applies more generally to other assistive technology-related services; there are certain Code Standards which provide a link to related services, which will assist with integration and offering seamless provision.

The Code is free of charge to organisations registered with CECOPS, or a hard copy or an eBook can be obtained from here: http://www.troubador.co.uk/book_info.asp?bookid=3270 or via the CECOPS website: www.cecops.org.uk

Revolutionary New Self-evaluation & Performance Management Tool now available to Support Planning, Commissioning and Provision of Assistive Technology related services, iCOPS®

In addition to the Code CECOPS has supported the development of iCOPS®, the first ever self-evaluation and performance management software tool for assistive technology related services, including wheelchairs, to complement its scheme.

iCOPS® gives commissioners, providers and clinical staff the ability to evaluate and review services, manage contracts, instil good governance, monitor, assess and manage quality, safety and performance, and drive continuous improvement.

iCOPS® also enables organisations to comply with all their obligations including CECOPS and ISO, for example.

Details about iCOPS® can be found here: www.icops.co.uk. A free one month trial is available.

Find out more about the Code and how it fits with the wider CECOPS scheme here: http://www.cecops.org.uk/2015/03/wheelchair-seating-services-now-covered-by-cecops-standards-uk-and-beyond/

Please get in touch if you would like to discuss any of the points above.

Brian Donnelly

Brian is the founder and director of CECOPS CIC and the author of the Code of Practice.

CECOPS CIC is a not-for-profit social enterprise and is the independent standards body for disability equipment services in the UK.

e: info@cecops.org.uk

t: 01494 863398

w: www.cecops.org.uk

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