Transforming Community Equipment Services

Health & Wellbeing Board 26th October 2011

Understand the background to TCES and explain the retail model

What has been achieved

What we plan to do and challenges to overcome

Answer any of your questions

The purpose of this presentation is to:

What is TCES?

The model had to support central government policy and the nationwide Personalisation agenda (2007) aimed at:

– Early Intervention and Prevention: Creates a growing, accessible marketplace for community equipment empowering individuals to self help

– Choice & Control: Gives power and control to individuals to shape the services they need

– Social Capital: Facilitates the development and sustainability of a vibrant and innovative third sector

– Universal services: To meet the needs of the whole population not just those

supported by the state

A collaborative model for equipment service delivery that puts users and carers at the heart of the service,

leveraging the strengths of the third and private sectors

0.0 5.0 10.0 15.0 20.0 25.0 30.0 35.0 40.0 45.0

2009

2014

2019

2024

2029

Hillingdon Demographics Older People 2009 - 2029

65-74 75-84 85+

Total Increase of 33%

65 – 74 up by 32%

75 – 84 up by 28%

85+ up by 48%

Increase in ‘000’s

The key drivers for a new model include:Changing Central Government policy

Increased demand on services due to an increasing older and disabled population

Budgetary constraints

The key drivers for a new model include:Changing Central Government policy

Increased demand on services due to an increasing older and disabled population

Budgetary constraints

What is “Community Equipment”?

Community Equipment is the term used to describe products that help disabled, vulnerable and older people live as independently as possible in their own homes

They have been separated into ‘Simple Aids to Daily Living’ (£0 - £100) or ‘Complex Aids to Daily Living’ (£100+)

Equipment is currently loaned by the council or the NHS through a contract that exists with Medequip. Prescribers (e.g. an OT) orders the equipment from a central store. Medequip deliver and collect all community equipment in Hillingdon

The retail model recommends a separate solution for simple and

complex equipment

The Retail Model means Simple Aids for Daily Living will be provided through the retail marketplace

Users will receive a prescription enabling them to obtain products free of charge

Users have the option to ‘top up’ should they prefer a product that better suits their lifestyle, within the same functional range, and pay the difference

In the future users will receive a prescription that they can redeem at a retailer of their choice

Reimbursement by the

State

Reimbursement by the

State

Redemption at Accredited

Retailer

Redemption at Accredited

RetailerPrescriptionPrescriptionNeeds

AssessmentNeeds

Assessment

1 2 4

Users will continue to have their

needs assessed as currently

Users who are entitled to

equipment will be issued with a prescription

Retailers will exchange the

prescription for simple aids to

daily living

Retailers will be reimbursed for redeeming prescriptions

3

The prescription model is supported by a National Catalogue and Tariff

The National Catalogue covers all equipment any Local Authority or NHS Trust is likely to prescribe

It has been decided locally which products will be prescribed from the National Catalogue

The products have generic product specifications which retailers then source

Retailers choose which products to stock, where to source products, and what products to physically display

A national tariff has been set across England for each product in the national catalogue– This is the value retailers will receive in payment for the items

issued on prescriptions

15

Live Prescribing Boroughs x 17 Undertaking model launch TBC x 12

Other x 4

Retail Model in London – September 2011

Ealing

Hounslow

Richmond

Merton

Sutton

Lambeth

Southwark

Greenwich

Bromley

Havering

Barking &Dagenham

Redbridge

Westminster

H&F

Camden Islington

Haringey

Waltham Forest

Enfield

Barnet

Harrow

Hackney

RBKC

Newham

Croydon

Tower Hamlets

Lewisham

Hillingdon

Brent

Wandsworth

Kingston

Bexley

City

To 30Sept 201115,500+ prescriptions

issued with over 240 accredited retailers

•20 - 25 local retailers; pharmacies and 3rd sector partners are being accredited

•All retailers are being trained prior to accreditation to ensure correct advice/ support and have to offer delivery and installation if requested

•Neighbouring Ealing has processed over 1000 prescriptions in 6 months

National Accreditation Standards

Physical Criteria:Physical Criteria: Competency Criteria:Competency Criteria:

1. Fulfilment of prescriptions face to face at a physical retail premises (i.e. not internet shopping or mail order)

2. Ability to display and demonstrate equipment in a form convenient to the business

3. Premises open at normal retail hours including weekend opening to suit the individual business requirements

4. Ability to offer qualified home delivery, and fit as a chargeable service (optional)

5. The existence of customer-facing staff, trained to a minimum level of competence, who are capable of:

– Communicating effectively with Users– Offering advice on suitability of

products to the User– Supporting decision making

1. Fulfilment of prescriptions face to face at a physical retail premises (i.e. not internet shopping or mail order)

2. Ability to display and demonstrate equipment in a form convenient to the business

3. Premises open at normal retail hours including weekend opening to suit the individual business requirements

4. Ability to offer qualified home delivery, and fit as a chargeable service (optional)

5. The existence of customer-facing staff, trained to a minimum level of competence, who are capable of:

– Communicating effectively with Users– Offering advice on suitability of

products to the User– Supporting decision making

1. At least 3 years experience in the disability / mobility / health retail sector, with proof that they have received equipment specific training

2. 6 months in the disability / mobility / health retail sector plus professional training (i.e. Occupational Therapist, Physiotherapist, Doctor, Pharmacist, Community Nurse etc) with evidence of equipment specific training

3. Already be accredited

4. Commitment to attend appropriate accreditation training within 6 months

1. At least 3 years experience in the disability / mobility / health retail sector, with proof that they have received equipment specific training

2. 6 months in the disability / mobility / health retail sector plus professional training (i.e. Occupational Therapist, Physiotherapist, Doctor, Pharmacist, Community Nurse etc) with evidence of equipment specific training

3. Already be accredited

4. Commitment to attend appropriate accreditation training within 6 months

Customer facing staff will need to demonstrate competency in Assistive Technology gained from one of the following:

Map of retailers in the Borough

Accreditation

Overall benefits of TCES• Normalisation / mainstreaming of the service - moving away from

institutionalised equipment • Increased innovation, choice and quality of equipment• User empowered to self help and has control over their independence• Reduced demand on the service for an assessment involving smaller

items• More trusted knowledgeable and competent staff in the marketplace• Increased information to understand options through our

communications campaign• Efficiency review of current equipment catalogue and authorisation

processSpecific state funded user

benefits:• Choice of Hillingdon retailer

to redeem prescription• Choice of when to redeem

prescription• Choice of brands of

equipment• Choice to personalise

equipment, “top-up”• User empowered to self help

and has control over their independence

Specific state funded user benefits:

• Choice of Hillingdon retailer to redeem prescription

• Choice of when to redeem prescription

• Choice of brands of equipment

• Choice to personalise equipment, “top-up”

• User empowered to self help and has control over their independence

Specific self funder user benefits:• Easily accessible supply of

simple aids and equipment• Removal of equipment

provision ‘horror stories’• Opportunity to have informed

support from accredited Hillingdon retailers

• Non-dependency of having to come to the service

Specific self funder user benefits:• Easily accessible supply of

simple aids and equipment• Removal of equipment

provision ‘horror stories’• Opportunity to have informed

support from accredited Hillingdon retailers

• Non-dependency of having to come to the service

So what has been achieved so far?

• Series of Prescriber & Retailer working groups • New equipment catalogue agreed• Prescription form defined • Prescriber criteria finalised• Financial benefits scoped and approved• Retailer event & visits conducted and accreditation approved • Waste management solution approved • Back office system developed to process prescriptions • Communications and awareness campaign developed including:

- Service user leaflet- Dedicated information on Hillingdon LA/NHS webspace - Presentation to Disabilities assembly, Carers forum, HCILL user group and Health & Wellbeing board

• Senior Management Team and Project Board approval obtained

What is left to complete to implement TCES in Hillingdon?

• Retailer training on 8th and 9th November 2011 at DASH/ HCILL

• Retailer launch event on the 16th November in the Middlesex Suite.

• Prescription training starts late November 2011- 432 Prescribers across 23 teams trained over 3 months

• Finalise Hospital Discharge involvement in TCES• Work with Neighbouring Boroughs Ealing and Hounslow

to allow freedom of movement for service users.

• First prescription planned for early December.

Thank you for listening – any further questions?