North Yorkshire County Council

 

Health and Adult Services

 

Executive Members Meeting

 

8th December 2023

 

REPORT TO Corporate Director of Health and Adult Services (HAS) in consultation with the

Executive Member for Health and Adult Services

 

Recommissioning of Contract for Technology Enabled Care Services

 

 

1.0          Purpose Of Report

 

To seek approval for the commencement of procurement activity to secure a new contract for Technology Enabled Care services to commence from 1st October 2024

 

 

 

2.0          Executive Summary

In 2018 HAS commissioned NRS to deliver Assistive Technology (AT) provision to people with assessed eligible needs across North Yorkshire. This contract was let on a 3 years +1+1 basis with an end date of 30th March 2023.

 

Due to work undertaken to explore potential alignment with existing District and Borough services, along with the need to avoid changes in service delivery occurring on or around North Yorkshire Council vesting day on 1st April 2023, the Executive meeting of January 2023 approved an extension to April 2024. Significant further work was then progressed on developing a new service, however as further complexities and dependencies became apparent it was agreed by HAS Executive on 20th October 2023 to extend the contract for an additional 6 months to September 2024 to allow all work to be fully completed and for a full, compliant procurement to be undertaken.

 

HAS, Community Development and CYPS are working closely together on what a future Technology Enabled Care (TEC) model may look like with one option being that existing in-house and commissioned offers will be brought together into a single offer although these discussions are at an early stage due to capacity within Community Development.

 

As such, this paper proposes a short-term, predominantly as-is contract of 2+1 years to allow NYC to reach a shared view on the future of TEC services and to develop a future model. This contract will build on the extensive good work which has been done since 2018, continuing to promote TEC as a core part of care and support services whilst promoting innovation.

 

3.0          Background

 

Technology Enabled Care (TEC)) services form a crucial and growing part of the HAS offer to people with eligible needs. Prior to 2018 it was apparent that despite best efforts, the pace of change in technology was outstripping the ability of the existing in-house provision to effectively keep up and deploy new and emerging technologies. To address this, the decision was taken to commission a service which would provide an end to end service that would assess and determine the most appropriate use of technology to support an individual based on their needs rather than on the pre-buying of large numbers of generic units that quickly become obsolete.

 

The contract was awarded to NRS in 2018 and has been successful in meeting the aspiration of rolling out a wide range of equipment based on assessed need. In addition to providing an assessment, installation and response service, the relationship with NRS has focussed on innovation and new ways of working. This has allowed pilots of products such as Canary and Brain in Hand to be progressed under the umbrella of the contract. Each of these products shows potential in improving independence and quality of life, whilst reducing the need for other care and support services.

The service is also used by CYPS, who often access some of the most complex equipment used to support disabled children. Costs from this are recharged based on activity to HAS.

 

Under the 2018 contract the range of TEC equipment utilised has grown significantly and the profile of TEC within the Directorate has improved, especially since the implementation of a dedicated service Manager post with a remit to grow the use of TEC. Significant issues remain in terms of the wider awareness and recording of TEC and the need for such solutions to be considered as a core part of support planning for individuals and carers.

 

4.0          Proposed Service

 

The proposed service will run from 1st October 2024 for an initial term of 2 years with the option of an additional 1 year from 1st October 2026 – 31st September 2027 should this be required and approved.

 

The service will replicate the existing provision as this model has worked effectively in terms of provider delivery and the expansion of the use and variety of TEC solutions being used by HAS. The service will be an end-to-end solution whereby the provider will take on all aspects of TEC delivery, working closely in partnership with HAS.

 

The proposed contract will provide a complete TEC offer with dedicated professional resource for all aspects set out below, this places the service provider as a key strategic partner for NYC. The commissioning of the service acknowledges that the successful delivery of TEC services is dependent on highly specialist knowledge and infrastructure in a context that changes very rapidly.

 

The service will deliver:

·         Referral management,

·         TEC Assessments delivered on behalf of NYC,

·         Alarm Receiving Centre,

·         Purchasing and warehousing of equipment,

·         Installation, repairs & maintenance,

·         Responder service,

·         Reuse and recycling,

·         Training,

·         Transformation and culture change.

 

The aim of the Assistive Technology is to ensure the residents of North Yorkshire are provided with a high quality, mainstream, innovative service that uses technology, monitoring, and support to:  

 

·         Enable people to live healthier, independent lives for longer  

·         Enable people to live in their own homes for longer  

·         Reduce demand on social care services  

·         Reduce demand on health services  

·         Prevent or delay unnecessary hospital or care home admissions  

·         Facilitate early hospital discharges  

·         Enable market innovation  

·         Provide solutions that complement our existing services  

·         Support our strength-based assessment processes  

·         Deliver services that provide value for money for the customer and the Council  

·         Provide Assistive technology solutions that changes lives, that enhances and compliments personal contact 

·         Improve access to Assistive technology services. 

 

And provides a service that; 

 

·         Is focused on prevention and early intervention within the context of assessed need

·         Has a clear process pathway, with a simple access to services for professionals through a self-referral route or information and advice on products to private paying customers 

·         Works with the private paying market which has an immense potential for expanding the service, offering more people more choices before the necessity to access statutory services. People requiring a private pay option are also signposted to the in-house services where they exist. 

·         Provides improvements in value for money, quality, and efficiency 

·         Targets the reduction in the cost of care with a technology first culture 

·         Delivers increased opportunities for complex installations, delaying escalation in care and/or support needs 

·         Ensures there is a place for all types of technology to meet all types of needs 

·         Has clear and accessible information and promotes the use of Assistive technology through social media and other methods of Marketing.  

 

 

5.0          Risks and Issues

 

The key risks associated with the procurement will be in the implementation and any technical compatibility issues that may need to be addressed. In the event of a provider change, The Housing, Technology & Sustainability Team will work closely with both the incumbent and new provider to ensure that a robust implementation timetable is put in place and adhered to as well as identifying any technical requirements which may require additional input.

 

Risk: The procurement and implementation timeline allows for a 4.5 month implementation which will be challenging for a new provider.

Mitigation: The timeline is clearly set out all in all procurement documentation and providers will be assessed in part on their plan to meet this timetable. Dedicated and experienced HAS resource will be focussed on the implementation throughout this period

 

Risk: There are a wide range of TEC solutions available to providers, there is a risk that Changes in, or Incompatibility of Equipment will involve significant requirements for equipment to be changed which will take time

Mitigation: This will be assessed as part of the evaluation process to ensure a smooth transition and compatibility of all equipment with proposed infrastructure

 

6.0          Financial Implications

 

The contract will operate on a model of fixed payments for aspects such as infrastructure and staffing (known as the Management Fee & connection charges) and variable payments based on actual use of equipment (known as Equipment Charges) as is currently the case.

 

The final cost of the service will be dependent on the submissions received from providers through the Procurement process, and will be assessed to ensure they fall within existing HAS budgets allocated to this service.

 

In addition, TEC is a chargeable service. Significant issues around recording have prevented charging TEC as data quality did not allow accurate billing to take place. Work is underway with Heads of Care and Support and Business Intelligence to ensure that data quality and processes are up to date ahead of the launch of this contract so that information can be managed effectively and users of the service can be billed appropriately.

 

TEC also providers significant non-cashable savings to HAS through the reduction in the need for direct care. Similar issues around recording have limited the use of this model, however the work outlined above will address this issue as well and will allow for a robust understanding of the impact TEC services have on Care and Support budgets.

 

7.0          Legal Implications

No legal issues have been identified through the development of the service.

 

 

8.0          Conclusion and reason for recommendation/s

 

TEC forms an essential part of the HAS offer and the impact of such services will only continue to grow in the future. This proposal will secure the delivery of TEC services through to 2026/27 whilst detailed work can be completed on the wider transformation of services across Directorates.

 

8.0       Recommendation/s (required)

 

That the Corporate Director in consultation with the Executive Member approve the

proposal to launch a procurement for TEC services.

 

Mike Rudd

Head of Housing, Technology & Sustainability

 

8th December 2023