11 Analogue to Digital June 2022v3
North Ayrshire Council · 16 June 2022
Back to Integration Joint Board — 16 June 2022 and its agenda
Text extracted from the council's PDF. Layout and reading order may differ from the original.
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Integration Joint Board 16 June 2022 Subject: Community Alarm/Telecare Service transition from Analogue to Digital (IP) Purpose: That the North Ayrshire Health and Social Care Partnership update the Integration Joint Board on the transition for Community Alarm/Telecare Services transition from Analogue to Digital Service Internet Protocol (IP) Recommendation: The Integration Joint Board is asked to: (i) Note the content of the report; (ii) Consider the information and proposals/implications detailed therein. Glossary of Terms NHS AA NHS Ayrshire and Arran NAHSCP North Ayrshire Health and Social Care Partnership TEC Technology Enabled Care TSA Telecare Service Association IP Internet Protocol PSTN Public Switched Telephone Network 1. EXECUTIVE SUMMARY 1.1 This report provides an update on how the North Ayrshire Health and Social Care Partnership will support North Ayrshire service users through the Telecommunication providers Analogue to Digital switchover. Community Alarm/Telecare users, in North Ayrshire currently receive their service via technology supported by analogue phone lines. As early as 2023 it will no longer be possible for customers to purchase an analogue phone service from many of the main telecommunication providers and all telecommunication providers expect to have fully transitioned their analogue telephone networks to a digital equivalent by 2025. Therefore, Community Alarm/Telecare users will require to have digital phone lines in place within their homes in order to access Telecare and Community Alarm technology. Telecommunications providers, of which there are over 600 in the UK, have confirmed that all analogue telephone services will be switched off and replaced by digital systems by 2025. Ofcom and telecommunication providers have confirmed that systems which are currently reliant on analogue and voice band data will be affected by this change. This includes systems such as security alarms, cash terminals, fire alarms and Community Alarm/Telecare systems. The move to digital systems is well underway with many providers accelerating their switchover to be complete by the end of 2023. As a result of accelerated timescales from telephony providers, the Scottish Local Government’s Digital Telecare Office are encouraging Telecare Providers to make the shift to digital solutions from as early as 2023.
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The current range of Community Alarm and Telecare equipment utilised in North Ayrshire is designed to send calls over the Public Switched Telephone Network (PSTN). If these devices attempt to connect with the Call Monitoring and Alarm Receiving Centre via a digital network, the call could fail to connect or be lost. 2. BACKGROUND 2.1 North Ayrshire Health and Social Care Partnership currently delivers a Community Alarm and Telecare service to around 5,000 individuals across North Ayrshire both on the mainland and the islands of Cumbrae and Arran. Service Users who access the Community Alarm and Telecare system have technology installed by NAHSCP staff, which is connected through their analogue phone lines, allowing them to access and request help and support via a Call Monitoring and Alarm Receiving Centre. The Call Monitoring and Alarm Receiving Centre will direct any calls it receives to a variety of sources including NAHSCP social care staff, medical services, emergency services, family and next of kin. The charge for Community Alarm and Telecare services £5.07 on the mainland and £2.48 for the islands. Users of the Community Alarm/Telecare service in North Ayrshire generate in excess of 20,000 calls per month via Community Alarm/Telecare equipment. North Ayrshire Council currently employs around 80 Health and Social care staff who are linked to this service including over 70 Community Alarm/Telecare Care at Home Assistants who provide a response service 24 hours per day on the mainland and between the hours of 8am and 11pm on the islands of Arran and Cumbrae. Prior to the Covid Pandemic the service generated calls which required approximately 5,000 responder visits per month however this activity has increased since March 2019 with responder calls of up to 7,000 alarm activations requiring a physical response on a monthly basis. 2.2 Community Alarm/Telecare users have a main Community Alarm unit installed in their homes, which can allow for numerous peripherals to be added, in order to support and monitor service users and to assist them remain as independent as possible in their own homes. Examples of peripheral technology includes things such as Smoke Detectors, Flood Detectors, Falls Detectors, Property Exit Sensors, Epilepsy Sensors etc. The Partnership mostly use Tunstall branded Community Alarm and Telecare equipment purchased via the Scotland Excel Framework. Tunstall are an ISO accredited technology provided and their equipment is compatible with Hanover Scotland’s device management platform (Tunstall PNC8) which is used for receiving calls and call handling. 2.3 This technology is vital in supporting individuals in North Ayrshire to continue to live safely in their own homes, with access to care and support when required, and is utilised by adults across all age groups. There are many benefits to Community Alarm/Telecare technology as detailed below: • Provides access to multiple items of advanced technology to support safety and independent living • Reduce pressure on traditional health and social care services • Preventing hospital admission and supporting discharge • Reducing the need to service users to leave their own homes and move into long term care settings
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The Partnership received investment in late 2021 as part the Winter Pressures funding which was provided as part of measures put in place to support system pressures and investment in our Community Alarm and Telecare services are integral to this. 2.4 Hanover Scotland are the current provider of Call monitoring and Alarm Receiving services for North Ayrshire’s Community Alarm and Telecare services. The contract for this has been extended until early 2023 however this is due to be tendered and work is ongoing regarding procurement action and there is potential that there may be a requirement for a transition to a new Call Monitoring and Alarm Receiving Centre in mid-2023. 2.5 Associated Risks Ofcom and the Telecare Standards Association, (TSA), are working alongside the Technology Enabled Care sector, Regulators and the Scottish Government to understand the challenges presented by this transition and to support Partnerships/Local Authorities through this process. A number of concerns and risks associated with the transition have been highlighted and these are detailed below. • Individual Telecommunications providers will work to different timescales within their own operational and strategic plans. This will have implications for service users within North Ayrshire who receive telecommunication services from a wide range of providers, and many have begun to transition sooner than the 2025 deadline and before replacement digital devices are provided. The current range of Community Alarm and Telecare equipment utilised in North Ayrshire is designed to send calls over the PSTN. If these devices attempt to connect with the Call Monitoring and Alarm Receiving Centre via a digital network, the call could fail to connect or be lost, with a potential risk to the service user not receiving the requested assistance. The Scottish Government Digital Office advises there is evidence from countries who have already undertaken the transition to digital technology of increased rates of call failure due to the distortion in analogue signalling from analogue telecare equipment as telecommunication providers prepare their networks. • The Partnership’s current Call Monitoring and Alarm Receiving provider, Hanover Scotland, are not yet fully digitally enabled to support receipt of digital Community Alarm and Telecare equipment. Hanover have advised they are committed to their Alarm Receiving Centre being fully digitally enabled in 2022 to ensure they can accept the different digital protocols and communication methods coming on to the market, as well as being able to continue to support the existing analogue equipment for as long as necessary. This includes supporting the digital communicators on warden call systems as well as newer fully digital grouped and dispersed alarms. Hanover were successful in securing funding from the Scottish Government’s Digital Office in December 2020. They are now one year into a two year project to expand the capability and capacity of their Alarm Receiving Centre’s digital environment to allow for testing and deployment of the various digital telecare products on the market. Hanover have agreed a timescale with Tunstall, who are their software provider, for the Alarm Receiving Centre to be compatible with digital protocols by September 2022.
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• Hanover Scotland are the current provider of Call monitoring and Alarm Receiving services for North Ayrshire’s Community Alarm and Telecare services. The contract for this has been extended until 2023 however this is due to be tendered and work is ongoing regarding procurement action and there is potential that there may be a requirement for a transition to a new Call Monitoring and Alarm Receiving Centre in mid-2023. Re-tendering of this contract was been delayed due to the Covid Pandemic. • North Ayrshire Health and Social Care Partnership has spent an average of £191,634 per year in purchasing new Community Alarm/Telecare equipment pre pandemic. Costs of telecare equipment have risen since the onset of the pandemic and there has been various supply issues in this period, including a global shortage of semiconductors that are installed in telecare equipment, which has affected the availability of vital equipment, including smoke detectors and fall detectors. The Telecare equipment providers have already indicated that the costs for Partnerships to purchase new digital equipment will be significantly higher. From the evidence already available the prices of the new equipment are almost double the current costs, with ongoing yearly costs attributed to sim card rental. Providers of Community Alarm/Telecare equipment continue to undertake testing to identify interoperability and establish how much, if any, of current equipment will be compatible with the digital system. However, it is likely that upgraded digitally enabled Community Alarm/Telecare equipment will require to be installed for the majority of users to ensure people continue to have access to support via their Community Alarm/Telecare equipment. There are some digital solutions available, however supply is limited at this time with the Partnership’s current favored provider advising of a 6 month lead in time for the purchase of digital devices. • At present much of Community Alarm/Telecare equipment is recycled. For the first 12 months of implementation, it is envisaged that there will be no opportunity to recycle any equipment. This, again, will have a negative budgetary impact for the Partnership. • North Ayrshire’s geographical footprint is in many areas rural and isolated with areas where signal strength is poor or indeed non-existent. Therefore, there are risks associated with digital connectivity and availability of digital service. • Cyber security risk – as Telecare Providers source new and more advanced technologies, this is likely to bring an increased cyber security risk. 2.6 Whilst the service has known for some time that there will be a requirement to shift technology, there are still many unknowns in terms of the practical implementation which has delayed the development of a business case and implementation plan. Clarification is required on the equipment specification, the availability of equipment, the compatibility of existing kit and call handling platform. Therefore, there would be little benefit in implementing a new system until these elements are confirmed. Some areas are further progressed with plans, with some now requiring to retrospectively amend implementation plans based on current advice. 2.7 The HSCP has issued communications directly to Community Alarm Service users to provide advice in advance of the switch over and also in respect of the potential for equipment to be removed in light of the Smoke Alarm Regulations. There is also radio advertising on a Pan Ayrshire basis to support services users who may be targets for
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scammers. The HSCP will review any switchovers for individual service users which it is made aware of that take place in advance of the planned roll out of new digital equipment to ensure arrangements are made in an interim basis – this may include the continued short term use of analogue equipment with regular equipment checks to mitigate any risk and the use of GSM equipment, dependent on availability. 2.8 Community Alarm and Telecare Equipment Costs As already outlined in this report there will be financial implications for the Partnership with the transition from analogue to digital. The Partnership had a successful bid in early 2022 of a grant for up to £50,000 from the Scottish Government’s TEC Programme to support the transition from analogue to digital. The North Partnership intends to use this grant to fund a Telecare Lead to Project Manage the analogue to digital programme and this post is currently at Job Evaluation stage. The Scottish Government have already confirmed that there is no further funding available to support Partnerships/Local Authorities with the transition of analogue to digital and that any other financial implications, including the full costs of upgrading Community Alarm and Telecare equipment, have to be met by each individual Partnership/Local Authority area. Within Community Care Services the planning work associated with the preparation that is required in the lead up to transition planned to commence in 2022 has been delayed due to the Covid 19 Pandemic. However there are still many variables to be finalised that makes some of that work difficult. What is evident though is that new digital Community Alarm/Telecare equipment is going to be more costly than the existing analogue equipment. There is currently average annual spend of £191,634 per year to replace and purchase equipment on an ongoing basis, with additional equipment and price increases and unconfirmed yearly sim card costs per alarm device it is anticipated this cost will increase. Testing remains ongoing by many Community Alarm and Telecare providers to determine if analogue telecare equipment can operate over a digital connection. At the moment the results of this testing have not been published and it remains the view of the Scottish Digital Office that this should not be viewed as a viable or long-term solution by service providers unless no alternative digital solution exists. The TSA recently published guidance which stated that ‘Organisations must no longer procure social alarms that can only establish connections to Alarm Receiving Centres using analogue communication’. If the Partnership requires to replace the current analogue equipment with an updated digital version of kit for every single user utilising the service at present, then that cost is anticipated to be approximately £800,000 to the Partnership with additional yearly sim rental costs. As such North Ayrshire Council has allocated £996,000 towards these costs. 3. PROPOSALS 3.1 It is important that the IJB note the digital developments above and the proposals detailed below. • The Partnership will recruit a project team consisting of a project lead and 4 project support officers who will develop an analogue to digital transition plan, including identifying the right digital solutions and call monitoring platforms required. This project team will be responsible for the procurement, replacement and delivery of all associated analogue to digital works.
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• The Project Lead will develop a full business case for the project and this will be brought to a future IJB for approval. • The business case and project plan developed will take into account a full survey of the telecommunications position across North Ayrshire – ie which providers are migrating when, when analogue lines will cease to become available, rural signal blackspots etc. This plan will also include details of how individual service users needs will be considered either in terms of assessing if existing technology is suitable, replacement technology is required and availability of connection in the event of rural location. This remains a risk where users are transferred to digital networks before the Partnership has suitable digital technology and call handling arrangements in place. • A procurement exercise will be conducted for the digital technology required to replace the existing analogue equipment installed in service users homes across North Ayrshire. This procurement exercise must take into account business continuity arrangements to ensure any technology procured provides robust back up arrangements in the event of system down time. • A procurement exercise will be conducted for a Call Monitoring and Alarm Receiving Centre which is digitally enabled to receive calls from both analogue and digital devices to meet current and future Community Alarm/Telecare requirements. This procurement exercise must take into account business continuity arrangements to ensure any technology procured provides robust back up arrangements in the event of system down time. • The Community Alarm/Telecare service is a generic service and is currently not age or condition restrictive. In consideration of the potential cost implications linked to the digital transition and beyond there may be the requirement for the introduction of a specific eligibility criteria to access the Community Alarm/Telecare service and future cost/charge considerations. 3.2 Anticipated Outcomes The anticipated outcomes of this paper are to update the Integration Joint Board on the potential impact of the forthcoming analogue to digital transition. By early identification of the proposals, financial implications and potential risks it is anticipated that the service will be in a stronger position to plan and deliver a safe and effective switchover for Community Alarm/Telecare users in North Ayrshire. 3.3 Measuring Impact Not Applicable 4. IMPLICATIONS Financial: There will be financial implications linked to the costs associated with the analogue to digital switchover. Further details of what those are will be provided when further developed as part of the analogue to digital switchover business case. Capital funding of £996k has been set aside in North Ayrshire Council’s Capital Plan to fund the switch over. Human Resources: There are no implications for NAHSCP staff as a result of this report. Legal: There are no known legal implications as a result of this report. Equality: There are no equality implications as a result of this report.
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Children and Young People There may be implications for Children and Young People who currently utilise Community Alarm/Telecare services in North Ayrshire. Environmental & Sustainability: There are no Environmental or Sustainability implications as a result of this report. Key Priorities: The Partnership are committed to investing in technology solutions to support independent living. Risk Implications: There are Risk Implications, and these have been outlined in section 2 Community Benefits: N/A Direction Required to Council, Health Board or Both Direction to :- 1. No Direction Required √ 2. North Ayrshire Council 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran 5. CONSULTATION 5.1 Representatives from Community Care Services have been involved in regular consultation with the TSA, Scottish Government, Telecommunication and Telecare providers. This consultation will continue throughout the preparation for transition from analogue to digital and will incorporate consultation with users of Community Alarm/Telecare services in North Ayrshire. In addition staff from the Community Care Services team are members of the networking groups who meet to discuss this transitional programme of work and the implementation of the analogue to digital strategy. 6. CONCLUSION 6.1 Members of the IJB are asked to note the information included within this report. A further paper will be submitted at a later date including the business case to support the analogue to digital transition. For more information please contact Kerry Logan, Senior Manager, Community Care Services on 07836246131, klogan@north-ayrshire.gov.uk