Keeping older people safe: why London is focusing on remote monitoring in care homes

Most people living in care homes are over the age of 80, have multiple long-term health conditions and are affected by physical disability and cognitive impairment. Our Head of Healthy Ageing Fay Sibley, who is leading on the NHSX Innovation Collaborative for London, sets out here why remote monitoring in care homes is so important for this vulnerable population.

The Covid-19 pandemic raised a new set of challenges for care home staff and their residents, including accessing healthcare services remotely, caring for residents with complex health needs and providing palliative care for residents, often without the face-to-face support from healthcare services they would normally receive. Care homes also face significant workforce challenges with many staff off sick, self-isolating due to Covid-19 or unable to work due to fear and anxiety for their own safety. In the England, residents of care homes for older people have been particularly affected by Covid-19 and have made up 39 per cent of all Covid-related deaths[i].

Most people living in care homes are over the age of 80, have multiple long-term health conditions and are affected by physical disability and cognitive impairment[ii]. These factors explain, in part, the vulnerability of older people living in care homes to Covid-19, and why there has been an increased focus from the NHS to support care homes over the last nine months, with several initiatives concentrating on improving quality and efficiency. However, many of these require vastly improved IT systems and technological solutions, further complicated by the variety in size, digital maturity and type of care provided by care homes.

If local authorities and CCGs are aware of these differences, they can better target support and interventions to London care homes so they:

• have the right Wi-Fi and infrastructure so they can access a range of digital products and solutions for care and wellbeing;
• can communicate sensitive care information safely, securely and in a timely way so care decisions can be jointly made while residents’ privacy and security are protected;
• can access and share care documentation and management, meaning staff from different organisations work together to develop a shared plan and each resident experiences joined up care without needing to repeat themselves if they change location;
• plan and manage care electronically, so that care provision is recorded and stored, and productivity is improved;
• have staff with the skills and confidence to use digital tools to access remote health care support for their residents and themselves; and
• undertake virtual consultations and remotely monitor the health of residents, so care can be provided where the residents are, care decisions are made at the earliest time possible and care is provided safely during the Covid-19 pandemic.

Remote monitoring is a fantastic opportunity for care homes to improve care. This is where hardware and a digital platform allows care home staff to take, record and monitor vital signs of care home residents. This information is then stored on a digital platform, which can be accessed by healthcare professionals, such as the GP. Having access to clinical information such as temperature, heart rate and blood pressure allows care homes to spot signs that a resident is becoming unwell early and share their concerns with healthcare professionals. Care home staff, in partnership with clinical staff, can then plan and prioritise care accordingly.

In partnership with the seven regions of the NHS in England, NHSX is pioneering a new Innovation Collaborative to (1) build on the digital health gains achieved during the pandemic, (2) accelerate the scale of those digital innovations that enable a redesigned outpatient and remote care service and (3) help save staff time. For the reasons outlined above, all five of London’s sustainability and transformation partnerships (also known as integrated care systems in some areas) have committed to work collaboratively to support the increased use of remote monitoring technology in care homes.

The London region is currently working with six remote monitoring companies to implement remote monitoring in approximately 600 care homes, supporting 21,000 older people to remain well in their own homes. Our collaborative will look at different methods and products for implementing and supporting remote monitoring and allow learning and best practice from each method to be shared across London.  This will improve the care of not just current but future care home residents, some of our most vulnerable members of society.

[i]https://www.bgs.org.uk/resources/covid-19-managing-the-covid-19-pandemic-in-care-homes

[ii]https://www.bgs.org.uk/resources/covid-19-managing-the-covid-19-pandemic-in-care-homes