LOTI’s work in this space is focused on digital assistive technologies – devices, software or equipment that can support individuals to overcome a broad range of challenges.

Over the past year and particularly over the past few weeks, LOTI boroughs have been working together to explore the role of assistive technologies in improving social care provision. Here I describe where we started and where we’re heading. 

Introduction

If you’re reading this, it’s likely you’ve seen two terms – “cost savings” and “quality adult social care provision” – used in the same sentence, for the best part of the last decade. Covid however, has amplified the need for both. 

London boroughs are now facing a £1.4bn funding gap and the needs of residents have grown exponentially over the past 7 months and are likely to continue to do so. It is the combination of these two great challenges that’s driving LOTI’s work in this area. 

Before describing what we’re planning to do, let’s first look at what we did in year one.

Developing a framework for evaluating the impact and effectiveness of assistive technologies

The ‘T’ in LOTI is about effective use of technology to realise outcomes for individuals. Right when we started, we heard about many of our boroughs being on a journey with AT, having been involved in trials of different assistive technologies. 

What became apparent quite quickly was the fact that despite numerous pilots (by boroughs, social care providers, NHS etc.), it was very difficult to compare like for like and draw meaningful conclusions about which technologies were effective and under which conditions.

So, our first mission (led by Newham and with great support from colleagues at Kingston and Sutton, Hackney and others) was to codesign a robust and trusted methodology for consistently evaluating the effectiveness of any future LOTI trials. 

Based on LOTI’s outcomes-based methodology, we created a simple evaluation framework. Its purpose is to:

• support AT leads to design pilots that address the needs of specific users, taking into account their specific set of circumstances.
• enable the consistent evaluation of AT trials so that other boroughs are able to learn from and build on, rather than repeat existing work.

The creation of the framework was a useful starting point. Boroughs reported that having this consistent way for measuring the impact and effectiveness of LOTI AT pilots will make it easier to evidence the benefits realised, particularly when making business cases for more investment in this area.

AT for Covid recovery – LOTI’s plans for rapid delivery

The Covid crisis brought its own unique challenges – for boroughs and residents alike. Boroughs were busy firefighting and responding to urgent needs and vulnerable residents were left isolated for considerably longer periods than ever before. 

With this in mind, boroughs once again turned their attention to ATs, attracted by their potential to help vulnerable and isolated residents live more independently, improve their wellbeing, and support them to maintain existing or create new social connections. 

Through four specific areas of activity, we’re hoping to cover significant ground and seek to resolve issues that LOTI members have identified as being important.

By establishing what’s already known, we’d like LOTI boroughs to be confident about and only invest in ATs that yield the greatest impact for their residents. This will also ensure that any future trials are informed by lessons from the previous ones, avoiding duplication and reducing waste. To make this happen:

• We’re creating a LOTI library of AT case studies, clearly outlining the evidence / investment case, the conditions required to realise outcomes and lessons learned
• We’ve created a template for recording the results of AT pilots, to ensure that boroughs can consistently compare the results from different trials
• We’re also conducting research into specific technologies boroughs have expressed an interest
• We’ll be engaging with and seeking the advice of our established community of colleagues actively working in this area, via interviews, workshops etc.

By running trials of AT using LOTI’s outcomes-based methodology, we’ll be supporting LOTI boroughs to address immediate challenges brought about by Covid. This will broaden our experience as a collective, learning from shared experiments and scaling up where there are clear benefits. To make this happen:

• We’re planning to run at least two trials with colleagues at Hackney and Greenwich, which will seek to test the role of two different ATs in reducing isolation and improving wellbeing.

By identifying and defining barriers to and opportunities for using AT effectively, we seek to address the broader systemic issues in this sector which hinder councils’ abilities to use these technologies. To make this happen, we held two workshops in September. We explored the barriers and problems currently experienced by boroughs and were able to define what support LOTI can provide. You can read the summary of the workshop including key actions we’re taking forward here, but here are some highlights:

Realising outcomes for specific personas

Any project we conduct is driven by outcomes for people and this project is no exception. The main personas LOTI boroughs identified in this case were: i) individuals in need of care, ii) main carers (both family and council employed carers) and iii) council staff leading on AT such as AT or Adult Social Care Leads and Chief Finance Officers.

The outcomes (for each persona respectively) ranged from accessing the right ATs to using ATs well to manage conditions to making ATs part of the decision making process.

Our mission to deliver tangible results

We’re determined in our mission to help deliver value to LOTI boroughs and will be taking the following actions forward. 

Procurement 

• The need: Identify existing frameworks and explore ways in which boroughs can engage with suppliers re interoperability of devices and use of common standards
• What we’re doing: 1) Connecting with Crown Commerical Service and 2) Finalising the standard T&C clauses for technology contacts we started developing a few months ago

Results of AT trials

• The need: Create a common template for recording the results of AT trials so they provide sufficient information to inform other boroughs’ trials
• What we’re doing: Template ready to use.

Plain English data sharing and privacy agreement

• The need: Create an exemplar agreement approved by the Information Governance Group for London (IGfL)
• What we’re doing: Working with Hackney to develop a model agreement, signed off by IGfL and shared with LOTI boroughs

Common questionnaire for AT trials

• The need: Create a standard template questionnaire to help create a baseline for individuals’ wellbeing prior to using an AT.
• What we’re doing: Working with Greenwich to develop a template 

Using existing funding to broaden access to ATs

• The need: Guidance on how boroughs can use existing funding streams such as the Disabled Facilities Grant to fund broadband/wifi connections as part of their care package assessment.
• What we’re doing: Creating guidance based on best-practice examples from LOTI boroughs.

Sharing council’s data allowance with digitally excluded residents

• The need: Guidance on how boroughs can share their data allowance with qualifying residents who may not be able to afford data.
• What we’re doing: Creating guidance based on best-practice examples from LOTI boroughs.

Networks

• The need: To explore setting up an AT Leads network
• What we’re doing: Exploring whether there’s value for LOTI to create and manage a distinct network.

Analogue to Digital Switchover

• The need: Engage with OfCom and TSA to ensure LOTI boroughs have full clarity of the implications of the analogue to digital switchover in Telecare and the opportunity to share their ideas and concerns.
• What we’re doing: Setting up a meeting with OfCom and TSA with LOTI AT Leads.

We know these actions are only the beginning and our work will not stop here. We’ll be reviewing progress with our members over the next few weeks and months and adapting our approach to an ever evolving Covid situation.

We’re grateful for input from others to help shape this work further, so please do comment or contact us with any relevant suggestions or feedback.

LOTI is committed to working in the open so we’ll share all our findings, templates, etc. on our AT project page.