Can home care visits be replaced with video communication?

In June 2017 Essex County Council, along with us (its Local Authority Trading Company), was awarded a grant by NHS Digital and the Local Government Association to pilot the use of video communication in care packages.

As we provide a range of care and support services in Essex, the short-term reablement service was identified for the pilot. A key driver of cost in care delivery is staff utilisation. Travel times between care visits impact the efficiency of services.

The pilot tested the hypothesis that video calls can replace physical visits to the home by a care worker to support reassurance checks and medication prompts. It also considered whether these solutions are effective and financially viable in short-term reablement care packages, which run for a maximum of six weeks.

The project used two different devices, SpeakSet and Breezie, which allowed individuals to make video calls with friends, family and health and social care practitioners.

SpeakSet is a set-top box and web camera which converts a television into a video communication device via a SCART connection. It is easy to use, with the customer requiring a five button remote to take or make a call.

Breezie is a tablet device with a simple user interface which makes navigating applications very easy. An application, ‘Vidyo’, was installed on the Breezie device to make secure video calls.

The pilot started in October 2017 and finished in June 2018. Over the eight months, 734 people were assessed for their suitability to take part in the pilot. If the individual had lack of capacity, poor dexterity, sensory impairment or did not want to be involved, they did not participate.

39 people were assigned either a SpeakSet or Breezie device depending on their experience using technology and personal preference. After giving consent, 20% of individuals returned to hospital or their health deteriorated so they could not continue. Another 23% left the service before their device could be installed.

In the end 17 people aged between 21 and 92 used a device, although none had a care visit replaced by a video call, for various reasons. Despite this, of the participants that gave feedback, 87% found benefit in using their device – it gave them increased confidence in using online services, more frequent and/or better quality contact with friends and family. Half of the participants said that they would have been happy to replace one or more care visits with a video call.

The most significant challenge to the pilot was the short length of time that people with lower needs (who tended to be more suitable) were in the service. This meant there was not enough time to engage them in using the technology. Also, whilst the majority of customers used the devices with little support after the initial induction, staff needed frequent training to retain the learning and operational pressures limited the capacity for teams to learn new processes and engage with the new technology.

The biggest benefit to participants was the ability to connect with friends and family, often at a time when their confidence was low following a hospital stay. Feedback from participants included ‘I would recommend to others. Brilliant idea that you have contact to others. Great communication aid’ and ‘I loved being able to try out gadgets I have not been able to try before. It has helped me feel better’. For staff, the pilot allowed them to think differently about how technology can be used alongside traditional care practice, even if it wasn’t operationally possible to get it into practice.

The innovation in this project was in the service delivery rather than the technology itself. There are various video conferencing solutions on the market but they are yet to be used consistently in replacement of traditionally delivered care. This pilot aimed to challenge the need to be physically present for certain support activities and whilst it did not evidence this in short-term care packages, the potential was identified for this to be a successful solution in longer-term care provision where individuals and professionals have more time to engage with the technology and form a relationship with the care provider.

Author Biography

Claire Shuter is Head of Strategy, Digital and Marketing for ECL. Prior to joining the Local Authority Trading Company in 2017, Claire worked in local government for 15 years at County and District Councils in Essex.