Welcome and introduction, TSA`s 2020 ambitions and aspirationsAlyson Scurfield, Chief Executive, TSA

Together, we are stronger

Shaping the future of Technology Enabled Care

Our Vision

People choosing Technology Enabled Care and support to enrich everyday life

Our Mission

Driving the transformation and growth of the Technology Enabled Care Industry

Our Goals• Grow TSA’s membership, impact and reach• Increase TEC standards through certification• Lead, aspire and promote service models that improve health and care outcomes• TEC Quality to achieve industry-wide compliance

For the past 4 years TSA has

reached new levels as ‘the voice of

TEC’

THE VOICE OF TEC

• Lobbying and influencing government• Raising profile of TEC in social care,

health and housing• Creating partnerships with

national bodies and regulators • Launching new Quality Standards Framework• Influencing Technology Standards• Developing training and networking events• Business Strategy & Transformation Consultancy

• CREATING TWO NEW ARMS

TSA to lead effectively we have changed our structure

‘TEC Services Association (TSA)’

A ‘parent’ Community Interest Company (CIC) will manage

membership activity and commercial

contracts

Quality · Safety · Innovation

A NEW SUBSIDIARY CREATED TO SET STANDARDS AND INSPECT ON QUALITY

TSA’s standards body will have its own board to guarantee its independence

Board will be supported by:

• Technical Expert Steering Committee

• Service and Operational Expert Steering Committee

• TQ will become a UKCAS accredited centre

For the past 4 years TSA has

reached new levels as ‘the voice of

TEC’

2020 BUSINESS PLAN

• Restructuring TSA Staffing• Restructure internal and external system and processes• Membership Proposition development• Become UKAS Accredited Centre• Growth Plan, membership, standards, events, consultancy

and education• Market and competitor analysis• Develop future prediction of TEC • Leading digital strategy • Digital marketing strategy and development• Development of new website

Ensuring Quality and Safety

Quality Standards Framework‘Moving from outputs to Outcomes’

“We value highly the benefit of showcasing both our membership and accreditation to the TSA quality standard framework, a key requirement to support our growth strategy. Presenting a hallmark of Telecare standard, which demonstrates all our

processes and principles are ratified independently by the TSA accreditation, assures clients that Anchorcall can provide cost effective Telecare monitoring solutions

based on an industry best practice standard in all aspects of our service delivery. Most importantly it shows that service user safety and security is at the heart of

everything we do.”

Jo Longfellow, Customer Centre Operations Manager, Anchor

CORE VALUE STRONG TOGETHER

Connecting People, Improving LivesA digital future for Technology Enable Care

TSA White Paper

Connecting People,Improving Lives:

A Digital Future for Technology-Enabled

Care?

www.tsa-voice.org.uk/digital-shift

Over the next few years (by 2025 latest?)

• Analogue telephone services in the UK will be switched-off, and replaced by packet-switched solutions (“ALL-IP”).

• Analogue systems (using ‘voice-band SIGNALLING’) are all affected to some degree, including:

Security systems

Fire alarm systems

Cash-payment terminals

TELECARE & SOCIAL ALARMS

Telecomms Digital Shift & Telecare

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THE THREATS

The Opportunity

TSA WHITE PAPER ACTION PLANRoadmapping• Capture telecoms switchover plan – OFCOM (timescales, geography)• Confirm Scale of Impact – manufacturers, telecoms testing • Service provider planning – response to switchover, systems affected, procurement• Roadmap for new technology - assistive solutions, evidence, regulatory

Standards & guidelines• Identify standards and guidelines affected – regulators, SDOs• Standards re-development for services & systems – CEN, Cenelec, BSI• Guidance updates for digitally-enabled services - inc. TSA Quality Standards Framework

Commercial Impact• Identify and promote new commercial models – connectivity, mixed models• Confirm costs of transition to digital• Lobbying Plan for transitional funding

Coordination• Rolling communication plan • Programme management coordination

A Digital Future for Technology-Enabled Care

FULLY DIGITAL PHONE SERVICES: INFORMATION FOR SPECIAL SERVICE PROVIDERS

A message from BT

https://www.btplc.com/DigitalServicesLab

• Telecare Monitoring Centre Inbound Telephone Numbers• Who Provides the Numbers• Total Number of Telecare Connections

Email: allip@tsa-voice.org.uk

2017 White Paper Update – Connecting People, Improving LivesA Digital Future for technology Enabled Care

Steve Sadler, Associate – Technology Strategist, TSA

To view the video please visit -https://www.youtube.com/watch?v=fJFI5msCSM4

Together, we are stronger

Regulations and standardsPaul Finch, Associate – Standards, TSA

Together, we are stronger

Events Management

Alan Williamson

Finance DirectorIan Clayton

Business Support CoordinatorJenna Lynch

Chief Executive OfficerAlyson Scurfield

Business Support Officer

Melanie Young

TSA President & Temp Chair of TQ

Paul Burstow

Marketing & Communications

Rowan Atkins

Marketing Content Manager

Andrew Tucker

Marketing & Events Assistant

Charlotte Young

Specialist Associates

Training & EducationGillian Austin

Business StrategyTim Mulrey

Social Care & HousingNathan Downing

Technology StrategySteve Sadler

ResearchMike Clark

2018 TSA Team Structure

Standards Management

Quality/TechnicalPaul Finch

AuditorsWendy Hodgson

Jane Turner-BraggSharon Le CorreHeather LaingJudith Allen

Temp Chair of TQPaul Burstow

2018 TEC Quality Team Structure

StandardsAdvisory Groups

(Technical/Service)

TEC QualityBoard

TSA Board LinkAlyson Scurfield (TSA, CEO)

Ian Clayton (TSA, FD)

TSA Quality Standards

Framework

Service Users

Association of Ambulance Chief Execs

European Standards

Boards

Department of Health

National Fire Chiefs Council

RegulatorsCI, CQC, RQIA, CIW

British Standards

Standards Collaboration

United Kingdom Accreditation

Service

• New Installation standard – BS 8604 (part 1)• BS EN 50134 part 9 (Sometimes Referred to as SCAIP +) Final Draft

for Consultation• NOWIP – business case to release to BSI to manage (BS 8521 – 2)• NOWIP V’s SCAIP debate

- NOWIP best on fixed broadband- SCAIP for mobile communications- SCAIP not developed for hardwired

• ISO 19011 Training for TEC Quality Auditors

• Memorandum of Understanding• Connection Agreement

- BS 5839 part 6 &BS 8591- CFOA Code of Practice (Unwanted Fire

Signals)

• Event in London 29th May

• Volante Case (House of Commons)

• Volume of calls• Information Sharing• Prof Jonathan Benger (NHS England)

• Call Handling Triage Algorithm

NFCC AACE

Department of Health

• Minister Caroline Dinenage has written to all CEO’s/MD’s of Monitoring Centres

• Stressing the importance of Standards• Urges organisations to ensure safety measures are in place• Next phase to ensure Commissioners of CCG’s and LA’s

stipulate standards

CEN TC/431

• European wide Service Supply Chain Technical Specification- UK, Holland, Sweden, France, Germany (Spain & Norway)- ANEC (Representing the European Consumer voice)

• Will replace some elements of BS EN 50134 – 7• Challenges in multi-cultural/operational context• Emphasis on the ‘WHAT’• Our role to enhance and develop the ‘HOW’

• On the journey to Accreditation with UKAS

• Important part of demonstrating impartiality

United Kingdom Accreditation

Service

Regulators

• Working with regulators to establish where regulation ends and Certification takes over

Quality Standards Migration

• 40 plus organisations completed their audits or in the process• 10 migrating early• 8 new applications this year already• Supply Sector

- Mobius Networks- Motech- Oysta- CAIR

- Legrand- Tunstall- Cascade3d

Together, we are stronger

Core Competency

• On Line Training Modules• For those organisations Certified,

or who have applied• 3 Modules

- Call handling- Installation of TEC- Response Services

• Available in April• More information on the TSA

Website• Look out for the Webinars• Will form part of standards

Positioning technology at the heart of the care and support offerNathan Downing, Associate – Social Care & Housing, TSA

Together, we are stronger

Consultancy supportTSA have supported organisations with their development of technology enabled care services, increasingly providing additional support to membership, commencing with initial scoping discussions to better understand problem areas to address and both strategic and operational aims to deliver

TEC service healthcheck – review of your service delivery model, alignment with commissioning strategy, gap analysis with best practice, provision of quick wins and development recommendations

Bespoke support with the development of new offers – mobile response models, proactive outbound calling, creation of hospital discharge/admission avoidance offers, redesign of referral process to focus on outcomes/risks

Strategy and marketing support – helping to develop marketing plans to deliver growth – business growth workshop to understand target audience, key messaging, marketing methods

Exploring new business forms to facilitate growth and enable organisations to respond to commercial opportunities

People/culture aspects underpin the systems/process approach –providing sustainability to achieving efficiencies.

Sustainability will not be achieved without on-going support of frontline staff to embed cultural change.

To achieve cost reduction/avoidance savings, organisations need to develop the TECS around the following principle:

Creating a technology first culture and positioning technology at a strategic level

Shifting the TEC conversation

The Connected Resident – Enabling Positive Ageing

Rita

Acute

Primary care CCGs

National datasets

Family

/carers

Additional Services

Social care and Public Health

Housing

Community care

Service users, patients, carers – must not be in position of leaving their everyday technology at the door when engaging with our Telecare service

Key drivers for technology – development areasOpportunities across Health, Public Health, Social Care and Housing – focus on problem statements and outcomes for the individual and services:

– Inactivity monitoring/dehydration - identifying lack of movement and providing prompts to move about the property, make a drink - focus on reducing risk of UTI/falls

– Reducing risk of falls - utilising wearable technology and activity sensors to understand falls risks and capture predictive data/trends or utilising gait analysis and exercise programmes

– Reducing avoidable admissions due to falls in care homes - utilising falls sensors linked to staff pagers/remote video consultation and basic vital signs monitoring

– Delivering proactive calls to identified vulnerable people to promote Public Health messages – e.g. flu jab reminder, keeping hydrated, reminder of exercise routines post reablement

– Partnership working with Fire & Rescue Services to deliver mobile response, incorporating lifting for non-injury falls, Safe & Well checks, vital signs reading (National Early Warning Score) – utilising public funds, using a trusted brand and delivering timely response (<15 mins average over past 2 years in Wolverhampton for example)

– Development of TECS commissioning strategy – Torbay & South Devon NHS Partnership Trust / Health & Social Care Northern Ireland

– Delivery of business growth workshop and marketing plan – Community Gateway Association / Shepway District Council

– Strategic review of technology services and development plan for benefits tracking, service improvement and growth model – Portsmouth City Council/CCG / Haringey Council

– Enhancing reablement delivery with activity monitoring to support right sizing of care – Bath & NE Somerset Council & Virgin Care

– Strategic outcomes workshop and critical friend to support TECS development – Bolton Council/CCG / Telford & Wrekin Council/CCG

Examples of support

Procurement of TECS cannot be seen as an extension of procuring IT solutions – single source for all solutions is not viable

Existing procurement frameworks allow procurement of mainstream, more traditional Telecare equipment, but range of options are limited

Organisations are struggling to procure identified solutions efficiently and in line with regulations

Organisations are looking for an effective procurement solution that encourages innovation and enables commissioners/service providers to be outcomes focused

Procurement issues – member feedback

A DPS is similar to a Framework Agreement, it provides a shortlist of suppliers from which buyers can conduct an e-competition for tenders. Unlike a framework agreement, suppliers can apply to join the DPS at any point during its cycle.

Accessing a DPS within the TECS sector would enable: Fair competition in terms of cost and quality Flexibility Timeliness Suppliers to join at any time Innovation in an ever-changing TEC environment Reduced timescales for procurement activity Procurement simplicity A true reflection of current and future market requirements

Benefits of a Dynamic Purchasing System (DPS)

Raising the standards for Mobile Communications in TelecareOliver Cox, Healthcare Communications Specialist, Mobius Networks Limited

Together, we are stronger

Mobile back up for the entire Store

Security PCI DSS

Rapid Deployment Not waiting for BT

Pre-Buy Overage

Double SIM Packages

Retail

Raising the standards for Mobile Communications in Telecare

TSA Connect – 12th March 2018

SIMs & Connectivity in Telecare

Roaming Rules

Security & Fraud

Real World Experience

Summary & Discussion

Agenda

SIMs & Connectivity in Telecare

Copper to Fibre

Consumer and network focus has shifted from voice to broadband

Key parts of PSTN will not be replicated in the new system

Emulation not consistent

Fibre more expensive to deploy

Especially away from domestic locations

Dual Location

Business Voice and Telecare have different Expectations

Low revenue

High reliability requirements

High cost of failure

Low data requirements per SIM

High level of technical support that is not handset based

Mobius works with the Operator to address bespoke opportunities that don’t fit well with operators normal processes, tariffs, and commercial models

Roaming Rules

Permanent Roaming - Mobile vs IoT & Telecare Behavior

“Customer Traffic” is primarily considered Voice Calls, Messaging and Data.

But signaling is internal data that makes mobile networks work!

Traditional SMS runs over the signaling channel. iMessage / Whatsapp are different.

Traffic Profile is Different for IoT/ Telecare

Traffic / Signaling Traffic / Signaling

M2M devices typically generate small amounts of chargeable customer traffic but still require the same amount of signaling.

Programmed logic in M2M devices can make them aggressively and repeatedly attach to the network when connectivity is lost. Humans tend to give up and try again later and at a random time.

Permanent Roaming – Are you covered?

1. European Regulations

Conditions - "Roam like at home" is intended for people who occasionally travel outside the country where they live or have stable links i.e. they work or study there. It's not meant to be used for permanent roaming. As long as you spend more time at home than abroad, or you use your mobile phone more at home than abroad, you can roam freely at domestic prices when travelling anywhere in the EU. This is considered a "fair use of roaming services".

http://europa.eu/youreurope/citizens/travel/money-charges/mobile-roaming-costs/index_en.htm

“** Roaming charges will no longer apply, as long as you are using your phone abroad temporarily. Providers can still charge you for using your SIM card in another country permanently.”

2. https://en.wikipedia.org/wiki/European_Union_roaming_regulations

“All roaming charges for temporary roaming will be abolished on 15 June 2017 (fair-use rules are to be applied)”

3. Vodafone UK standard T’s & C’s

“Inclusive roaming allowances are only for our UK customers who are on short holidays or short business trips to countries within our Europe Zone. If you’re permanently roaming abroad – for example, you continuously use your phone from within our Europe Zone for more than 30 days – we may suspend international roaming on your account so you’re no longer able to use your phone abroad. We’ll contact you before we do this.”

Is there really a difference?

MBB A data-only SIM lets you stay

connected on the move – just pop it into your device… all while you're out and about.

You may only use your SIM card in…modems, dongles, iPad, tablets and/or laptops… If you do not we’ll suspend your service, restrict your use or speed, or charge you for unauthorised use.

Is there really a difference?

MBB You must not use your O2

SIM…with applications that primarily transfer information between fixed systems and remote…assets or any other remote computer systems.

Using your O2 SIM in a modeminstead of a mobile phone or tablet would fall outside this Fair Usage Policy

Data Transfer During day

Mobile Broadband data SIMs have an expected pattern of usage over a day

IoT Machines have a requirement to maintain a session

Such behaviour will be out of profile and ‘unfair’

MBB Attachment

Signaling

Not on Network

Background Updates

Real Time Use

IoT Attachment

Signaling

Not on Network

Background Updates

Real Time Use

Active Data Transfer

Active Data Transfer

24 Hour period of which

24 Hour period of which

Why is Mobile Broadband a problem?

Mobile Broadband

Fair Usage

Deep Packet Inspection

Choking

Occasional Use Profile

No Peer to Peer

No Software Updates

Machine to Machine/IoT

No Fair use policy

No Inspection

Unrestricted

24/7/365 Profile

Supported

No Restriction As networks become busier, profile becomes key

0

200

400

600

800

1000

1200

1 4 7 10 13 16 19 22 25 28

Mb

Days

Fair use in practice

Does it Matter? - Right First Time

Home Finance Company – Why? : MVNO• 50,000+ Home visits to swap SIMs

Telecare Hardware Manufacturer – Why? : MVNO• 10,000 Device returns for swaps

Local Authority Telecare – Why? Wrong SIM for product – low performance• Just about to swap 800+ SIMs

Does it Matter? - Right First Time

Local Authority Telecare – Why? Wrong SIM for product – low performance

• Same Device, SIM Changed

• One of many considerations

Security and Fraud

Poor IoT security Damages the Brand

Limits uptake

Simple to implement

Customers need signposting to what they are buying and the risks they are running

IoT Security

Portals can be a window into the devices

Built for the credit card industry from the ground up

Only IoT MVNO to have full PCI DSS Accreditation

Only IoT MVNO able to provide full off-net Private Mobile Network (PMN)

More experience of building PMN than any other IoT MVNO

IoT Security

http://www.bbc.co.uk/news/technology-22524274

Shodan to easily find public devices.

Public IP – Security

Have you ever looked at how much Internet traffic your corporate firewall blocks?

50% of traffic is unsolicited.

Excessive usage.

Requires more security hardware and software.

Bill Shock!

Public IP – Uncontrolled Usage

Real World Experience

Deploying connectivity with longevity

Local Government and Public Transport

All images remain the property of their respective owners

Retail and Industry

All images remain the property of their respective owners

Case Study- Availability

“the project has also shown that 3G suppliers are not necessarily the same and standard 3G SIM cards do not always work”

As availability approaches 99% use of the app has shifted from customer focus to Operations."

Real Time Information- Arriva

“

Compliant with current protocols including STMF Health Care Standards

Reliable CLI Presentation

Compatible with dual channel GPRS and voice

Unique interconnects with global mobile operators

Resilient, redundant and reliable Dual Location+ Network

Un-steered connection to multi-operator networks

Longevity of solution: 10 years +

Profile for Health

Roaming made easy

Dual Location

Case Study- Second to none

The SIMs from Mobius worked very well, especially in the environment where we needed a robust data communication. Their support throughout was second to none”.

“

Case Study- Seamless

We weren't worried about the mobile coverage to be honest we really see successful Mobius operation as a given now! It's just seamless.”

“

Summary

Communications path is critical in Telecare

If using mobile, then consideration must be given to;

Security of comms and platforms

Consider costs associated with retrospective swaps

Trial multiple SIM options as part of the process

Permanent roaming Type of SIM deployed Infrastructure of the provider Choose an expert partner

Multiple operator interconnects Signal storm protection Secure end to end – accredited

Mobile back up for the entire Store

Security PCI DSS

Rapid Deployment Not waiting for BT

Pre-Buy Overage

Double SIM Packages

Retail

The digital future of dementia careNicola Cooper, Senior Technology Coordinator, Alzheimer’s Scotland

Together, we are stronger

Many thanks for this. We really enjoyed the day.The 'no pressure' format was great and the presentations, along with the hands-on sessions, very useful indeed.Also a good chance to share experiences with other attendees.I've already recommended the session to a relative in Inverness, if one becomes available there, and hope to arrange a fire safety inspection visit asap. Well done, everyone.

M a l c o l m a n d I m k e a r e t e s t i n g t h e O n e To u c h G P S .M a l c o l m a l r e a d y h a s a n e c h o w h i c h h e l p s h i m t o d o h i s e x e r c i s e s t w i c e a d a y. A l e x a a l s o t u r n s o n t h e l i g h t s , p l a y s m u s i c a n d a u d i o b o o k s a n d h e l p s h i m c a l l h i s d a u g h t e r i n G e r m a n y.

Scottish Technicians Forum UpdateMairi Morris, East Lothian Council

Joyce Wilson, Telecare Technician, East Lothian Council

Together, we are stronger

Scottish Telecare Technicians Forum

Mairi Morris, Telecare Development Officer

mmorris3@eastlothian.gov.uk

Joyce Wilson, Telecare Technician

jwilson6@eastlothian.gov.uk

Why necessary?

• Number of changes in particular– Analogue to Digital

• Technicians key in implementing changes

• No opportunities for Technicians/installers to meet and discuss common areas of practice

Scoping exercise

• Distributed email via STFG to determine level of interest

• Interest noted by 14 authorities

• ELC agreed to host first meeting – emphasis on Technician led

• First meeting would determine future Agenda items and which stakeholders to be invited to future meetings.

Planning

Consulted with those who had expressed an interest and agreed :

• to have quarterly meetings in November, February, May, August

• Opportunity to invite companies to showcase their products and deal with any technical queries.

• Meetings to be geographically spread to allow for maximum participation –

• Received several offers to host future meetings

• Prior to first meeting a questionnaire was distributed to provide an overview of each organisations service.

• TAG IP Standards were distributed for information

• Invitation to Possum to support event and give short presentation on technical aspects of their products

First Meeting

• Held on 14 Nov 2017 and it was attended by representatives from:

• Bon Accord Care (Aberdeen City)

• Edinburgh City Council

• Midlothian Council

• Moray Council

• SB Cares (Scottish Borders)

• West Lothian Council

What we discussed

• Role of the technician

• Installation of Equipment• Fault diagnosis• Programming • Allocating • Stock control• Admin

• Possum Representative

What we discussed• A2DT

• fears and anxieties – that foggy bridge again!

• Varying degree of knowledge available regarding future expectations

• Equipment Reviews

• Beneficial discussion on common equipment issues

• Sharing of best practice hints and tips

• Action plan for future meetings

Evaluation - Survey Monkey

What did you find most useful about the event?

• Exchange of information and the difference between councils

• All

• Gaining more understanding of how other services work to bring help and assistance to client's.

• Meeting others from different authorities and being able to discuss the issues we face carrying out our roles as Telecare Technicians.

• The opportunity to meet with others to discuss any issues and problem solve.

• chatting to other authorities and finding out we all do a similar thing but differently, it was really useful.

• The opportunity to meet and network with other Technicians

• Meeting with others in the same field and realising our problems are very similar. Just the fact this has taken place is a massive step forward.

• Finding out how other organisations ran their telecare. We all have similar problems and pitfalls.

• Great opportunity to liaise with others in the same field and share experiences.

Next Meeting

• Hosted by Bon Accord Care, Aberdeen on 8 February, 2018 and was attended by representatives from:

• Angus Council

• Dundee Council, and

• East Lothian Council

• Tunstall Representative invited

• Lead from each organisation to coordinate future meetings

Conclusion

• Valuable Forum which needs to continue and hopefully improve TEC services across Scotland with the shared learning and networking opportunities for our staff.

• Issues with distribution of information needs improved.

• Potential for using technology to allow for wider participation