Previously, telehealth and telecare systems have run independently, and service users in receipt of both services have had records on each system. Not only does this double the amount of data entry, it also means that health and social care professionals must make decisions based on incomplete information about a patient/client.

This issue has been addressed within the European Union co-funded Commonwell project initiative, which aims to overcome the communication gaps which separate health and social care service provision. Ten partners working in four member states cooperated to develop integrated service delivery in order to better support older people and those with long term conditions.

Milton Keynes Council's Telecare service working in partnership with Milton Keynes Foundation Trust Hospital and Community Nursing Service (Community Matrons and District Nurses), provided more than 100 patients with telecare and telehealth equipment in their homes. All patients were provided with a Tunstall Lifeline Connect+ home telecare unit, which allowed them to raise a call for help if they require assistance, either by pressing the button on the unit or on their personal trigger. This in turn raised an alert at a monitoring centre where trained operators were available to talk to patients 24 hours a day, and action an appropriate response. The patients also used mymedic telehealth equipment to measure their vital signs daily, and these results could also be viewed at the monitoring centre, where the relevant clinician could be notified if necessary, enabling them to take prompt action to stabilise the patient's condition and thereby avoid unplanned episodes of care, such as hospital admission.

The new project means that, for the first time, the same monitoring centre receives alerts and information from telecare and telehealth equipment, allowing both sets of data to be viewed together.

Sandra Rankin, Head of Service at Milton Keynes thinks the system has huge advantages "We are starting to join up information from different systems in order to get a more holistic view of the person and tailor the support on offer. A health and Social Care system that talk to each other enables us to give a much better response to needs. It also means the district nurses and community matrons can prioritise their workloads more easily, because they have extra information about patients from the telecare equipment. The integrated system also avoids wasted home visits as health professionals can easily see on the system if, for example, a patient has been taken into hospital."

The pilot phase of the project ran from September 2010 to August 2011, and was subject to evaluation using quality of life measures and cost savings calculations. The results of the evaluation process, from the perspective of users, relatives and care professionals, were very positive, including:

• 79% of end users stated they experienced major benefits from the programme. These benefits included increased control/self-management, their relatives feeling reassured, fewer visits to their GP and a more active daily life.
• 88% of carers said having the system had resulted in major benefits, including being more able to help, fewer worries about the health and safety of the person they care for, and trusting that early intervention will take place if a problem arose.
• Care staff also reported that the service had a positive impact on clients, providing reassurance that their condition is being constantly monitored. They reported a reduction in exacerbations, and the number and length of hospital admissions because of prompt treatment.

In terms of cost savings, 168 hospital admissions and 85 GP visits were avoided based on 108 patients enrolled in the service. In summary, the project provides clear evidence of the benefits of integrated health and social care support underpinned by telecare and telehealth to people with long term health and care needs.

Cllr Debbie Brock, Cabinet Member for Adult Social Care Health & Wellbeing at Milton Keynes Council said: "My congratulations go to all involved with the CommonWell Pilot, which has demonstrated to users of the service, their families & carers that Telehealth can provide appropriate support and greater reassurance for the management of long term conditions and confidence that help will be given when needed. This project highlights the way forward for whole system benefits for investing in preventative initiatives within the community setting."

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• Tunstall's Profile

About Tunstall
Tunstall Healthcare Group leading the technical work on the Commonwell project, and is the market-leading provider of telehealthcare solutions, with over 2.5 million users globally. Tunstall's solutions support older people and those with long-term needs, to live independently, by effectively managing their health and well-being. Tunstall provides technology, expertise and advice to millions of people enabling them to lead independent more fulfilling lives.

About Commonwell
Commonwell is an EU initiative to promote better quality and more economically efficient solutions for the provision of health and social services. The project has participants from five European countries, and aims to support independent living and improve the quality of life for older people and those with long-term conditions.

12 partners are cooperating in the project, supported financially by the European Commission and coordinated by European consultants Empirica, to deliver ICT-enabled health and social care services in four Member States. The integrated services are to support the effective management of chronic disease, and to address issues which affect independence, such as reduced agility, vision or hearing, in order to significantly improve the quality of life for older people and their families. The project members are Milton Keynes Council, Stichting Smart Homes, Ev. Johanneswerk und Johanneswerk im Stadtteil, Empresa Pública de Emergencias Sanitarias, Fundación Andaluza de Servicios Sociales, Tunstall Healthcare, InterSystems, Work Research Centre and Empirica Communication and Technology Research.

A total of 400 users across four locations in Europe will receive the newly integrated services. The results of evaluating the pilot operation will be used to extend service provision and promote the wider uptake of this model of care across Europe.

Milton Keynes and Eindhoven are the pilot locations that will initially address chronic disease management for older people suffering from Chronic Obstructive Pulmonary Disease (COPD) (in Milton Keynes), and Chronic Heart Failure (CHF) (in Eindhoven). The CommonWell services will improve communication between health and social care providers, helping to reduce anxiety and improve health outcomes for people with chronic conditions and those who need support when leaving hospital.

FASS and Johanneswerk are the sites focussing on improving services for independent living for older people. FASS currently operates the largest centre for social alarm in Europe with over 90,000 clients across Andalusia in Spain. Johanneswerk runs several hospitals, a social alarm service and provides domiciliary care. CommonWell promises to support integrated care delivery in both organisations.

The project is part funded by the EU Competitiveness and Innovation Framework Programme.