St Helens Approach to Tech Enabled Care

Briefly describe the initiative/ project/service; please include your aims and objectives 

St Helens Council has recently introduced a new Technology Enabled Care (TEC) model within our Adult Social Care (ASC) department to improve care, support more people to live independently and ensure we can meet demand by using new technologies such as artificial intelligence (AI). This model supports our Borough Strategy priority “Promote good health, independence and care across our communities” and our Adult Social Care Strategy 2024 – 2027 ambitions by using TEC that we can digitally deploy and manage remotely, bringing benefits to our residents, ensuring we can meet their increasingly complex needs, helping more to live independently within their own homes, and reducing bed usage within our hospitals. Using the TEC and the data we gather from it can significantly increase the quality of the care we can provide and at the same time reduce the costs of delivering that care. 

One of the key transformations introduced through the TEC model is our new TEC Hub which we opened on the 31 October 2024. The TEC Hub is embedded within our Brookfield Resource Centre, a 30-bedded care unit for people who don’t need to remain in hospital but who are not quite fit to return home. The TEC hub has introduced a number of new innovative technologies which ensures individuals can live more independently whilst still receiving safe and effective care with limited human input. These include items such as, Radar Falls Monitoring Lamps, Interactive devices such as Amazon Alexa and Google Hubs, Companion pets, Automated Medication Dispensers, Multi application sensors, Dedicated Video Communication Devices, Alerting sensors that can trigger our Alert Receiving Centre (ARC) or our own Contact Cares staff, One Cup Kettles, and many others that can be seen in the pictures we have provided with this submission – we also have a video on YouTube that shows the hub and how it is being used on this link: Brookfield Resource Centre TEC Hub. The TEC Hub is one initiative we have introduced but we do have further plans to ensure our TEC model if effectively embedded. We have five objectives that we needed to achieve to deliver this project, each one with its own aspect of innovation. 

To bring the TEC to life in a place where it can be actively used on a daily basis, so that its benefits can be easily seen and understood by carers, those who are being cared for, and anyone who is trying to gain insights as to how the TEC can help them – and not only to those who are in receipt of Council provided care, but anyone who wants to provide for their own care needs independently. The placement of the hub in Brookfield has met this objective and more innovation is being explored. 

To do this with a limited budget. For this, due to budget pressures we ended up having to work to a budget that didn’t exist. We had to think innovatively and reviewed the range of TEC that we had researched, looked at where we might gain the most financial and care impact, and focussed on one piece of kit (a medication dispenser) that could automatically and safely alert patients as to when they needed to take their medication, enabling the correct dose to be dispensed at the right time, but required no care intervention beyond a pharmacy managing the refill of the device. We knew that for every 20 patients we had this for, we could save up to £160Kpa by reducing domiciliary care costs, and for an estimated 60 people enrolled less the costs of the dispensers, savings over £430Kpa were possible, with the initial 20 devices paying for the project making a significant early saving. 

To integrate TEC with AI Insights and predictive analytics. This priority has progressed significantly, we have been enrolled onto the Microsoft AI Masterclass programme, an innovation and achievement in its own right and are now working to bring together care assessment documentation with our personally curated TEC catalogue to let generative AI create a personal care plan with scenarios and costs that could support patients as they return home and keep them there for longer. In-house capabilities mean we can use data from devices and sensors to monitor situations where interventions may be needed; for example, our radar movement lamp can detect falls and notify us. If the patient has a device like an Alexa, we can contact them to check on them – we are developing this approach with the new Alert Receiving Centre we are procuring, to incorporate as many devices as possible, to encourage device agnosticism by ARC and TEC vendors alike. 

There is significant innovation taking place in the way we have delivered the TEC into a real life environment, making a real difference to those who see and use it, made it affordable to implement and sustainable for the future, embraced AI which we have largely done ourselves or by working with Microsoft, utilised a common platform for this and other development across the Council. 

What are the key achievements? 

Our first achievement was around speed of delivery. In a little over seven months, we achieved our first objective of creating and opening the new TEC Hub including, research, business case production, a procurement exercise, and fitting out the hub which was opened on the 31 October 2024 by the Leader of the Council, and relevant portfolio holders. Speed was a necessity to ensure it was open before the Winter and could support more during a time when people are particularly vulnerable. 

The success of the new hub cannot be understated and has brought TEC to life. The patients who pass through Brookfield now have access to all the TEC facilities and can see how it can be used in practical ways to assist them. Alongside TEC, we have also placed everyday items like self-draining washing up bowls, one cup kettles, and other things connected to SMART plugs to support with independent living. 

This makes it a comfortable and safe place to see and use things simulating the way, the same way it would work at home . We believe this is one of the things that sets our hub apart from its contemporaries. 

An early example of the use of one piece of TEC, a companion pet cat called “Jess” which one patient grew very fond of and resulted in her taking it home as it was clearly helping her cope with her dementia and making a positive impact. 

Our second achievement was to do this with delivering this on virtually no budget, how did we do that? Well, we reviewed the range of TEC that we had researched, looked at where we might gain the most financial gains and care impact, and focussed on one piece of kit (a medication dispenser) that could automatically and safely alert patients as to when they needed to take their medication, enabling the correct dose to be dispensed at the right time, but required no care intervention beyond a pharmacy managing the refill of the device. We knew that for every 20 patients we had this for, we could save up to £160Kpa by reducing domiciliary care costs. For an estimated 60 people enrolled we estimated that savings of over £430Kpa were possible, with the initial 20 devices paying for the project making it a significant early saving. This saving delivered the TEC hub and also the revenue for our Magic Notes project (not an objective of this programme) but we realised we could fund it as well. An unexpected but welcome benefit. 

On project delivery we believe this is an innovation, with early identification of savings made ahead of the main project being delivered. This removed the burden of how to pay for it and mitigated any financial risks to the project. 

Our third achievement, integrating TEC with AI Insights, and predictive analytics has progressed significantly. As a result we have been enrolled onto the Microsoft AI Masterclass programme, an achievement in its own right, and are now working to bring together care assessment documentation with our TEC catalogue. The catalogue is personally curated by care professionals to let generative AI create a personal care plan document with scenarios and costs of how TEC might support patients as they return home and keep them there for longer, in support of our home first approach and early intervention and prevention strategy. 

In-house capabilities mean we can use data from devices and sensors to monitor situations where interventions may be needed. For example, our radar movement lamp can detect falls and notify us. If the patient has a device like an Alexa, we can contact them to check on them. We are developing out this approach with the new Alert Receiving Centre we are procuring, to incorporate as many devices as possible, to encourage device agnosticism by ARC and TEC vendors alike. 

Our fourth achievement uses the same approach to our DOFD for all directorates, our new IDAC framework. IDAC manages Integrated Systems, Data Modelling, Artificial Intelligence, and Connectivity (IDAC is not part of this submission), and by using this common model we have a DOFD that is the same for all, allowing AI to determine which service is required, signposting the customer to what they need. 

Services like OT Self-Assessment, Podiatry, or Incontinence support, use the AI conversationally, and if the customer is registered with us, can keep them updated on progress via the bot or website 24x7x365. 

The common approach to our DOFD and data lets us develop AI at scale and pace, and at a low cost because we are doing this in-house on the Microsoft Copilot Studio platform rather than using a packaged system. This is another huge saving costing less than £5Kpa (for Copilot Studio Licences), and developer time. 

Our final achievement was to do this safely, The TEC has been carefully managed by our Brookfield Centre staff as well as ICT & Digital to ensure it is safe to use. We used guidance from GOV.UK, LGA, NWE, and NWDASS, and others to create an internal “Guidance and Principles of Usage of AI. 

How Innovative is your initiative? 

First and foremost, our approach to the TEC hub is our key innovation. By placing it in a reablement centre, and spreading the TEC within that centre to help show how it can be embedded into real life situations, offers a unique perspective to those who are passing through the hub or who come to see it. If the TEC is not visible and easily used by those whom it is intended for then we cannot succeed. Placing it at Brookfield overcomes this, and provides us real feedback from patients who use the centre from whom we can learn valuable lessons. 

The impact of this innovation brought to our Home First approach, and the ability to interpret data from the TEC we use is huge. It really starts to deliver our early intervention and prevention approach as we monitor events in real time and respond to them. A simple example of this is combining measures of how much liquid is being consumed with how many times a toilet is flushed. Using trend analysis we can spot early potential UTI’s and act before these become urgent cases. 

Data is key to our approach – not only its security, which is extremely important, but what we do with it when we have it. Using our existing data model which we developed as part of our previous St Helens Care project, we have used that as a premade anchor data model off which we will hang device and sensor responses. This means that we are reusing an existing data model for a purpose it was not originally intended for, and we know it is safe and secure. Alongside this there is no risk to personal data as we don’t need to hold it on the devices we deploy, we simply need to know its ID and the sensor data it is returning and we can link these to the client details at the centre. This approach means that we have all of the data we need to perform sophisticated Business Intelligence, Predictive and Assumptive Analytics, as well as AI Insights. 

Our funding model has shown innovation as well as initiative in the way we have looked to do this, guaranteeing that the project could be delivered as a result of the significant revenue savings we identified and implemented ahead of the full TEC hub implementation. This not only released immediate revenue savings and funded the project, but it entirely mitigated any risk that we may be exposed to from a financial perspective very early on in its lifecycle. 

Alongside this, by engaging with TEC vendors, we have created a self-funding and sustainable model for the hub by working with these vendors and selectively endorsing products and bringing them into our hub and digital catalogue. 

We are primarily developing this technology ourselves. We believe this is innovation in itself as we are not aware of any other local authority that are developing their own AI models, or at the very least to the extent that we are, without using a surrounding off the shelf package. As part of this we have integrated CoPilot Studio into our developer’s toolkit, and made it something they can use across any development they’re involved in. This has the effect of growing our AI offer across multiple services using the same learning and tools that we are using for this ASC project – and in doing so have achieved a low cost secure model for AI development in-house which as previously stated has cost of less than £5,000 per annum for developer licences. 

Using our IDAC framework which we developed in-house, we ensure that we have an innovative way of bringing commonality to anything we develop, and one that is replicable across the whole AI toolset wherever we need to use it. 

We have innovated in our approach to governance by combining our Digital and Information Governance teams to work as one researching AI governance issues, looking at what “good practice” looks like, and developing a Council wide approach to the use and governance of AI – underpinned by a common e-learning module available to all staff whenever they need it, sitting alongside our other e-learning modules for ICT & Digital related topics and policies which form part of this. 

We have ensured we are not thinking of TEC and AI as a standalone things, instead we have combined them with our other development capabilities and used what was most appropriate to deliver outcomes. So, we have used our workflow, programming, and Robotic Process Automation tools to further enhance what we can achieve when we combine all these things together. 

This common platform approach ensures the actions the bot can perform are available through the council’s existing website and Contact Cares Centres, providing choice to those using our services. This has triggered the change in our digital platform, helping to move us away from being a telephony first Council to one that recognises that we also need to utilise other technologies on SMART phones and tablets, to be further enhanced in 2025 when we introduce the capability to the bot to recognise speech and the ability to speak those using it. 

What are the key learning points? 

There are many things we have learned from this project, some more obvious than others. 

Replication – There is very little in our submission that others cannot replicate, in fact we ensured the approach can be replicated for our own purposes including the possibility of expanding this approach through other TEC hubs at other centres in the borough, and AI adoption using an in-house approach. This project has already been demonstrated to many local authorities at presentations and follow up one to one meetings with us and we are keen to share our approach with others. 

Collaboration – This project was a joint effort between ICT & Digital, and ASC colleagues, and included a perfect blend of individuals who could together understand, collaborate and map out the solutions to the task at hand. Without this we could not have succeeded. 

People Matter – The use of TEC and AI is digitally focussed but it’s the people who are using it who matter. What has been particularly important to our approach was taking on user’s views and acting on them. The use of our Brookfield Centre made this ideal as we have been able to interact with them throughout the project and learn valuable insights from them. 

Unexpected Gains – We have learned that sometimes you can achieve more than was your original intention, devices like Alexa /Google hub are not only great to have in the home to automate things, but are great tools to create digital communities, and have a real impact on digital inclusion and address isolation. They also play a part in alerting us to when someone needs help. We have started to think about these devices becoming integral to the way we can integrate them into our Alert Receiving Centre systems and Contact Cares service. 

Choice is key – We live in age where we can do more for ourselves and offering choice in TEC is important. It doesn’t have to be the most expensive to be effective. Our approach not only delivers for council provided care, but to those who want to do it privately. There is a wide range of TEC in our digital catalogue that can be purchased without the need for the council to be involved. The fact we have endorsed it though does give some assurance to those looking at options that it fulfilled our needs and objectives. 

Project Funding – We also learned that even when there are no budgets available to deliver the ask, you can by careful analysis identify savings that can be quickly delivered and therefore generating a budget that can be used to fund the wider project – in our case we identified medication management as something we could do very quickly and make those savings to deliver the project and mitigate any financial risk. 

Opportunity Identification – By implementing our TEC hub in a real life setting we have been able to use this to act as the catalyst to drive further innovation 

– Identified TEC that is of real value and removed care tools that aren’t. This is important as not every piece of TEC you procure will give you the outcomes you wanted, or it is superseded by better technology. 

– Created a centre of excellence so that we can engage with vendors to work with us and showcase their TEC at no cost to us. Without this the TEC is something that simply exists in a catalogue or brochure. 

– Having an available incubator space to test out TEC and understand its value set against other pieces of TEC in the hub rather than as an isolated piece of kit was integral. We learned that not only was the hub a great place for this, but we needed to create our own innovation lab in our ICT & Digital section to pre-test things before we put them into the live hub. 

– This is not just a model for Brookfield, it can be replicated in other centres in the borough (or indeed anywhere else); to engage carers and those being cared for to see and use the TEC (try before you buy if you like), so that the right choices are made. 

– Through the work we are doing on the AI Masterclass programme we have learned that the same approach can be used for care documents coming from any source and not just transient patients at Brookfield. In essence it can be used in the field because of sessions that care workers undertake with those for whom they care or their families. 

– Probably the biggest piece of learning we have had is that we are working through a time of incredible technological change, similar to things like the advent of the world wide web, the introduction of the PC, and Cloud computing. The pace at which that is moving is only accelerating, and it’s important that you remain focussed on your initial objective and deliver them. The foundations we have put in place with this will allow us to develop and keep up with the pace of new and emerging technologies. 

Additional Comments 

It’s easier to see the impact of our TEC hub by seeing it in person, this isn’t possible with a written submission, but we have provided some photographs of what we have in place attached to this submission, we also have a video on YouTube which does it much more justice and includes words from the leader of the Council and portfolio holders which if successful we would probably be used as our video to accompany this – however please feel free to check it out.