Making Use of Evidence in Commissioning Practice: Insights into the Understanding of a Telecare Study’s Findings
In less than a generation, telecare has become a significant new resource for local authority (LA) Adult Social Care Departments (ASCDs) in England and other European countries to offer to people eligible for social care and support. All English ASCDs either have directly managed, or commissioned, telecare services, and telecare is often used as a 'first line' service (that is, before other forms of intervention). The Whole Systems Demonstrator Project (WSD), a very large clinical trial funded by the English Department of Health (DH) concluded that it does not deliver better outcomes. Despite this, and in the context of unprecedented reductions in adult social care expenditure over the last decade (Innes and Tetlow, 2015), investment in telecare has continued in the UK. This article explores the extent and nature of the evidence used in LAs to support investment in telecare.
The paper draws on (100+) survey responses from social services authorities in England. It established their generally minimal understandings of (largely negative) outcomes of the government promoted (Whole System Demonstrator (WSD) project. The WSD project involved over 5000 mainly older people - half of whom were, following assessment, assigned telecare equipment (others telehealth). The robustness of the outcomes are discussed; issues about the effectiveness of assessments are raised; and the appropriateness of the methodology (an RCT) is questioned. In sum the paper provides an example where shortcomings of RCTs are exposed in a context where technological changes impact on ‘traditional’ (health and) social care service frameworks. The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.
Citation : Woolham, J., Steils, N., Forsyth, K., Fisk, M. and Porteus, J. (2019) Making Use of Evidence in Commissioning Practice: Insights into the Understanding of a Telecare Study’s Findings. Evidence and Policy
ISSN : 1744-2656
Research Institute : Centre for Computing and Social Responsibility (CCSR)
Peer Reviewed : Yes