Assisted Living UK Capabilities
Opportunity Report

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East Midlands - full text version

1.0 Introduction

This case study provides an overview of the assisted living sector in the East Midlands and is part of a wider UK Capability Map commissioned under the KT4i Project[1]. The case study looks at the Demographics, Health Profile, Provision of Care and the Industrial and Research base within the East Midlands. The mapping exercise is intended to illustrate areas for potential investment, either in service or product development.

2.0 Regional Overview

The map illustrated in Figure 1 shows the 6 sub regions covering 35 Council areas.

  • Derbyshire: Derbyshire Council, Derby Unitary Authority, High Peak, Derbyshire Dales, South Derbyshire, Erewash, Amber Valley, North East Derbyshire, Chesterfield and Bolsover
  • Nottinghamshire: Nottinghamshire Council, Nottingham Unitary Authority, Broxtowe, Ashfield, Gedling, Newark and Sherwood, Mansfield and Bassetlaw
  • Lincolnshire (Partial): Lincolnshire, Lincoln, North Kesteven, South Kesteven, South Holland, Boston, East Lindsey and West Lindsey
  • Leicestershire: Leicestershire Council, Leicester Unitary Authority, Charnwood, Melton, Harborough, Oadby and Wigston, Blaby, Hinckley and Bosworth and North West Leicestershire

 Figure 1: East Midlands Region Map

east midlands region

The East Midlands region covers 6,033 square miles and represents approximately 6% of the landmass of the UK. The region contains the conurbations of Leicester with a population of 306,631, Derby (246,855), Northampton (212,130), Nottingham (306,697), Kettering (90,631), Lincoln (89,668), Daventry (78,959) and Corby (55,833).

2.1 Demographics

The following section describes the demographics of the East Midlands region including the population density, urban and rural population characteristics, population age, life expectancy and population projections.

2.1.1 Population

Figure 2 below ranks the East Midlands 9th in relation to population size across the other UK regions.

Figure 2: UK Population by Region 2010[2]

Figure 3 below illustrates the population of the East Midlands by Female / Male age ranges. The chart shows the greatest proportion of the population sits in the 40-59 age range. This is a characteristic similar to the North West, North East and West Midlands.

Figure 3: Population by Age Range[3]

2.1.2 Urban and Rural Population and Population Density

The East Midlands region has a population of 4,481,431 people representing 7% of the total population of the UK. The rural counties of Rutland with just 263 people per square mile and Lincolnshire (264) are most sparsely populated. The highest density areas include the major urban conurbations of Leicester at 10,950 people per square mile and Nottingham at 10,576 people per square mile.

Approximately 19% of the population live in urban areas of over 10,000 people including Leicester and Nottingham. 81% live in rural areas representing 6423 square miles or 98% of the total landmass for the region.

2.1.3 Population Over 65 Years

Figures 4 and 5 illustrate the distribution 65+ population over the East Midlands region.

Figure 4: Population by Region

Figure 5: Age Profile Map

age profile map

The map shows the rural county of Lincolnshire as having the highest overall 65+ population at 20% of the total county population. At local authority level, East Lindsey in Lincolnshire has the highest over 65 population at 24%.

The urban areas of Leicester and Nottingham have the lowest percentage at just 11%. Figures 4 and 5 illustrate a fairly consistent distribution of the over 65 population over the whole region. 

2.1.4 Life Expectancy

The average life expectancy at birth for Females in the East Midlands region is 81.7[4] years and 77.6 years for Males. Leicestershire County has the highest life expectancy for both Females (83.4) and Males (79.7) years. Nottingham City has the lowest life expectancy for both Females (80.3) and Males (75.2) years. This is lower than the UK average which is 82.0 years for Females and 77.7 years for Males.

2.1.5 Population Projections

The overall population is projected to grow by 19%[5] (852,200) by 2030. Figure 6 illustrates the projected population for the 65+ age group. The chart suggests that the greatest growth in the 65+ population will be in Females post 2020 with a rapid increase in the over 75 age group. Figure 6 illustrates the population growth of the 65+ age group over 5 year intervals from 2010 to 2030.

Figure 7 illustrates how the East Midlands compares with other areas of the UK between 2008 and 2033.

Figure 6: Population Projections (000’s) of Older People in East Midlands by Sex (2010 to 2030)[6]

Figure 7: Estimated and Projected % of the Population Aged 65 and Over by Region[7]

2.1.6 Old Age Support Ratio

The old age support ratio compares the number of people of working age (20-64) against the retired population (65+) of a given area. Areas with a lower ratio of working age people indicates fewer people able to support the over 65 population.

Figure 8: Old Age Support Ratios[8]

Figure 8 illustrates Northamptonshire as the county with the lowest ratio of working age people against the retired population (65+). This is significantly higher than any other county in the region and is one of the highest ratios for the UK. This low ratio will have an increasing impact on the provision of services across the region as the population ages.

2.1.7 Internet Usage

The following diagrams illustrate the internet usage of the over 55 age group. The diagrams are based on data collected by the Office for National Statistics and provide a general over view of usage across Great Britain.

Figure 9: Internet Purchases 2008 to 2011 by Age Group 2008 - 2011[9]

Figure 9 shows a gradual year on year growth of internet purchases made by people aged over 55. The largest growth is in the 55-64 and 65+ age groups.

Figure 10: Internet Purchases by Type 2008 to 2011 (Adults Aged 55+)


Figure 10 illustrates the types of products and services being bought by this age group. The highest percentages of purchases related to travel arrangements (68%), books, magazines, newspapers (66%) and clothes, sports goods (63%). This indicates the 55+ age group are using the internet primarily to make leisure purchases rather than buying essential goods and services. The diagram indicates E-Learning (5%) at the lowest percentage; again this may be indicating that this age group is using the internet for leisure and entertainment purposes.

Figure 11 illustrates the uptake of mobile internet connections by age group between 2009 and 2011. The chart shows a steady increase in connections by the 55+ age group, however, this is insignificant in comparison with the 16 – 34 age groups. The lower uptake may be due to fewer people in the 55+ age group using mobile devices for work based activities. The usability of mobile devices can also be prohibitive as age related physical (dexterity) and sensory (sight and hearing) degeneration can make using such devices difficult.

Figure 11: Mobile Phone Internet Connections by Age Group 2009 to 2011



3.0 Regional Economy

The following section describes some of the key facts of the East Midlands economy. The section focuses on the assisted living industry base and regional economic structure.

3.1 Economic Overview

The East Midlands has a GVA[10] of approximately £17,349[11] per head. This is a similar level to the North West (£17,263). London has the highest GVA at £34,200 followed by the South East at £20,923. The lowest level of GVA can be found in the North East at £15,621 followed by Northern Ireland at £15,795. The East Midlands has a strong manufacturing industry including Rolls-Royce, JCB, Caterpillar and Toyota. The region also has a one of the highest concentrations of medical technology companies in fields such as drug development, oncology, regenerative medicine and animal health.

3.2 Supplier of Products and Services

Figure 12 illustrates private companies selling products and services into the Assisted Living market. The chart includes companies whose primary area of business is manufacturing and / or selling the following products and services:

  1. Telecare: Telecare products and services only, includes devices and managed services
  2. Telehealth: Telehealth products and services only, includes devices and managed services
  3. Telecare & Telehealth: Combined Telecare & Telehealth products and services, includes devices and managed services
  4. Environmental Control: Home Automation and Environmental Control solutions
  5. Communication Aids: Including Video Conferencing solutions and products and services for people with Dementia, Learning Disabilities and Sensory loss
  6. Care Technology: Devices and services to support care workers delivering assisted living services in the community

Statutory Telecare and Telehealth providers are excluded from these figures unless they provide a privately managed service option.

Figure 12: Type and Number of Companies by Region[12]


The East Midlands is ranked 4th in relation to the number of companies categorised above. The region has a high number of Telecare companies; these are largely high tech SME’s developing paging and alarm products. This includes Alert-It, Clofield and Easy Link. The region is also home to Nottingham Rehab Supplies, one of the largest suppliers of daily living aids in the UK. United Tele Health, a provider of Telemedical solutions is also located in the region.

The chart suggests that these companies tend to locate in the English regions of the South East, North West and Midlands regions. This may be due to a number of factors including access to technical knowhow and skills and the availability of academic institutions supporting research and development.

More information on UK companies can be found by accessing the KT4i Assisted Living Directory see


 3.3 Regional Economic Infrastructure

In 2010, the UK Government developed a National Infrastructure Strategy [13] as a first step towards providing a more integrated approach to infrastructure development across the five sectors and networks that directly contribute to economic growth (energy, transport, water, waste and communications). This strategy has distilled into a National Infrastructure Plan, first issued in 2010 [14] , revised to include more regional detail in 2011 [15] , and updated in 2012 [16] to report progress against the plan.

A region's economic infrastructure can have a significant impact upon the ease with which technology innovations can be deployed to meet social objectives such as healthcare. The sectors and networks that are of most relevance to AL are energy, transport, and digital communications and surrounding them all is the region's ability to generate intellectual capital. Given the recent nature of the strategy and plan, there are few statistics at the moment to support the development of the economic infrastructure at regional level. Instead, regional initiatives and projects have been used to illustrate activities in the relevant areas.

Based on the framework in the National Infrastructure Plan [17] , Figure 13 shows the interrelationships and interdependencies between the care network and the regional economic infrastructure. For example, a poor transport infrastructure can offer opportunities for AL services, whereas a poor digital communications network would be a constraint.

All the elements within this infrastructure depend on utilising the Intellectual Capital within a region, and it in turn depends on these networks to facilitate the take-up of science and technology innovations. The 2011 Infrastructure Plan recognised the importance of good transport and digital communication links in facilitating the development of innovation hubs, science parks and clusters, which will all benefit from investment in world class research facilities. Co-location of these innovation clusters with universities will also foster knowledge transfer and expertise exchange.

Figure 13: Regional Infrastructure Interrelationships and Interdependencies

3.3.1 Transport

Access to health care provision can depend upon the ease with which people can move around the region. If roads are congested, people may find it difficult to reach care services, and once there, they may find parking is either not available, full, or presents a costly challenge. Remote delivery of care via AL services, could be a potential solution to transport and travel issues.

The Communications Infrastructure 2012 [18] update reports the following progress on infrastructure delivery programmes and Autumn Statement 2012 capital announcements relevant to the East Midlands region:

Starting soon: Loughborough Road Improvements – work starts 2013
Starting soon: London Road Bridge, Derby – work starts 2013
Under construction: Nottingham Tram Extension – opens to public in 2014
Under construction: A43 Corby Link – due to complete in 2014
New funding announced: M1 J28 to 31 accelerated delivery pilot (part of £95 million scheme)

3.3.2 Digital Communications

Ofcom, the independent regulator and competition authority for the UK communications industries has reported [19] that during the last 10 years, the UK's communications market has been totally transformed. Digital technology has developed extremely quickly, and has changed the way that communications services work for consumers. It has also had a major impact on businesses and networks. For AL to take advantage of these rapid developments, a region must have an adequate digital communications infrastructure. Ofcom is now tasked with reporting on broadband take-up, speeds and availability, using data provided by communications providers.

The connectivity of a region has a direct impact upon the implementation and take-up of AL products and services. The UK Government aims to have the best superfast broadband network in Europe by 2015 by providing all homes and businesses in the UK with access to at least 2Mbit/s broadband and that superfast broadband should be available to 90 per cent of people in each local authority area. There will be a particular focus on making sure that people in remote, as well as urban areas, get good online access.

The most recent information on broadband in the UK has been compiled by Ofcom. The Digital Economy Act 2010 requires Ofcom to report on the state of the UK's communications infrastructure every three years. The Communications Infrastructure 2012 report [20] has been published and highlights the availability and take-up of superfast broadband, the increasing use of mobile Internet services and the completion of the digital TV switchover. The report also provides regional information useful not only for local authorities developing broadband plans, but also for businesses wanting to develop and deliver services – see Figures 14, 15 and 16.

In addition to its UK Communications Infrastructure Report, Ofcom has produced the UK's first interactive map showing accurate information on broadband take-up, speeds and availability, using data provided by communications providers.

Figure 14 shows the availability of broadband across the region based on:

  • the percentage of homes with broadband currently not achieving 2Mbit/s speeds
  • the percentage of addresses which are within the coverage area of superfast (over 24Mbit/s) broadband networks
  • the percentage take-up of superfast broadband
  • the total take-up (including superfast broadband)

Figure 14: Broadband availability and take-up by Local Authority (Source Ofcom)

Ofcom has also collected data on the average maximum speeds of existing broadband connections, although notes that speeds achieved in the home will be slower. Figure 15 shows the Average modem speed (Mbit/s) by Local Authority.

Figure 15: Average modem speed (Mbit/s) by Local Authority (Source Ofcom)

Ofcom [22] has ranked each area on a scale of 1 to 5, with 1 the highest or fastest, and 5 the lowest or slowest on how they score on four broadband metrics to provide an overall view of broadband in each region:

• Average modem sync speed (Mbit/s): The average maximum speeds of existing broadband connections. Speeds achieved in the home will be slower.
• Percentage receiving less than 2Mbit/s: The percentage of homes with broadband currently not achieving 2Mbit/s speeds.
• Superfast availability: The percentage of addresses, which are within the coverage area of superfast (over 24Mbit/s) broadband networks.
• Average take-up: The number of existing broadband connections as a proportion of premises, excluding superfast broadband connections.

Figure 16 shows the ranking (1 = highest /fastest, 5 = lowest/slowest) within the region by local authority. The majority of local authorities within the region have good broadband performance with 6 out of 9 local authority areas with a ranking of 1 or 2. Lincolnshire has a ranking of 3. The remaining 2 areas (Derbyshire and Rutland) have a ranking of 4.

The Communications Infrastructure 2012 update reports [23] that the Government has 'established a framework agreement for Local Authorities to use to deliver rural broadband projects and secured state aid clearance to enable investment to proceed.' Rutland is one of these rural areas that has signed a contract and is preparing for implementation. Derby is one of the first ten 'super-connected' cities that has been successful in its bid for funding to deliver ultrafast broadband and public wireless connectivity.

Figure 16: Overall Broadband Quality by Local Authority (Source Ofcom)

3.3.3 Energy

With smart meters being considered as a potential important opportunity for the delivery of AL, the roll-out of smart meters represents a significant milestone. As part of its National Infrastructure plan, the UK Government aims to make every home and every business an intelligent part of an electricity network, to help moderate demand at peak times and to preserve supply and demand balance despite increased amounts of intermittent, renewable electricity generation. The aim is also to ensure greater energy interconnection with continental Europe and Ireland.

Currently, there is no regional data available, but by 2019, the Government will 'complete the rollout of smart meters, so that electricity customers can participate actively in helping reduce carbon intensity (by consuming less energy) and maintain security of supply (by smoothing their consumption over time). Development of the communications and data infrastructure required to support smart meters is expected to commence by 2014.'
According to the Government's National Infrastructure Plan, 2011 'widespread use of smart meters can be accommodated within the current digital communication network infrastructure, but potential future developments of smart energy grids might require further innovation and investment in communications infrastructure.'

3.3.4 Intellectual Capital

Intellectual capital is vital for attracting inward investment, stimulating innovation and allowing the UK and its regions to be competitive in the global knowledge economy. In its Infrastructure Plan 2010, the Government recognised the important role that Intellectual Capital plays in the UK's economic infrastructure and is committed to providing funding to develop the UK's Intellectual Capital, for example:

  • enabling investment in science, research and innovation through provision of research facilities and equipment in universities.
  • supporting (including by way of capital investment) the work of the Research Councils and investing in innovative technologies in and for infrastructure
  • supporting the Technology Strategy Board to incentivise business led technology innovation;
  • establishing a network of Technology and Innovation Centres.

See Section 6.1.1 for information about regional Centres of Expertise and Innovation.

4.0 Health and Social Care


The new health and care system for England become fully operational from 1 April 2013 when NHS England, Public Health England, the NHS Trust Development Authority and Health Education England took on their full range of responsibilities (1).

Nationally, NHS England commissions specialised services, primary care, offender healthcare and some services for the armed forces (4). It has 27 area teams but is one single organisation operating to a common model with one board.

Locally, clinical commissioning groups (CCGs) will buy services for patients (2). These are groups of general practices which have come together in each area to commission the best services for their patients and population. Most of the NHS commissioning budget is now managed by 211 clinical commissioning groups commissioning care for an average of 226,000 people each.

The CCGs are supported by commissioning support units (CSUs). As at June 2013 there were 19 CSUs and they will be hosted by NHS England until the end of 2016 (3). They will support clinical commissioning groups by providing business intelligence, health and clinical procurement services, as well as back-office administrative functions, including contract management.

Commissioning of public health services is undertaken by Public Health England (PHE) (6) and local authorities, although NHS England commissions, on behalf of PHE, many of the public health services delivered by the NHS.

Each top tier and unitary authority has its own health and wellbeing board promoting public health (5). Board members will collaborate to understand their local community's needs, agree priorities and encourage commissioners to work in a more joined up way. As a result, patients and the public should experience more joined-up services from the NHS and local councils.

Healthwatch will provide a powerful voice for patients and local communities.



The following section describes the health and social care landscape of the East Midlands Region. The section looks at the health of the population and the levels of provision available from statutory and private providers.

4.1 Health Overview by Long Term Conditions

Figure 17 illustrates the percentage of people suffering from the following long term conditions, Diabetes, Coronary Heart Disease, Heart Failure, COPD, Hypertension, Epilepsy, Dementia and Stroke. The figures are based on data published by NHS Information Centre.

Figure 17: Long Term Conditions Profile for the East Midlands Region[25]


The incidence of LTC’s based on the NHS Information Centre data suggests that 29% of the total population suffer from an LTC. Hypertension represents the single highest condition at 639,935 both Diabetes (221,947) and Coronary Heart Disease (169,210) come in close second and third. The prevalence of Hypertension (50%) is relatively high and can have major long term implications.

5.0 Existing Care Provision

The following section outlines the existing care provision in the East Midlands and looks at the levels of support to enable older and disabled people to live at home. The section also examines the availability of residential care and NHS beds by county area. This information provides insight into where there may be lower levels of provision.

5.1 Elderly Living at Home

A total of 575 households within the region are receiving intensive home care services to support elderly (65+) residents. This is the lowest level of provision in the English regions. Intensive Homecare is defined as the number of households receiving more than 10 contact hours and 6 or more visits during the week. Households receiving home care purchased with a direct payment are excluded.
This is less than half of the level of provision in comparison with London where the number is much higher at 2518 households. Figure 18 shows the number of households receiving intensive home care across England.
For figures covering Scotland, Northern Ireland and Wales please refer to the separate reports. Figure 19 shows the proportion of elderly households receiving intensive home care as a percentage of the total number of elderly households receiving intensive home care.

Figure 18: Households Receiving Intensive Home Care Aged 65+[26]


Figure 19: Households Receiving Intensive Home Care Aged 65+[27]

5.2 Residential and Domiciliary Care

The East Midlands has a total of 983 registered Care Homes, 340 Nursing Homes and 517 Domiciliary Care Providers. Figure 20 illustrates the number of care providers and available residential beds for the region. Figure 21 shows the population over 65 for each county set against available Care and Nursing Home beds and the percentage over 65 receiving Domiciliary Care.

Figure 20: Care Homes and Domiciliary Care Agencies in the East Midlands

Figure 20 illustrates the percentage of Care and Nursing home beds available and percentage of people receiving domiciliary home care by county. This is set against the percentage population over 65.

Figure 21: Population Over 65 Compared to Care Home Beds

Figure 21 illustrates relatively high levels of care home provision in Derbyshire (5%) and Northamptonshire (4%). The highest overall levels of domiciliary, Care and Nursing home provision can be found in Northamptonshire and Nottinghamshire. Lincolnshire has the lowest level of provision but the highest percentage of the population aged over 65. This suggests that there may be an opportunity to develop services in Lincolnshire to help plug the gap in provision.

Figure 22 illustrates the percentage of the population over 65 compared with NHS bed provision across the regions PCT’s and Acute Trusts. The diagram describes the number of acute beds including Intensive Care, Palliative Care, General Acute and Elderly Acute. The diagram also shows residential beds including Elderly and Learning Disability short and long stay beds. Many of these residential beds are within mental health wards. These bed types have a direct relationship to users of assisted living technology.

Figure 22: Population Over 65 Compared to NHS Bed Provision[28]

The chart illustrates that there are slightly more acute beds available in comparison with residential beds. Bed provision is also fairly level across the region. The chart does however show a significant gap with respect to Lincolnshire which has the highest percentage of population aged over 65. Again, as with care provision this may indicate an opportunity to develop services to plug the gap in provision.

6.0 Current Assisted Living Activity

The following section details some of the key assisted living activity in the East Midlands ranging from research activity, projects and centres of excellence.


6.1 Regional Projects in Health and Social Care

The East Midlands has a number of programmes across the region initiated under the Regional Improvement and Efficiency Partnerships (RIEP) and Regional Innovation Funds. The RIEP programmes have focussed largely on the use of Telecare to support Dementia and Learning Disability. RIEP's allow councils in the region to work together at a regional and sub-regional level to pool experience and resources and make decisions based on local needs. The East Midlands Telecare Programme consists of 5 initiatives led by Derby City Council, Leicestershire County Council, Lincolnshire County Council, Nottingham City Council and Rutland County Council. The initiatives were allocated capital funding from RIEP and revenue from local NHS partners. The funding provided an opportunity to initiate and evaluate services over a 5 year period ending in 2012. The projects aim to deliver significant savings (£708,122) and return on investment by embedding Telecare into mainstream care pathways.

Leicester City CCG is using an integrated health and coaching telehealth service, delivered by Totally Health in collaboration with the CCG and Leicestershire Partnership Trust, supporting the management of 50 COPD patients and has saved more than £350,000 in its first 26 weeks. In this period alone, the programme averted 87 hospital admissions amongst patients registered with the service - with unscheduled admission rates for the cohort falling from 3.29 to 1.24. The CCG had originally set a target of 70 unscheduled admissions to be averted during the first 12 months. The service has delivered, and continues to deliver considerable savings. It has also led to a demonstrable improvement in patient satisfaction. As a consequence, Leicester City CCG is now extending the programme further.

Nottinghamshire County Council is piloting a 24 hour telecare response service, extending the operating hours of their current Night Response Service. The service will provide rapid access to a home care visit if telecare equipment has identified a risk in the home, or a manual alarm call has been made for help. Calls for help will be assessed by the telecare monitoring centre, and if necessary they will ask the 24 hour telecare response service to attend the service user's home to deal with the immediate need. The response service aims to be at the service user's home within 45 minutes of being alerted. As the pilot progresses Nottingham County Council will assess its impact on service user and carer outcomes to inform any future decisions about providing the service.

The University of Nottingham is developing the 'Improving Dementia Education and Awareness' virtual learning environment. This is a free online learning resource for health professionals, care workers and carers, which aims to improve the care and quality of life for people with dementia. The website is currently in the testing phase, and they would like people to test the website and learning resources and provide feedback. Visit the website at



6.1.1 Regional Universities and Centres of Excellence

The East Midlands is home to 10 Universities. De Montfort University Leicester (DMU) is perhaps the most active in terms of assisted living. In 2010 the University took a key role in developing the iCARE project funded under the Technology Strategy Board’s Assisted Living Innovation Platform. The project aims to develop a mobile Telecare device which can monitor the well-being of older people when they are away from their home. The device will raise the alarm if the person gets lost or needs medical assistance. This is part of an initiative to develop technology which can provide support outside of the home utilising the potential of mobile phone technology and networks. Other regional Universities including University of Leicester, Loughborough University and the University of Nottingham have research areas with relevance to assisted living, but no specific centres of excellence exist at the time of writing.

6.1.2 Support Organisations 

Midlands TeleCare is a support organisation for Telecare providers in the region. The organisation was formed in 1987 and now includes 37 local authority, housing association and charitable organisation members. Members of the organisation receive benefits in relation to the purchase, up-grading and maintenance of their Telecare equipment through a contract with Tunstall, one of the UK’s largest Telecare providers. For more information please see

Medilink East Midlands is part of Medilink UK a national health technology business support organisation, working across all sectors of the life sciences sector. Medilink UK helps companies take new concepts through to commercialisation and supports collaborations between academics, clinicians and industry. Medilink UK is made up from the following organisations MediWales, BioBusiness Northern Ireland, Medilink North West, Medilink West Midlands, Medilink Yorkshire & Humber and the South East Health Technology Alliance. For more information please see

7.0 Summary: Regional Opportunities for Assisted Living

The aging population will be the key driver for the development of the assisted living sector in the East Midlands. The region has an ageing population profile typical of the UK average. It will see its 65+ population grow by 77% by 2030 with the steepest growth in the Female population post 2020. The health profile indicates that 29% of the total population currently suffer from one or more long term conditions (LTC’s) with 50% of those registered suffering from Hypertension. Hypertension increases the risk of stroke, heart attack, heart failure, aortic aneurysm and is a major cause of chronic kidney disease. Therefore closer management of patients is required to reduce the risk of further health complications.

The prevalence of LTC’s will grow in line with the ageing population and put increasing pressures on services. Northamptonshire in particular will see significant pressure on services as it currently has the lowest level of working age people in comparison with the 65+ population. Northamptonshire does however currently have the highest overall levels of domiciliary, Nursing and Care home provision indicating that the care sector is growing in the county. Lincolnshire has the lowest level of care provision but the highest percentage of the population aged over 65. This is mirrored by comparatively low levels of NHS bed provision indicating a significant gap in overall provision of services to support the ageing population.

The East Midlands like the rest of the UK is in the grip of major reforms within health and social care. These reforms have been put in place to reduce the costs of health and social care in order to meet the demands of the ageing population. The changes are creating a climate for private providers to enter the sector and deliver services on behalf of Social Care and the NHS through “Any Willing Provider” contracts. Section 6.0 of this report illustrates some of the development work the region has been undertaking in Telecare and Telehealth. Despite the strong evidence produced by these initiatives the move to mainstream Telecare and Telehealth to all who require them has been slow. This is in part due to the need for organisational change to enable these initiatives to embed within services and operate at scale. However the current redesign of health and social care provides an ideal opportunity to put in place the required organisational changes.

At the time of writing 2 major initiatives are looking to support and underpin the mainstreaming of Telecare and Telehealth.

Dallas is an initiative backed by the Technology Strategy Board, The UK’s innovation agency; it kicked off in 2012 and currently is supporting four delivery partner organisations around the UK.

living it up logo

Living it Up (LiU), a digitally-enabled community that supports better health, wellbeing and active lifestyles in Scotland. LiU provides personalised experiences to keep people connected with one another and with their health and wellbeing.

ifocus logo

i-focus collaborates with health organisations on interoperability and best practice to transform health and care by providing better service delivery through digital comms and technology. Part of i-focus, Warm Neighbourhoods helps families stay connected by using simple sensor technology. It provides support and reassurance for families with vulnerable members who live alone.

mi logo

Mi (More Independent), a Liverpool-based scheme designed to enable people to take charge of their health, wellbeing and lifestyle through technology. Mi allows people to live more independently in their own homes, offering peace of mind both to them and their family, whilst reducing the amount of time spent on appointments by supporting people to manage better at home.


Year Zero is creating a suite of innovative digital products based on personal health records (PHRs) to allow people to take greater control of their own health and wellbeing, while transforming the relationship between patients and health care professionals. Products developed to date include the online personal care planning tool A Better Plan, digital care and support network Good Neighbours, a diabetes goal-tracking app uMotifand a digital version of the Personal Child Health Record (also known as the Redbook) eRedbook.

With an investment of £37.3million dallas aims is to improve health, wellness and quality of life through innovation, technology and digital services.

For more information see:

 TECS Technology Enabled Care Services (3 Million Lives)

NHS England Integrated Care for 3millionlives :
(Delivering Improved Heath and Wellbeing through Technology Enabled Care Services (TECS))

Launched in December 2011 3millionlives is underpinned by the idea of service integration to improve patient care and outcomes. When different services and sectors work together, towards shared goals, patients get far more flexible, better, and more appropriate care. To achieve true service integration, NHS England recognise that 3millionlives needs to be delivered through a genuine partnership across NHS England facilitating collaboration between clinicians, and empowering patients to better self manage their conditions, with the use of technology. They also recognise this cannot be achieved through technology alone the key will be to deliver service transformation through realising the potential of that technology to support clinicians, patients and carers.

It is known that there is a growing elderly population, a growing number of people with Long Term Conditions (LTCs), and growing numbers of people with multiple LTCs. This is putting an increasing strain on already stretched NHS resources. One in three people are living with at least one chronic condition, such as asthma, heart and lung disease, arthritis, hypertension and diabetes and half of people over the age of 60 have one. One in three of the population in England amounts to just over 15 million people with an LTC and its estimated that by 2025 this will rise to 18 million. People with LTCs are the biggest users of the NHS, accounting for around 50 per cent of GP appointments, 64 per cent of inpatient appointments and 70 per cent of inpatient hospital beds meaning 30 per cent of the population accounts for 70 per cent of the spend. If care is continue to be managed in the same way as it is now then NHS can expect to see an estimated of additional cost in five years. In the new NHS and social care landscape, we need to find new approaches and service delivery models that will deliver more efficient and effective care. There is a need for better health outcomes and innovations that support people to live more independently, and the NHS know that technology enabled care services can transform peoples lives. The challenge now faced is integrating these technologies into the NHS and wider health and social care services, so they become a mainstream service, not a side-line proposition. And this is where the 3millionlives programme, delivered in the right way, can really make a significant difference

NHS England took action on implementing the delivery programme from April 1st 2013, a rapid review of 3millionlives implementation to date was conducted, as there was a significant risk the programme as previously delivered would not hit the interim ambition of 100,000 new users in 2013. The review resulted in a need for a significant shift in strategic direction for the 3millionlives programme, including a redefined vision, mission and objectives for delivery, and bringing on board strong clinical and technological advocacy and a reframed partnership with Industry.

An early outcome from the review was an agreed change in governance arrangements, so that 3millionlives will be delivered going forward through a matrix approach of clinical advocacy, service improvement and technology strategy making it a true partnership and synergy within NHS England.

There is now tri-partite accountability for the successful delivery of the programme at Director level, with co-ordination for delivery and implementation of the programme residing with the Collaboration for Excellence Team.

Under a redefined vision for the programme, the Collaboration for Excellence Team intend to engage with, work with, and enable the 3millionlives brand to be associated with a much broader range of technology solutions and organisations. Its therefore essential to ensure that industry is working with NHS England as a true strategic partner in the delivery of 3millionlives. NHS England has now convened a much wider 'Integrated Care for 3millionlives Stakeholder Forum', bringing together Industry including all of the original members of the Industry Group commissioners, providers, colleagues from Social Care, the Third sector, and Local Government and housing, to form a collaborative group to collectively debate and resolve key system-wide issues around the delivery and implementation of the programme.

Now all of the different stakeholder groups with an interest in delivery of 3millionlives have been brought together to look at issues collaboratively and The Forum met for the first time in October 2013. The programme will also now look much more widely across the system, to harness where the energy lies locally for delivery of 3millionlives.

The programme is closely aligned with both the integrated care and technology strategy agendas, and has been repositioned as Integrated Care for 3millionlives It will be delivered as a unique collaboration between the NHS, Social Care and Industry to support integrated care, management of Long Term Conditions, and the enablement of 7 day services.

The team established four rapid Task and Finish Groups, one to progress each priority area and the findings and recommendations of these Task and Finish Groups informed the publication of a 3millionlives NHS England Delivery Plan for 2014-17.

Academic Health Science Networks

 Innovation is recognised as an essential part of the future of the NHS. The development of Academic Health Science Networks (AHSNs) across England resulted from the 2011 report Innovation Health and Wealth: accelerating adoption and diffusion in the NHS. NHS England has confirmed the designation of 15 new Academic Health Science Networks (AHSNs).

AHSNs have the potential to transform health and healthcare by putting innovation at the heart of the NHS. This will improve patient outcomes as well as contributing to economic growth.

AHSNs present a unique opportunity to pull together the adoption and innovation with clinical research and trials, informatics, education and healthcare delivery. They will develop solutions to healthcare problems and get existing solutions spread more quickly by building strong relationships with their regional scientific and academic communities and industry.

The AHSNs provide an important mechanism for achieving step-change in the way the NHS translates research, innovation and best practice in to effective and cost-effective treatments and services for patients. They will help to develop better technology and make better use of the skills of NHS staff.

The designated AHSNs are:

• East Midlands
• Eastern
• Greater Manchester
• North East and North Cumbria
• North West Coastal
• Imperial College Health Partners
• Oxford
• South London
• South West Peninsula
• Kent, Surrey and Sussex
• UCL Partners
• Wessex
• West Midlands
• West of England
• Yorkshire and Humber

 Bibliography - References

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[13] HM Treasury, "Strategy for National Infrastructure," 2010 1-March,

[14] HM Treasury, "," 2010 1-March

[15] HM Treasury, "," 2011 1-November

[16] HM Treasury, "" 2012 5 December

[17] HM Treasury, "," 1 March 2010

[18] Ofcom, "Communications-infrastructure-report 2012 update," 20 December 2012,

[19] Ofcom, The Communications Market 2011, 4 August 2011,

[20] Ofcom, "Communications-infrastructure-report 2012 update," 20 December 2012,

[21] Ofcom Broadband Speeds Map,

[22] Ofcom, "Communications-infrastructure-report 2011," 6 July 2011,

[23] Ofcom, "Communications-infrastructure-report 2012 update," 20 December 2012,

[24] HM Treasury, "," 2011 1-November,

[25] The NHS Information Centre (2011) Compendium of Population Health Indicators

[26] NHSIC Community Care Statistics (2008), Home Care Services for adults, England 26 March 2009

[27] NHSIC Community Care Statistics (2008), Home Care Services for adults, England 26 March 2009

[28] Department of Health (2009) Average daily number of available beds by ward classification, NHS organisations in England, 2008-09


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