Assisted Living UK Capabilities
Opportunity Report

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Northern Ireland

Northern Ireland - full text version

1.0 Introduction

This case study provides an overview of the assisted living sector in Northern Ireland 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 Northern Ireland. 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 5 Northern Ireland districts covering 26 Council areas. Unlike other countries in the UK councils in Northern Ireland have no responsibility for planning, housing, road building or education. The country is split into the following 5 regions:

  • North Eastern: Antrim, Ballymena, Ballymoney, Carrickfergus, Coleraine, Larne, Magherafelt, Moyle, Newtownabbey
  • Belfast
  • South Eastern: Ards, Castlereagh, Down, Lisburn and North Down
  • Southern: Armagh, Banbridge, Cookstown, Craigavon, Dungannon and South Tyrone, Newry and Mourne
  • Western: Derry, Fermanagh, Limavady, Omagh, Strabane

Figure 1: Regions Map

Northern Ireland covers approximately 5,345 square miles. The major conurbations include the capital city of Belfast with a population of 267,500, Armagh (14,590), Derry (90,663), Lisburn (71,465) and Newry (27,433).

2.1 Demographics

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

2.1.1 Population

Figure 2 below ranks Northern Ireland 12th in relation to population size across the other UK regions.

Figure 2: UK Population by Region 2010[2]

Figure 3 illustrates the population of Northern Ireland by Female / Male age ranges. The chart shows the greatest proportion of the population sits in the 20 – 39 age range. Northern Ireland has a younger population than any other region of the UK with a higher percentage of the population aged less than 40 years (54%).

Figure 3: Population by Age Range[3]

  2.1.2 Urban and Rural Population and Population Density

The Northern Ireland Statistics & Research estimate the population of Northern Ireland to be 1.799[4] million representing around 3% of the total population of the UK.

Northern Ireland Assembly estimates that 80% of Northern Ireland’s landmass and 35% of the population are defined as being rural[5] equating to 4,276 square miles and 589,843 people. These figures are based on 2001 census data. In their 2010 report entitled “Rural Development issues and challenges in Northern Ireland” between 2001 and 2008 the rural population grew by 61,000 people compared to a growth of 25,000 for urban areas. This indicates a rapidly expanding rural population.

2.1.3 Population Over 65 Years

Figures 4 and 5 illustrate the distribution of the 65+ population over the 5 Northern Ireland regions. The map shows the percentage of the population for each region aged over 65. The map shows fairly even percentages across the 5 regions with ranges of between 13 and 16%. The district with the lowest percentage of people over 65 can be found in Derry at 11.6% in the Western region. The district with the highest percentage can be found in North Down at 18% in the South Eastern region. Overall the Belfast region has the highest percentage of people over 65.

Figure 4: Population by Region[6]


Figure 5: Age Profile Map
age profile map

2.1.4 Life Expectancy

The average life expectancy at birth for Females in Northern Ireland is 81.40 for Females[7] and 76.96 years for Males. The UK average for Females is 82.0 years and Males 77.7 years. The South Eastern region has the highest overall life expectancy with Females expected to live to 82 and Males 78 years. Figures released by the Department of Health, Social Services and Public Safety stated that between 2006 and 2008 male life expectancy reached 76.4 years which represented a 0.8 year increase from 2001-03. Female life expectancy also increased by 0.8 years to reach 81.3 years in 2006-08. These improvements were driven mainly by falling mortality due to circulatory disease amongst those aged 60 years or more[8].

2.1.5 Population Projections

The overall population is projected to grow by 11%[9] (193,800) by 2030. Figure 6 illustrates the estimated growth of the 65+ population between 2010 and 2030.

Figure 6: Population Projections (000’s) of Older People in Northern Ireland by Sex (2010 to 2030)[10]


The diagram illustrates a steady increase in both the Male and Female populations over 65. The diagram also shows a steep increase in the Female population over 75 post 2020 whilst the Male population over 75 is still in relative decline.

Figure 7 illustrates the projected growth of the 65+ population for Northern Ireland in comparison with the rest of the UK. 

Figure 7: Estimated and Projected % of the Population Aged 65 and Over by Region[11]

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 Ratio


Figure 8 shows a consistent support ratio by area across the region. This indicates that the aging population is evenly dispersed across the country.

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.

Whilst the results don’t include survey data for Northern Ireland they do provide insight into the general uptake from across England, Scotland and Wales.

Figure 9: Internet Purchases 2008 to 2011 by Age Group 2008 - 2011[12]


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


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 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 Northern Ireland economy. The section focuses on the assisted living industry base and regional economic structure.

3.1 Economic Overview

Northern Ireland has the smallest economy in the UK with a GDP of £30 billion. The GVA[13] per head is one of the lowest in the UK at £15,795[14]. 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 of England at £15,621. The country has moved from a traditional manufacturing, shipbuilding and textiles economy to a service based economy.

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[15]

Northern Ireland has a growing Telecare and Telehealth industry sector. Belfast and the Northern region has become a centre for many of the most innovative companies in this space. This includes Telehealth companies Alere Connected Health Ltd (Formally Home Telehealth) a leading provider of Telehealth services and Heartsine Technologies who design and manufacture Automated External Defibrillators. S3 Group is also a major Telehealth provider and part of the TF3 consortium delivering the new Telemonitoring NI initiative (see section 6.1). The region is also home to McElwaine Smart Technologies Ltd providers of Telecare and personal tracking devices for the elderly, carers, friends and family. TASK Community Care and Fold Telecare are also located in the region.

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[16] 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[17], revised to include more regional detail in 2011[18], and updated in 2012[19] 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[20], 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 utilizing 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 recognized 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 update reports[21] the following progress on infrastructure delivery programmes and Autumn Statement 2012 capital announcements relevant Northern Ireland:
Rail, roads, local transport, water, flood and waste – devolved to the Northern Ireland Executive
New funding announced: Additional capital allocation of £132 million

3.3.2 Digital Communications

Ofcom, the independent regulator and competition authority for the UK communications industries has reported[22] 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[23] 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[24] 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[25] 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 Northern Ireland by local authority. The majority of local authorities within the region have good broadband performance with a ranking of 1 or 2. None of the remaining areas rank lower than 3, showing that overall, connectivity throughout Northern Ireland is good.
The Communications Infrastructure 2012 update reports[26] 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.’ Derry/Londonderry 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.’[27]
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 recognized 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

Health and Social Care in Northern Ireland are provided as an integrated service. There are a number of organisations who work together to plan, deliver and monitor Health and Social Care across Northern Ireland.

There are a total of 6 Health and Social Care (HSC) Trusts in Northern Ireland. 5 HSC Trusts provide integrated health and social care services across Northern Ireland: Belfast HSC Trust, South Eastern NHS Trust, Western HSC Trust, Southern HSC Trust and Northern HSC Trust. HSC Trusts manage and administer hospitals, health centres, residential homes, day centres and other health and social care facilities and they provide a wide range of health and social care services to the community. The sixth Trust is the Northern Ireland Ambulance Service, which operates a single Northern Ireland wide service to people in need and aims to improve the health and well-being of the community through the delivery of high quality ambulance services.

The following section describes the health and social care landscape of Northern Ireland. 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, COPD, Hypertension, Epilepsy, Dementia and Stroke. The figures were sourced from reports published by the Department of Health, social services and public safety and Long Term Conditions Alliance Northern Ireland. No accurate figures for Learning Disabilities were identified in the research.

Figure 17: Long Term Conditions profile for Northern Ireland[28]

The figures presented in the chart suggest that 38% of the total population suffer from a long term condition. Hypertension represents the single highest condition at 395,529 second is Chronic Obstructive Pulmonary Disease (COPD) at 80,000 and third is Coronary Heart Disease at 75,158 patients. The high levels of Hypertension are close to those found in Scotland (60%).

5.0 Existing Care Provision

The following section outlines the existing care provision in Northern Ireland 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

Data on the provision of domiciliary care for Northern Ireland is limited. However a survey published in 2010 by the Department of Health, Social Services and Public Safety indicated that a total of 23,389[29] people were in receipt of home care, of which 78% (18,243) were aged over 65. The report also revealed that 7,346 people were receiving intensive home care services. However, the data doesn’t determine how many receiving intensive home care were aged over 65, therefore it is difficult to draw comparisons against other regions of the UK. Intensive Homecare is defined as the number of households receiving more than 10 contact hours and 6 or more visits during the week.
The survey also reported an 11% increase in the number of people receiving intensive home care. This increase suggests a sharp increase in demand for intensive home care across Northern Ireland.

5.2 Residential and Domiciliary Care

There are a total 89 statutory and 178 private Care Homes in Northern Ireland and 116 registered domiciliary care providers. Figure 18 illustrates a relatively high level of provision for both residential and nursing home beds across Northern Ireland. Residential care homes provide living accommodation and support whereas nursing homes provide medical and nursing support. The chart suggests that Northern Ireland has the best level of provision in Southern and Western regions.

Figure 18: Population Over 65 Compared to Care Home Beds[30]

Detailed data for NHS bed provision (Acute and Residential) for Northern Ireland was unavailable at the time of writing. Therefore no analysis of NHS bed provision by county area can be made in this case study.

6.0 Current Assisted Living Activity

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

6.1 Regional Projects in Health and Social Care

Health and Social Care in Northern Ireland are provided as an integrated service. There are a number of organisations who work together to plan, deliver and monitor Health and Social Care across Northern Ireland.

The Department of Health, Social Services and Public Safety (DHSSPS)

Much of the major investment in assisted living has been through joint initiatives between the Department of Health, Social Services and Public Safety (DHSSPS) and Industry.

Through the European Innovative Partnership on Active and Healthy Ageing (EIP-AHA), Northern Ireland is now seen as a forerunner in Europe in bringing about a higher quality of health and social care for the older population. Innovation in medicines management, long term conditions management and implementation of Integrated Care Partnerships to enhance cohesion among health professional involved in the care of older people have helped Northern Ireland achieve this world class recognition.

Within the past year Northern Ireland have rolled out an £18million telemonitoring project. The service enables those with chronic conditions to live independently in their own homes while still being closely monitored by health professionals. This results in earlier interventions which can help prevent deterioration of condition and acute illness - the end result being reduced numbers of hospital admissions. The introduction of a Telepresence robot at Daisy Hill Hospital's High Dependency Unit is also at the cutting edge of innovation in Northern Ireland's health service. It enables intensive care specialists from one hospitals to examine and interact with patients in another more than 20 miles away. For patients, this means better access to specialist advice and expertise, while optimising our healthcare resources.

For more information please see:

The Centre for Connected Health and Social Care

The Centre for Connected Health and Social Care has been established to promote improvements in patient care through the use of technology, and to fast track new products and innovation in the Health and Social Care system in Northern Ireland. The primary purpose of the CCHSC is to improve the patient and client experience, and to provide better quality and more effective care. By supporting the more efficient delivery of services, it will also enable the healthcare system to respond better to the future need of the population. In addition to this, the CCHSC wishes to contribute to the advancement of the wider European e-health agenda and work with partners to secure economic gains for Northern Ireland through the development of the region as a centre for research, development and application of connected health technologies. In August 2008, the CCHSC put out a tender for the provision of an end-to-end remote telemonitoring service in Northern Ireland (RTNI). The development of the RTNI service was initiated by the DHSSPS as part of a modernisation of services for patients/clients living with complex long term conditions such as heart failure, chronic obstructive pulmonary disorder (COPD), diabetes and stroke. As required over time, the service will be applied to patients / clients with other conditions, including (but not limited to) cancer and neurological diseases, as well as with those receiving palliative care. It will also be applied to the provision of telecare services. After a complex procurement process, the RTNI managed service contract was awarded on 16 March 2011 to TF3, a consortium comprising Tunstall, Fold and S3 Group.

For more information please see

Telemonitoring NI

TF3 is the industry consortium chosen to provide the remote Telemonitoring service to Northern Ireland. The consortium is made up of Tunstall Healthcare, S3 Group and Fold Telecare. The consortium started to implement services for heart, respiratory, diabetes and stroke patients in March 2011. The consortium has a 6 year service contract and aim to delivery remote Telemonitoring to 8000 people.

The Telemonitoring NI service provided by the TF3 Consortium, has to date benefitted over 1500 patients with long-term conditions in Northern Ireland, helping them to better manage their health. The clinical triage service is delivered in Northern Ireland by nurses to monitor readings such as blood pressure and weight on a daily basis. This remote management allows patients who would otherwise have to travel to their GP or hospital to be monitored in their own homes. This means less stress for patients and helps them in understanding and managing their condition. The service has an ambitious programme for development and next year plans to accelerate the uptake of telehealth into broader clinical conditions and expand in to telecare.

The TF3 consortium comprises Tunstall Healthcare, Fold Housing Association and S3 Group. In March 2011 TF3 was selected through a process led by the CCHSC part of the Public Health Agency (PHA) to provide a nationwide remote telemonitoring service to the Northern Ireland Health and Social Care System. The procurement of this large scale, ‘end-to-end’, managed service is already supporting in excess of 1,200 active users.

For more information please see

6.1.1 Support Organisations

Biobusiness Ireland is the business association for the Life and Health Technology sector in Ireland. Biobusiness has a range of roles including an advocacy role representing its members to government and regulatory bodies. The organisations primary role is to provide business support through networking, events, collaboration and the dissemination of best practice. For more information please see

Biobusiness Ireland 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, Medilink North West, Medilink West Midlands, Medilink Yorkshire & Humber, Medilink East Midlands and the South East Health Technology Alliance. For more information please see

Invest Northern Ireland is the regional development agency for Northern Ireland with a remit to support regional business and attract international investment. The organisation is part of the Department of Enterprise, Trade and Investment and works to the deliver the government’s economic development strategies. Invest Northern Ireland is collaborating with the Department of Health, Social Services and Public Safety to support the development of the Centre for Connected Health and Social Care. For more information please see

6.1.2 Universities

Northern Ireland has 4 universities including the University of Ulster, Queens University Belfast, St Mary's University College and Stranmillis University College. In terms of assisted living both the University of Ulster and Queens University Belfast are the most prominent. The University of Ulster took a leading role in the development of the European Connected Health Campus (ECHCampus). ECHCampus was established to lead the development of connected health across Europe. The campus focuses on the development of areas including Telecare, Telehealth, eHealth, mHealth, Nursing and Homecare. In January 2012 the European Connected Health Campus and European MHealth Alliance merged to create the European Connected Health Alliance. The alliance has over 100 members ranging from academic institutes, SME's through to large corporations. Corporate members include the Department of Health, Social Services and Public Safety, Bosch Healthcare and Intel Health. 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 Northern Ireland. Northern Ireland has the youngest population in the UK with 54% of the population under 40 years old. However the countries 65+ population is projected to grow by 69% by 2030. This rapid growth is attributed to the large 40-59 age group who will transition into the 60-79 age bracket over the next 20 years. The steepest growth in the Female 75+ population post 2020.

The health profile indicates that 38% of the total population currently suffer from one or more long term conditions (LTC’s) with 58% 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 aging population and put increasing pressures on services. Currently the provision of Care and Nursing home beds across the country is consistent. Belfast, Northern and South Eastern areas have marginally lower provision in comparison with the 65+ population. Northern Ireland is experiencing the majority of its population growth in rural areas, with an estimated 80% of the country defined as rural this will put increasing pressure on health and social care services. In response to this the country has been at the forefront of the development of ambitious Telecare and Telehealth programmes. Section 6.0 of this report illustrates some of the development work the country has undertaken in Telecare and Telehealth. Northern Ireland has quickly moved to mainstream Telecare and Telehealth services largely by commissioning managed services from the private sector.

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.


[1] Knowledge Transfer for Implementation - KT4i is a knowledge transfer programme underpinning the dissemination of outcomes from the Technology Strategy Board's Assisted Living Innovation Programme. KT4i is managed by the HealthTech and Medicines KTN. For more information please go to

[2] Office for National Statistics (2010) Population estimates: United Kingdom estimated residential population for constituent countries and regions

[3] UK National Statistics (2011) Population Estimates for UK, England and Wales, Scotland and Northern Ireland - Mid-2010 Population Estimates

[4] Northern Ireland Statistics & Research Agency (2011), Population and Migration Estimates Northern Ireland (2010) Statistical Report

[5] Northern Ireland Assembly (2010), Rural Development issues and challenges in Northern Ireland

[6] Office for National Statistics (2011), Principal projection - Northern Ireland population in age groups (2010-based)

[7] Office for National Statistics (2011), Interim Life Tables, Northern Ireland (2008 – 2010 based)

[8] Department of Health, Social Services and Public Safety (2011), Pre Release Access List HSCIMS Life Expectancy Decomposition 2011

[9] Office for National Statistics, (2008) 2008-based sub national population projections by broad age groups for Regions and Local Authorities in England & Office for National Statistics (2011),

[10] Office for National Statistics (2011), Principal projection - Northern Ireland population in age groups (2010-based)

[11] Office for National Statistics, (2008) 2008-based sub national population projections by broad age groups for Regions and Local Authorities in England & Office for National Statistics (2011), Principal projection - Wales population in age groups (2010-based) & Office for National Statistics (2011), Principal projection - Scotland population in age groups (2010-based) & Office for National Statistics (2011), Principal projection - Northern Ireland population in age groups (2010-based)

[12] Office for National Statistics (2011), Internet access, households and individuals

[13] Gross Value Added (GVA) is used to measure the economic output per head of population for a given area

[14] Office For National Statistics (2010) Regional Trends - Directory of Online Tables

[15] Medilink West Midlands source data on UK healthcare companies

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

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

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

[19] HM Treasury, "" 2012 5 December

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

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

[22] Ofcom, The Communications Market 2011, 4 August 2011,‌a=0

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

[24] Ofcom Broadband Speeds Map,

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

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

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

[28] Figures for stroke, hypertension, CHD and Diabetes sourced from Living with Long Term Conditions: A policy Framework (2011) Department of health, social services and public safety. Figures for COPD, Epilepsy and Dementia sourced from Response to Proposals for Health & Social Care Reform in Northern Ireland (2008) Long Term Conditions Alliance Northern Ireland

[29] Department of Health, Social Services and Public Safety (2010) Domiciliary Care Services for Adults in Northern Ireland

[30] Department of Health, Social Services and Public Safety (2011 )Residential Accommodation in Northern Ireland, by Type of Home as at 30 June 2011


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