Council-led Co-Design of Automated Telephony and App Services

OVERVIEW

This collaborative project will deliver a personalised automated telephony solution to people within your community who are in need of additional support due to isolation or vulnerability. Automated telephony was used by a small number of councils in the first wave of Covid to effectively support people who were shielding, enabling councils to prioritise resources based on need. 

Working with a technical partner – Message Dynamics – who has delivered automated telephony and app services to the NHS for over 10 years, we are bringing a group of councils together to define those people and services that would benefit most from automated contact approach (possible use cases below). To then co-design the scripts and questions and deploy automated telephone/app support in a matter of weeks.

With the ability to manage thousands of calls per day and provide a detailed dashboard to guide councils as to where to prioritise support, this project seeks not only to co-design, build and deploy the technology swiftly, but prove the business case for a blended automation and personal support approach focused specifically on people most in need. 

CURRENT NHS MODEL

Developed over 10 years with primary care settings and NHS Trusts, Message Dynamics’ automated telephone/app triage system has been iteratively built for a variety of NHS pathways and patient cohorts. It is currently used in a number of NHS settings and supports patients across COPD, diabetes, asthma and recently operated patients. The technology uses conditional logic to assess and score the needs of patients, the results of which can be seen within a dashboard, with integrated alerts to trigger additional support or services as required. 

Engagement rates are typically between 80-90% and there are additional proven physical and mental health benefits to the approach; including a 65% reduction in people suffering from severe anxiety or depression following hospital stays due to the continued contact.

PARTNERS REQUIRED

Three local authorities for a two month co-design project.

Resource requirements from each partner will be no more than two hours every two weeks for two months from project initiation. We are looking for subject matter expertise from appropriate teams, plus engagement of communications colleagues.

COSTS

£10,000 per partner (plus VAT)

This includes: 

  • Service identification and scripting 
  • Building of the logic models and telephone/app triage systems
  • Refinement of the analytics platform to meet local government/service requirements 
  • 75,000 completed interactions* (CI) to be used as quickly as the partner needs (up to one year)
  • Access to the analytics platform for up to 12 months or until CI quota is used
  • Business case and metrics research leading to agreed commercial model

*A completed interaction is up to 4 calls or 2 SMS messages to an identified person or household to ensure questionnaire completion – ie, should the person not respond or be available on the first attempt the system will try another 3 times via telephone and once more via SMS to drive compilation of the survey. 

People/households this project could support (total of 75,000 calls/CIs based one call/CI per week**):

  • 1,442 people/households over 12 Months
  • 1,875 people/households over 9 Months
  • 2,885 people/households over 6 Months
  • 5,770 people/households over 3 Months
  • 18,750 people/households over 1 Month

**frequency can be more or less than this – rate will determined by each partner 

BUSINESS CASE

This project will work with partners not only to build and deploy automated telephony for the appropriate priority services, but also to validate the business case, ROI and savings for local authorities as well as uncover the frontline staff and end user benefits. We are clear that the comparative costs for undertaking this work with a traditional call centre are much higher and take considerably longer to deliver, this will be modelled as part of the project.

In terms of getting involved as a co-funder now as opposed to waiting until the solution is delivered and more widely available, the financial saving is estimated to be £7,250 (simply from call costs and platform fees – not including any of the system benefits or financial savings of moving to an automated approach). 

Research conducted on the use of Message Dynamics’ system published by the National Institute of Clinical Excellence (NICE) specifically focused on COPD, shows financial savings of £1,546 per patient per year – so we believe there are significant savings to be uncovered for local government.

PROJECT OVERVIEW

Key Stages of the Project: 

  • Workshop to outline approach, overview current system, identify and prioritise appropriate services 
  • Co-design of agreed pathway/s (maximum two pathways as part of this project)
  • Build of pathways and conditional logic (for both telephony and app) 
  • Prototyping
  • Deployment of technology with each partner, setting up of alert protocols, live monitoring and system training
  • Business case and metrics research leading to agreed commercial model

TIME FRAMES

This project seeks to start as soon as possible, however start times will be dependent on the three co-funding partners confirming their involvement.

POTENTIAL LOCAL GOVERNMENT USE CASES:

Whilst we are looking to the collaborating councils to identify and agree the services where automated telephony will be most valuable and deliver the most efficiencies, some candidate services have already been outlined.

  • Covid-19 Response 

Whilst people are not being advised to actively shield in the same way as the Spring lockdown, councils will know from the first wave who are vulnerable within their communities and that many will be self-shielding or having less interaction with their friends, families and wider community due to Covid, as well as the winter weather. 

Use Case: The idea for this cohort would be to have a weekly or twice weekly call that might check that they are OK, have the heating on, have enough food or are in need of support, meaning that Mrs Jenkins (who lives alone and was on the original shielding list) knows she is ‘on your radar’, giving her peace of mind and a route through to the right team for support should she need it. Additionally there may be a use case to support local test and trace programmes.

  • Reducing Isolation

Social isolation is a national challenge at the best of times, but in lockdown the issues have been significantly exacerbated. People with known mental health conditions, known to live alone and thousands of others will benefit from a connection with their community and the offer of help if required – even if in the first instance it is automated. Whilst not wanting to increase demand on stretched services, this project could consider how to address the needs of socially isolated people and give them the contact and resources they need. 

  • Post Reablement 

Use Case: Mrs Smith is released from hospital after a fall and following six weeks of reablement care, she is still building up her strength and getting used to life back at home. Whilst Mrs Smith used to be quite independent, outgoing and capable, her confidence has been knocked and she is struggling to get back to her pre-fall way of life. Now that the carers are no longer coming in daily, she feels isolated and anxious that she may end up back in hospital if she falls again. 

Having been briefed by the reablement team Mrs Smith receives an automated call to check in on her every Monday and Thursday at 10am. Whilst it’s not exactly the same as the personal visits Mrs Smith has become used to, she likes this approach as she feels like she is still ‘in the system’ and not alone. Additionally she knows that if she were to have difficulties, that the automated system is linked directly into the reablement team in real time and has a system of integrated alerts, so that her situation if worsened would be assessed and actioned as required.

PROVIDER PROFILE

Message Dynamics provides digital solutions that improve the quality and efficiency of healthcare services. Its Patient Monitor service is used by the NHS in a variety of areas including COPD, asthma and diabetes. This service has been shown to be very effective in both improving the quality of care and at the same time reducing costs. 

In addition, its services are used commercially to help provide care at home and by the pharmaceutical industry. The company has won a variety of awards for both partnership with the NHS and innovation.

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