‘active & healthy ageing’ - manchester informatics · and resource base for ageing...
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‘Active & Healthy Ageing’
Thursday 14th January 2016 MSP CityLabs
Wifi Username: MSP PUBLIC
@Man_Inf #McrEcosystem
Manchester Ecosystem GM AHSN Meeting
Accelerating Innovation into Practice Pathway
Jane Macdonald Director of Nursing and Implementation
GM AHSN
What is the pipeline for this? OBJECTIVES •Integral role for Health Innovation Manchester •Aligns to GM Strategic Plan •Designed to ensure Greater Manchester is an early implementer/adopter of disruptive innovation •Will build investable propositions for NHS commissioners (& potentially providers … & also social care).
Key here will be: •The economic case for change •Plausibility •Benefits realisation •Methodological support for implementation and evaluation •Will link into devo governance arrangements to ensure we have the mandate that brings rapid and effective adoption through GM
Manchester Institute for Collaborative Research on Ageing (MICRA)
RESEARCH PRIORITIES AND THE OPPORTUNITIES FOR TECHNOLOGY
AREAS COVERED
• Development of MICRA • Role of technology • Opportunities • Challenges • Research gaps
Development of MICRA
• Establish in 2010 as an interdisciplinary research network on ageing. Formed as an Institute in 2014
• The information hub for research on ageing at the University of Manchester, operating across all faculties
• Provides a framework for academics to engage others in their research through collaboration and impact
• Brings together academics, practitioners, policy makers and older people so our research meets the real challenges and opportunities of an ageing population
• 2,000 members including academics, practitioners, policy makers and older people
• 1,300 registered attendees for MICRA events in 2014/15 • 1,200 Twitter followers
KEY AMBITIONS
• Continue to strengthen research on ageing at Manchester in priority areas: e.g. work, retirement & pensions; social and biomedical aspects of dementia; frailty/vulnerability
• Internal capacity building - continue to grow the staffing and resource base for ageing research, especially with early career researchers
• Development of Greater Manchester Ageing Hub to co-ordinate research initiatives on ageing across GM – comprises MICRA, Manchester City Council, New Economy and Public Health England.
• Extend influence in key policy networks and research organisations
Key Partners
• Manchester City Council & Greater Manchester: Partnerships in research projects (e.g. fRaill; EWL) and policy development (Age friendly Cities; Ageing Hub)
• Age UK: partnership agreement (e.g. Seedcorn funding; development of research agendas in particular areas; support for research)
• International Longevity Centre –UK: partnership agreement (fringe event at Labour/Conservative conf.); conferences; research partner
• Government Office for Science: support for Foresight programme: preparation of research reports
• Great Manchester Centre for Voluntary Organisation (GMCVO) – Ambition for Ageing (£10 million programme to combat loneliness).
Figure 1 – Percentage change in GM population by age band: mid-2001 to Census 2011
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Office of National Statistics
Mini baby boom
Migration: expansion of
universities; better enumeration
1960s baby boom
Post-war boom
1930s depression
War deaths
CHALLENGES FOR OLDER PEOPLE IN GM RELEVANT TO APPLICATION OF TECHNOLOGY
• The projected growth in single-person households: a 66% increase in the numbers of people in GM 75 plus living alone by 2036, with one in three men aged 75 and over living alone by 2036.
• Based on national data around 61,000 men aged 50+ (14%) and 53,000 women (11%) in GM are likely to experience social isolation
• The projected growth in the number of people predicted to be diagnosed with some form of dementia: from 32,000 in GM in 2011 to 61,000 in 2036
OPPORTUNITIES FOR TECHNOLOGY
• Community - Technologies that maintain social connections (Skype) • Home environment - Products that support ‘ageing in place’ (‘smart home’) • Body - Strategic use of ICT to improve functional ability (e.g. body sensors to monitor health) • Care-giving - Technologies assisting carers supporting older people
Maintaining social connections
• Internet use 9% 65+ using internet on daily basis in 2003 42% 65+ in 2014 - But social divisions around class/income & issue
of between 3% and 10% of people who stop using the internet because of range of changes (sensory, physical, cognitive) arising in later life
- Digital exclusion in care homes: of the 20,000 plus homes in UK, just 4, 178 provide access to the internet (carehome.co.uk -2014 figures)
Maintaining support
• Tele-care systems long-established – likely shift from alarm-based to ‘continuous monitoring’; development of telecare services for people when outside the home1 but:
- older people in poor health least likely to accept new technologies; 2 - Stigmatising effect of ICT-based care services – wearing monitoring devices which carry the implication of frailty.3,4
CHALLENGES
• Diversity of people 50 plus driven by widening social inequalities may lead to unequal distribution of technology to support older people: technology rich versus technology poor.
• Concerns about privacy may affect growth of connected devices 5
• Budget restrictions may restrict application of technology
Key research gaps & challenges
• Explorations of the impact of connectivity linked to everyday objects (so-called ‘pervasive computing’)
• Investigations of how people deal with changes to domestic technology (e.g. smart appliances) and how their use can be supported long-term
• Engagement of older people as co-researchers • Research on causes and effects of digital
disengagement • Research on causes of resistance to take-up of
technology (amongst both professionals & older people).
REFERENCES
1. Damodaran, L & Olphert, W. (2015) How are attitudes and behaviours to the ageing process changing in the light of new media and new technology? How might these continue to evolve by 2025 and 2040. Foresight. Government Office for Science 2. Heart, T. & Kalderon, E. (2013) ‘Older Adults: are they ready to adopt health-related ICT?’ Int.Jrnl. Medical Informatics, 82: 209-231. 3. AgeUK (2010) Technology and older people: evidence review. London: AgeUK 4. Damant, J & Knapp, M. (2015) What are the likely changes in society and technology which will impact upon the ability of older adults to maintain social (extra-familial) networks of support now, in 2025 and in 2040? Foresight, Government Office for Science. 5. Accenture Digital Consumer Survey (2015) More about MICRA http://www.micra.manchester.ac.uk/
Aim: Focus on actions required to help individuals flourish in work, delay and plan early for retirement and remain active in their local communities Objective: Take stock of progress to-date and drawing on the experience of ‘what works’ across Europe, set out a framework for positive action Premise: Good work as a tool to promote future health and social resilience and independence in later living
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The Task We Set Ourselves
4 Themes: o Workplace Adaptations o Retirement Choices o Managing Chronic Conditions in the Workplace o Managing an Older Workforce
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Project Themes
o In-depth reviews o Analysis of Public Health Outcomes Framework (PHOF)
Learning exchange with EU partners o Insight work: NHS Health Checks and Health Trainers
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Project Methods
The Age Of Opportunity In 1951 a 65 man could expect to live to 77, today he can expect to live to 86 and by 2050 to 91 More over 50s in workforce than ever before. Over 50s form a quarter of workers in GB. By 2020, it is set to rise to a third
Reworked view of retirement and later living. Rejecting cliff-edge retirement. Age of no-retirement and portfolio working. View retirement as an active/independent phase BUT 2.9 million people aged 50-SPa who are out of work, only 0.7 million see themselves as retired, 1.7 million think it is unlikely that they will ever work again – many of these are sick or disabled
26% of people aged 50-64 who are out of work would like to work
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Prevention and Targeted Action o Poorest social class have 60% higher prevalence and earlier
onset of LTCs
o Employees with a mental health condition, who remain in work without the support they need, cost UK businesses around £15 billion a year
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Prevalence of selected long-term health conditions by age group
18-24 25-49 50-SPA
Musculoskeletal problems 3% 9% 21%
Chest or breathing problems, asthma, bronchitis 5% 5% 8%
Heart, blood pressure or blood circulation problems 1% 4% 17%
Stomach, liver kidney or digestive problems 2% 3% 7%
Diabetes 1% 2% 7%
Depression, bad nerves or anxiety 3% 6% 8%
Other health conditions 7% 9% 17%
• Loss of talent –1 in 6 carers leave work or reduce hours to care
• Costs of recruitment and productivity –Employee’s last salary or more
• Lost potential –Reducing working hours/working below skills level
• Absenteeism –Caring identified as a factor (if unsupported) by the Confederation of British Industry (CBI)
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The Workplace Challenge: Impact of Caring
Source: Employers For Carers
o Greater Manchester Devolution Agreement settled with
Government in November 2014, building on GM Strategy development
o Powers over areas such as transport, planning and housing – and a new elected mayor
o Ambition for £22 billion handed to GM o MOU Health and Social Care devolution signed February 2015:
NHS England plus the 10 GM councils, 12 Clinical Commissioning Groups and NHS and Foundation Trusts
o MoU covers acute care, primary care, community services, mental health services, social care and public health
o To take control of estimated budget of £6 billion each year from April 2016
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GM Devolution – the background
o MoU–Prevention o Requires a substantial reduction in demand for health and care
services in part as a consequence of transformational improvement of population health and wellbeing
o Supports pre-eminent argument in NHS 5 year forward view o Linking prevention and health improvement to economic
growth and jobs o Aligns with the recognition of the role of local leadership to
improve health and wellbeing in the local population o The Agreement is focused around major transformational
programmes of work including:
Starting Well, Living Well, Ageing Well and Reform and Growth 26
Prevention at the heart of Devolution
o If GM 50-64 employment rate was at the UK average for this age group then
GM GVA would grow by as much as £813.6M per year o AWiW has demonstrated that healthy life expectancy is strongly and
consistently associated both with lower exposure to known ‘RISK’ factors; and is also associated with increased access to ‘ASSET’ factors, such as higher wellbeing and lower poverty including employment in 50+
o Understanding the risks for falling out of work early will provide direction around effective resilience initiatives and increasing productivity
o We have a range of models to promote health at work across the conurbation
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Linking prevention and health improvement to economic growth and jobs
o Work for Health has been developed as an enabler of system
change to increase the number of people who remain in or return to employment during periods of both chronic and short term ill health
o Ageing Well in Work aims to reduce the numbers of people who leave work early after the age of 50 years and support individuals to flourish and contribute meaningfully in the workplace/community
o Workplace Wellbeing Charter provides employers with easy and clear guides on how to make workplaces a healthy, supportive and productive environment in which employees can thrive
Greater Manchester Work and Health Programmes
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More than a quarter of the 28 million workers in this country are managing a
long term health condition or impairment
For too long we have assumed that people with health conditions should be
protected from work. The reality is that work can be good for health, aid recovery and support people to manage their conditions better
o Commissioned Univ Of Salford to deliver the innovative Healthy
Work Conversations training to 185 AHPs and PWPs. Training stresses the importance of having early conversations about work in routine practice
o Evidence that professionals receptive to a new focus. Increase in confidence and changes in practice. Not necessarily how much, but how you engage with clients that is key
o Portability to other workforces within primary and social care and third sector settings recognising that a range of professionals are well placed to influence decisions in relation to work and health
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Healthy Work Conversations Training
The evidence base internationally and from the UK demonstrates that midlife is a time when health, social and employment opportunities converge and it is a key point to build resilience and future-proof opportunities for later living Challenges in work ability occur at times of transition, e.g. retirement and Rehiring [Finland] Work adjustments are often implemented following sick leave. It is advised that supervisors should gain insight into the needs of workers with chronic disease earlier, to be able to implement work adjustments to prevent sick leave [Netherlands] The topic of retirement/transition rarely discussed [Finland]
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Ageing Well in Work: A Call to Action
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Action in Partnership
Action by a range system players will be required. These include local government, NHS agencies, third sector partners, employers and citizens
By promoting wellbeing at work we can improve quality of experience, productivity as well as work participation • Development of an organisation and work conditions that
stimulate employees to work beyond 65+ • Continued salary increase and competence development after
the age of 60 • Possibilities to work full or part time – • Individual adjustment for those who have retired: provisions to
return to work and to work periods according to their wishes • Middle management must prepare and stimulate
Age Management
Aircraft manufacturer Airbus experienced high sickness absence in its highly skilled workforce, with poor psychological health the primary reason for absence. The company developed an innovative partnership with the NHS with the result that sickness absence was reduced significantly. Airbus used the initiative to heighten managerial awareness of the issues and tackle stigma, which may have prevented workers disclosing health problems. 89% of workers remained in the workforce whilst receiving treatment
Let’s Get Creative
Institute of Directors calls for employers to allow staff time off for volunteering when 58% of employers admit they don’t. JRF commissioned research a decade ago which showed that pre-retirement recruitment tended to get lost in financial and other planning. 6 months post retirement or as part of the mix within phased retirement might work better. “We could have simply had a whip round in the office and donated money to charity. But we wanted to use our creative skills to bond as a team, have fun
and do something to make a big impact somewhere nearby that really needed it” Shelley Hoppe, CEO, Southerly
Volunteering
Old age is like everything else. To make a success of it, you’ve got to start young
Theodore Roosevelt
Paul McGarry Strategic Lead, Age-friendly Manchester,
Manchester City Council Honorary Research Fellow, University of Manchester
Overview
• Overview of patterns of ageing across GM • Inequalities in later life from Fraill project • Policy response – Who Age-friendly Cities and
Environments • Citizenship approach to ageing • Age-friendly Manchester – the ups and downs • Opportunities for collaboration
Population change in four city regions
Source: Buckner, L et al (2011) N8 Research Partnership
City Region
Population: 75+ (‘000s) % of population 75+
Change 2011 - 2036
2011 2036
2011 2036 No.s % Greater Manchester
221 387 166 75 8.6 14.2
Liverpool City Region
154 257 103 67 10.4 17.3
Leeds City Region
260 475 215 83 8.7 14.3
Sheffield City Region
171 290 119 69 9.5 15.1
Population aged 75+ who live alone 2011 - 2036
Source: Buckner, L et al (2011) N8 Research Partnership
City Region
People aged 75+ who live
alone (000’s)
People aged 75+ who live alone: % Men
2011 2036 2011 2036 Greater Manchester
97 161 29 33
Liverpool City Region
67 107 30 34
Leeds City Region
112 192 29 34
Sheffield City Region
75 121 29 33
The patterning of inequality
The richest 10% of the population aged 50 and older own 43% of total non-pension wealth, while the richest 30% own three-quarters of total non-pension wealth.
Wealth differences in levels of frailty are stark; the trajectory of frailty for an individual in the richest third of the population at age 80+ is comparable to that for a 70-74 year old in the poorest third.
The patterning of inequality
There is also a suggestion that inequalities in levels of frailty widened between 2002 and 2010.
Perhaps more troubling is that among the poorest third of the population more recent cohorts appear to have higher levels of frailty compared with earlier cohorts. Levels of frailty are increasing over time for the poorest in our population.
Wellbeing in later life is similarly strongly graded by socioeconomic position.
The policy context in relation to inequalities in later life
The possibility that inequalities in health in later life are increasing and that healthy life expectancy might be worsening for poorer segments of the population, is a cause for concern.
The reasons behind these changes are not clear, but they could be a consequence of widening social inequalities.
Despite this evidence, both interventions and broader policy work (including the Marmot Review) have ignored older people and relevant processes operating in later life.
The policy context in relation to inequalities in later life
Evidence suggests there is some success from interventions focussed on: Promoting valued social roles and broader social inclusion; Physical activity and exercise, and falls prevention
programmes; and Housing quality, particularly heating.
However, there is insufficient evidence to assess whether, if appropriately targeted, such interventions would reduce inequalities in health in later life.
There is a lack of more broadly focussed interventions to address the more fundamental drivers of inequalities in later life
Inequalities in later life: Mean walking speed and wealth,
people aged 60+
0.75
0.8
0.85
0.9
0.95
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Richest 2nd 3rd 4th Poorest
Met
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per s
econ
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English Longitudinal Study of Ageing
“There is emerging evidence that urban environments may place older people at a heightened risk of isolation and loneliness.”
- Changes in which urban spaces are developed to meet the needs of younger consumers;
- Older people’s social well-being is prone to changes in population. The loss of family members, friends and neighbours has implications for the maintenance of stable social relationships.
- Older people are affected by changes linked to social issues, such as changes in services and levels of crime.” Scharf/Gierveld 2008
Ageing in the city “Some councils will see an outward migration of affluent people in their 50s and 60s who choose to leave the cities…..the remaining older population…tends to be….poorer, isolated and more vulnerable with a lower life expectancy and a need for acute interventions” Audit Commission 2008
“Manchester has established itself at an international level as a leading authority in developing one of the most comprehensive strategic programmes on ageing.” John Beard, Director, Department of Ageing and Life Course World Health Organisation
Medical Care Citizenship Patient Customer Citizen
Rights to the city Focus on individual Focus on individual,
family and informal networks
Focus on neighbourhood and city
Clinical interventions Care interventions Promoting social capital and participation
Commission for ‘frail elderly’
Commission for vulnerable people
Age-proofing universal services
Prevention of entry to hospital
Prevention to delay entry to care system
Reducing social exclusion
Health (and care system)
Whole system Changing social structure and attitudes
Citizenship-based policy approach Source: P.McGarry/MCC 2013
About Age-Friendly cities and communities:
• Age-friendly neighbourhoods
• Age-friendly services • Research and
innovation • Communication and
engagement • Influence
Age-friendly neighbourhoods
• Improve AFM locality structures and plans, working with regeneration teams, NHS agencies, and Council ward coordination groups
• Support the AFM locality networks
• Support community projects that increase social participation, including the AFM small grants fund
• Promote a range of volunteering opportunities
Research and Innovation
• Support the Manchester Ageing Study
• Develop Manchester as a centre of excellence
• Publish Research and Evaluation Framework
• Collaborate with (inter) national research and policy projects
• Economy and Ageing project • Age-friendly design project
Age-friendly services • Apply ‘ageing lens’ to city plans
and strategies and support Public Sector Reform
• Contribute to (GM) Health and Social Care integration
• Health and Well being Strategy • Deliver next phase of ageing
studies programme • Expand the AFM Cultural Offer • Support a range of
intergenerational projects
Involvement and Communication
• Further develop the AFM Board and Older People’s Forum
• Improve how older people inform decisions about their areas and services
• Promote AFM protocol for involving older people
• Improve AFM on-line resources and promote AFM through ‘pledge’
• Review how we communicate with older people
The Approach in Practice
Key achievements: the AFM programme in numbers
• 11: Years since VOP launch • 350: Local groups receiving small grants • 2,000: People attending winter warmth events • 1,500: people receive e-bulletin • 6 weeks: Older People’s Board meets • 200: members of the Older people’s Forum • £6.5m: AFM external investment since 2004 • 10-240: WHO affiliates 2010-2014 • 100: front-line staff trained • 150: Culture Champions • 1: number of age-friendly parks
Greater Manchester Ageing Hub • Hub which brings together capacity and expertise
from across GM on ageing • Strategic focus on how urban environments can work
with and for older people in order to support and facilitate people living longer, healthier lives
• A ‘living lab’ to test interventions, products and services
• GM Ambition for Ageing programme oversight • Capacity to work with national and international
partners
Summary: key success features
• Political leadership and support is key • A team of people supporting age-friendly initiatives and
partnerships • A local narrative that agencies and residents understand • Develop mainstreaming ageing issues to everyone • Promote a ‘citizen’ perspective rather than a ‘deficit’
model: Involving older people as actors in setting the age-friendly agenda
• Support a partnership strategy: research – policy – practice; multiple stakeholders
Buffel, McGarry et al 2014 Journal of Aging Social Policy
Thanks….
For more information: [email protected] www.manchester.gov.uk/info/200091/older_peopl
e/3428/age-friendly_manchester www.micra.manchester.ac.uk
Discussion Themes Falls: prevention, detection & monitoring
Mental Health
Ageing well in work
Integrated modules of care
Independent living
The Greater Manchester/ City role in ageing well
@Man_Inf #McrEcosystem
European Connected Health Alliance Bringing Together the future of Health, Social Care & Wellness
www.echalliance.com / [email protected]
The Global Connector Greater Manchester Ecosystem 14th January 2015
About ECHAlliance
Non-profit organisation
66
300+ member organisations Companies, policy-makers, researchers,
health & social care providers, patients, insurances, etc.
15,000+ individuals as a community
International Network of Ecosystems
25+ countries Europe, USA, Canada, China
International Events
Connector Digital Platform
MAP expert services & Innovative Projects
International Network of Ecosystems
100 Ecosystems meetings / year
in Europe
Existing Ecosystems Estonia Greece
Manchester, UK North West Coast, UK
Oulu, Finland Northern Ireland, UK
Scotland, UK Republic of Ireland
New York, USA Barcelona, Spain
Nice-PACA, France Warsaw, Poland Valencia, Spain
Yorkshire & Humber, UK
Launch within 6 months
Galicia, Spain Paris, France
Toronto, Canada Slovenia
Netherlands Czech Republic
Zealand, Denmark
In progress
South London, UK Wales, UK
Berlin & Cologne-Bonn, Germany Skane, Sweden
Limousin, France Kuopio, Finland Turku, Finland
Latvia Italy
Austria Belgium
Basque Country, Spain
Ecosystems opportunities
Access to all Ecosystems meetings across Europe • for ECHAlliance members
Ecosystems coordinators meeting • 2 Ecosystems coordinators physical meeting / year • Ecosystems coordinators calls every 2 months • 1 to 1 exchanges between Ecosystems
Attract investment & funding • European Projects (H2020…), other public fundings • Private investors: industry, charities, social impact investors…
Increase international visibility • 15,000+ profiles, newsletter, social networks… • CONNECTOR platform with marketplace, showroom, publications, newsletters… • International events, webinars
ECHAlliance working groups • Medicine optimisation • eHealth Strategy • Other topics: interoperability and data exchange, innovative public procurement…
Opp
ortu
nitie
s
Learn more contact [email protected]
Medicines Optimisation Inter-Ecosystem Group Group Chair: Prof Mike Scott
Head Pharmacy & Medicines Management, Northern Health and Social Care Trust - Northern Ireland
eHealth Strategies Inter-Ecosystem Group Group Chair: Ain Aaviksoo
Deputy Secretary General, E-Services & Innovation Estonian Ministry of Social Affairs
To provide a platform for stakeholders responsible for a given topic area, to meet, promote and advance their work across the ecosystem network, therefore maximising knowledge sharing and best practice.
Inter-Ecosystem Working Groups
Global Connector Digital platform
www.echalliance.com / [email protected]
European Connected Health Alliance Bringing Together the future of Health, Social Care & Wellness
Digital Health & Wellness Summit @ Mobile World Congress 2016
22-25 February 2016, Barcelona (Spain)
Be a part of it!
European Connected Health Alliance Bringing Together the future of Health, Social Care & Wellness
www.echalliance.com / [email protected]
#MWC16Health
The Investors Challenge Start-ups & SMEs competition
- Best Digital Health Start-ups & SMEs - Best Innovations on Digital Health, wearables, IoT, active ageing…
- Key customers involved (governments, hospitals, insurances)
Roadshow across: - Europe (25+ countries & regions),
- North America (USA & Canada)
- China
From September 2015 to February
2016
Great Final @ Digital Health &
Wellness Summit 2016
Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Health & Wellness @ MWC 2015 Digital Health & Wellness Summit – Barcelona 2016
Digital Health & Wellness Summit – Shanghai 2016
ECHAlliance Health Mission to China June 2016, SHANGHAI [email protected]
European Connected Health Alliance Bringing Together the future of Health, Social Care & Wellness
www.echalliance.com / [email protected]
Contacts Brian O’CONNOR, Chair – [email protected]
Liz ASHALL-PAYNE, International Outreach Co-ordinator-
Julien VENNE, Strategic Advisor – [email protected]
Damian O’CONNOR, Director of Operations – [email protected]
Background: Stockport Experience in Eu Cooperation Projects
5 Interreg Projects 2 CIP ICT-PSP projects
1 AAL Project 1 Grundtvig Project
1 7th Framework Project PCP Robotics EU Commission evaluator and reviewer *
Background
Funded for 3 years Combine assistant with companion robot Targeted at people living with Dementia
Stockport:Work Package leader Budget for Stockport €305,000
How we got involved
Help with scoring previous robotics projects for EU Commission
Targeted our partners and the area of interest Met regularly online
Planned involvement in drafting bid
Took active role
What we had to provide
Ensure end user driven approach Targeting real problem for us Had to be beyond the state of the art Had to have involvement of people living with dementia
What did this involve?
Regular online meetings (should have had a face to face) Met UK partner Drive through quality in bid Lots and lots of drafting (emails) Act as quality check – English Use cloud storage
Why was it approved?
Scores were excellent - 14/15 Highest scores on impact Given a copy of the scores Targeted Dementia Targeted Isolation Scalability
What we will be doing
End user specification Testing prototypes Helping with development of semantics (speech) Final testing with people with dementia in their homes Part of 3 test settings (scalability)