Ageing population offers big opportunities

Engineers have a chance to develop technologies for the growing number of elderly people and cut healthcare costs, says Simon Fielden

This century offers outstanding opportunities for engineers and technologists to make significant contributions to healthcare in the UK. The government acknowledges that the traditional system cannot survive, as demand continues to grow alongside rising expectations.

Demand is now being driven not by acute healthcare needs but by long-term conditions such as heart failure, stroke, diabetes and dementia, many of which are associated with older age.

The UK population is undergoing a process of ageing, which means there are a growing number of older people and falling numbers of working age people. The number of people over 65 is predicted to rise from about 10 million to 17 million in the next 50 years.

Thus, there is a triple effect of an increase in the number of people with long-term health conditions, fewer people to generate wealth to support these needs and fewer carers to work in healthcare services.

Rising expectations stem from the development of a consumer-based society. People are no longer prepared to wait for whatever healthcare service is offered them; they demand high-quality care focused on their needs and lifestyle — personalised care.

Such demands require a radically different approach to meeting healthcare needs and will place technology at the heart of service provision. Assistive technology — any product or service designed to enable independence for disabled and older people — has a key role to play in providing care at, or close to, home, avoiding hospital admissions and speeding hospital discharges. It ranges from simple aids and adaptations such as grab rails and wheelchairs, to sensor and ICT-based technologies such as telecare.

Telecare embraces alarm-based devices in a home that could detect, for example, a fall or a flooded bathroom. It also includes lifestyle monitoring, observing how someone interacts with their home environment to ensure they are looking after themselves.

Another facet of telecare is telehealth, which is the monitoring of vital signs in the home. Such systems combine sensors, data processing and two-way communication technology to provide patient health data to clinicians and health management information to patients.

Telecare is the fastest growing sector of assistive technology development. Health and social care services are lagging behind technological capability in telecare for a number of reasons, including their risk-averse nature and workforce skills gaps.

Despite these challenges there are exciting opportunities for engineers to contribute to the field of assistive technology. The UK telecare market has undergone rapid growth and, given the demographic and social drivers, this trend is set to continue.

As a result, opportunities to contribute in the commercial sector, particularly in device design and development, continue to arise. Alongside this, engineers and technologists can make a significant contribution to direct service provision to end-users, in both health and social care organisations. This may involve aspects of clinical assessment, bespoke design and development of devices, device evaluation and risk management.

It is clear the UK will need more engineers and technologists contributing to this area of healthcare technology. There are a number of courses across the UK that combine engineering and a clinical education. For example, Coventry University’s Health Design and Technology Institute (HDTI) has a graduate diploma (top-up degree) and BSc in rehabilitation engineering.

Modules are being developed that combine telecare technology and clinical skills. These will be complemented by work placements in telecare services and graduates will be equipped to work in the private sector and statutory services.

One of the critical success factors for effective assistive technology products is user-led design. This is often a challenging area for companies as medical device regulations can limit access to service users at appropriate stages of the design and development cycle.

HDTI is to offer companies help through a usability service, targeting SMEs (supported by the regional development agency Advantage West Midlands) and larger organisations. It offers a range of services, including desk-based studies, focus group activities and field trials.

An exciting area of development for telecare technology is the move from the home into the community and the provision of truly mobile care.

Once someone is living safely and independently in their own home, the next step is for them to rejoin the community. Mobile technology solutions are being developed to address this, together with a recognition of the need for improved connectivity of devices.

From the design and development of products, through to patient assessment, service evaluation and service redesign, telecare offers engineers and technologists the opportunity to redefine healthcare in the UK.

Simon Fielden is director of the Health Design and Technology Institute, Coventry University