Title: Mobilising knowledge to improve assistive technology commissioning, service provision and sustained implementation
Funder: Department of Health and Social Care

Abstract: Global health and social care policy views assistive technology (AT) as integral to new ways of working that make best use of limited resources by improving access to care and supporting people with complex long-term conditions to live independently at home. However, AT in England struggles to be part of mainstream care provision with sustained use and opportunities for wider spread and scale-up. Local authority commissioners are committed to technological innovations but need help to synthesise knowledge about AT effectiveness and assess the relative value of myriad devices for both service users, carers and the supporting services. The aims of this Fellowship are twofold; to research AT uptake in one local authority, and acquire new knowledge and skills in knowledge mobilisation to support future work on the use of AT. Specifically; To undertake research that addresses the key challenges to AT implementation for community dwelling people living with frailty and or long term conditions within a local authority To test and refine a technology implementation framework (NASSS) for predicting and evaluating the success of AT implementation To draw on a communities of practice perspective to identify and foster new ways of working to address the key challenges to AT implementation for community dwelling people living with frailty and or long term conditions within a local authority To develop as a leader and exponent in knowledge mobilisation to support future implementation of AT that aligns with the views and aspirations of (potential) service users and service priorities. Organised in two phases, phase one will map (including documentary analysis, review of service uptake and interviews with key stakeholders) the context of existing and planned AT provision in the local authority for older people. This will provide a systematic account of how implementation of AT has been achieved (or not), the data available, and planned or established AT interventions that offer opportunities for learning. Phase two is the case study phase. Using participatory research approaches that emphasise context sensitive plans of action and progress review, two AT projects will be studied in depth. The implementation framework will structure data collection on implementation. As part of the action research cycle, co-design approaches supporting communities of practice (that include users) will be explored to see if knowledge mobilisation impacts on AT becoming embedded within service provision. The education and training programme that accompanies this work will inform the project in three ways. It will provide training in leadership and theories of knowledge mobilisation and develop national and international collaborations with AT researchers, health and social care professionals, service users and carers, working to support the implementation of AT that is evidence informed and adaptable to the needs of AT users and the services that support them. This Fellowship addresses the well documented need to develop context sensitive approaches to AT implementation that can build on the evidence of what works and reflect the everyday challenges of working with multiple stakeholders and organisations.

Lay abstract: Mobilising knowledge to improve assistive technology commissioning, service provision and sustained implementation. What are the challenges of sharing knowledge about technological equipment that supports older people? Assistive technology' is equipment that can help people with health and care challenges to live as independently as possible. It includes alarms to help people to stay safe around the home and devices that make it easier for people to keep in contact with others. Knowledge mobilisation' means using the evidence from research to influence the way in which healthcare is provided. Governments worldwide are keen for health and social care organisations to make the most of assistive technology in the services they provide. There is a lot of technology on the market and pioneering products are being developed at a fast pace. People in charge of services are learning about assistive technology from those who design and sell these products, from research about what the technology can do, and from talking to people who might use the devices about what they want. It can be difficult to bring all this knowledge together in decisions about how assistive technology can improve people's care. In my project I will help professionals in health and social care to identify what they need to understand about people's lives, about new and current technology and the different priorities of people involved in designing and delivering services. This will help to choose assistive technology that fits with the person and the services supporting them. I want to find out what helps assistive technology to become a useful part of health and social care support for older people with multiple needs living at home. My proposed research: I will work with Hertfordshire County Council as they introduce new assistive technology as part of their services. I will also get support from two NHS organisations working to ensure patients and service users benefit from the best research evidence (CLAHRC East of England and the Eastern Academic Health Science Network). I will use research methods that involve, from the outset, those who are using or working with assistive technologies. My research activity will include: Looking at current local practice and knowledge. Talking to people about their experience of using services and their knowledge of assistive technology. Identifying older people to work with as they start using new assistive technology. Observing and interviewing older people and others supporting them about the advantages and challenges of using the equipment over time. Testing a new framework for predicting and evaluating the success of assistive technology for older people. This will help us to understand what needs to be in place so that people and organisations really benefit from assistive technology. Involving patients/service users and the public in research ensures studies are accountable to the people whom the research might affect. It also results in more relevant research. A reference group made up of experts by experience will support this project and current users of assistive technology will be part of my project steering group. I will work with these people, among others, to find the best ways to tell people the results of my research. This may be through blogs and social media. One idea is to develop a YouTube video on what works when introducing and using assistive technology. I will also share findings through academic papers and presentations. Finally, I will produce guidance that helps professionals consider what they need to know to develop an assistive technology service that will improve experiences for people using it and improve the delivery of care.

Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE