Around 150,000 people receiving home care also require assistance with shopping, but council-run schemes are under pressure and new approaches are needed. This report is the first major study whether the introduction of 'teleshopping' - using information and communication technology (ICT) - could help provide home shopping services.
The report opens with a discussion of previous initiatives, and the current impetus towards teleshopping arising from changes to government care policy. It then evaluates a series of pilot teleshopping trials run by Bristol City Council and the Dolphin Society in relation to the city's existing home shopping service. These involved a variety of models linking the service user, home care assistant and supermarket in different ways and with alternative approaches to payment and delivery of the goods.The report confirms that lack of access to computers or interactive digital TV, lack of computer knowledge, and the limited use of credit or debit cards among many service users, are all current barriers to the introduction of internet-based teleshopping models.
The authors outline a simplified ICT-supported system which would overcome these issues, but this will need the support of major supermarkets for further development.
Teleshopping for people with limited mobility
Home shopping is an important aspect of community care services for older and disabled people, but is costly and complex to administer. As social services struggle to find the necessary resources to support them, new approaches involving internet- or phone-based 'teleshopping' services are being explored. This research, by James Barlow of Imperial College London and Mary Breeze of Bristol City Council, designed and tested several models for teleshopping. It has provided new information on user needs, possible teleshopping models, and on technology options and financial and legal issues. An intermediate teleshopping model, for use before internet access becomes widespread, is identified. The project also explored the technology requirements for a more sophisticated internet-based service that might be developed in the future. The study found that:
- Past attempts by local authorities to introduce teleshopping have often foundered because supermarkets did not co-operate fully or because the service was linked to wider objectives and the shopping element was under-used.
- Low ownership of computers and digital interactive TV, limited computer experience, but near universal access to the telephone amongst current home shopping service users, suggest that, in the short-term, a telephone-based model is more likely to succeed that an internet-based one.
- A teleshopping service which requires the use of bank cards would exclude many people. However, if the direct payment of pensions becomes established, bank cards will become more familiar and their use may become more widespread amongst older people.
- Different internet-based teleshopping models piloted in Bristol suggest that this approach could be acceptable in the longer term. For the current generation, an interim solution is needed. This might involve the use of intermediaries ordering online for their clients. Another option would be to develop a simplified system of home-based ordering involving bar-code readers and catalogues of goods. Both would be cheaper to run and offer greater choice than the current system, but would require alternative payment methods to be developed.
As age and frailty increase, a visit to the shops for essential supplies can become a major burden or an impossible task. Home grocery shopping services using information and communications technology (ICT) - generally called teleshopping - have been developed over the last twenty to thirty years. Several early schemes in the UK involved collaboration between local social services and retailers in order to address the problems of people accessing grocery stores. Most of these schemes failed to progress, largely because the technologies used were not robust.
In recent years the growth in internet use has given renewed impetus to local authority teleshopping schemes. Several models are in use on a small scale. These generally involve either the internet or telephone, with assistance from social services, the voluntary sector and grocery retailers.
Online shopping has not proved popular amongst the clients of local authority home shopping services. This is partly because of the lack of ownership of bank cards or wariness about using them online, and partly due to low levels of computer literacy. However, there is evidence that cost, productivity, and value for money benefits can be achieved through services based on the telephone and the internet.
Bristol's existing home shopping service
In Bristol, local home care team leaders have some discretion over the way they operate the home shopping service. The normal model is for home care assistants to visit the client at home to collect their list and money, shop at the supermarket and deliver the groceries with the change. The case study district was representative of group shopping schemes, where the shopping for several clients is batched and carried out weekly. The area contains approximately sixty clients, served by five home care assistants.
There are many benefits to the existing system and clients are very supportive of the service. As well as doing the shopping, home care assistants provide valuable social contact and support and are trained to report changes in service users' health or behaviour. There are, however, a number of problems with the current approach.
For the individual client, there is little choice over the supermarket, and the shopping can only be carried out on a specific day. Because they do not visit the supermarket, many clients are unable to update their shopping list and may have a limited diet because they do not have current knowledge of goods that are available. Given that the average cost of a weekly shop is about £20, the service charge of £7-10 is very high.
There are also problems relating to the home shopping process because of complications in carrying out transactions for groups of clients and dealing with special offers and loyalty points. The physical volume and weight of shopping carried by home care assistants can also be a problem and there is a security risk in collecting cash from clients.
For Bristol as a whole, the total cost of the home shopping service is high. At between £1.2m and £1.7m per annum, it represents about a fifth of the total home care budget. There is also a chronic shortage of home care assistants, and shopping represents a significant drain on their time.
Bristol's teleshopping trials
With support from the Dolphin Society, the researchers designed and tested four different approaches for teleshopping in the case study area (see Table 1).
|Models||Pros and cons|
|Assisted online shopping: home care assistant |
visits the client with a laptop computer
|Gives client more choice and personal influence – 88 per cent were happy to use this method |
Expensive compared to the current home care service, but improved social contact is achieved due to the time spent with the client
Opportunities for wider social interaction, by using a computer in a communal setting in sheltered accommodation
|‘Virtual shop’: home care assistant and client meet at a community centre to place the order online||Would be considerably faster per transaction than the current approach (about thirty minutes compared to one hour), but this would be negated once the time taken to transport clients to the community centre is included|
|Standard supermarket telephone shopping service||Can give client independence with their shopping |
Only one major national supermarket chain offers a telephone ordering service and it is not generally publicised
Useful for those who can devise their own shopping list, have bank cards and are able to use them on the phone, and are sufficiently organised to store their customer details safely
Clients need to be able to cope with some variation in delivery time
Telephone ordering reduces social contact, compared with the current home care service
Some people may need assistance in registering and placing initial orders
|Council-run telephone ordering: home care assistant rings the client to take their order||Would be cheaper to run than the current service |
Clients could be given a choice of supermarkets, but would lose social contact with a home care assistant
Would be suitable for people who are capable of giving their order over the phone and can cope with some variation in delivery time
Complex problems over responsibility for payment
Telephone ordering reduces social contact, compared with the current home care service
|Ordering using digital interactive TV||User interface was relatively simple but it was hard to manipulate using a TV remote control without a dedicated cordless keyboard |
Relatively fast, at around thirty minutes per transaction
As well as trialling these models with service users, a digital interactive TV shopping service run by one of the major supermarkets was used on three occasions to shop for a standardised shopping list.
The trials were evaluated by comparing them with data obtained on the current shopping system. This included the service users' perception of the quality of the service and cost effectiveness.
In time, use of the internet will rise and the difficulties caused by low use of bank cards amongst disadvantaged groups will probably cease to be the problems they are today. There is, however, a need to develop intermediate teleshopping models to cover the period before there is widespread computer access and experience, and before digital interactive TV ownership becomes mainstream. The Bristol trials suggest that a simplified ICT-supported system is needed. This should be based on intermediaries who handle the transaction, but without the need for individual service users to have access to the internet or use a bank card.
One such model involves council-run telephone ordering. Here, an intermediary such as the home care assistant telephones the client to ask for their shopping list and to check their welfare before placing the order online and paying with a centrally held credit card or account. Selection of the goods and delivery is carried out by the supermarket. Clients are invoiced monthly for their goods and can pay in the same way as they do for home care charges. This approach needs appropriate software to relate the cost of a service user's transaction to the entry on their invoice to be developed. Other than this, the service would simply require access to the internet and a telephone line.
Another approach would be to develop a system which allowed people to order groceries directly from the supermarket, without the need for an intermediary. This could involve the use of a bar-code reader to scan items in a catalogue and send a shopping list to a chosen supermarket using the home telephone line.
The costs to local authorities
The annual cost of the various teleshopping models is estimated to range from about £1 million for council-run telephone ordering to £2.2 million for assisted online shopping. The local authority would not, of course, incur costs if individuals paid the delivery and phone charges associated with standard supermarket telephone ordering.
While the council-run telephone ordering model might therefore allow a local authority to make significant savings on its home care budget, this is to take a narrow perspective on the costs and benefits of home shopping. Visits by home care assistants represent a significant opportunity for social contact for older and disabled people, with benefits and resource implications for other parts of the care system.
The need for clients to use a credit or debit card for payment was a major problem during the trials. There are difficulties in using a local authority credit card, partly because of the problems in tracking individual payments when a single card is used for multiple orders. This could be resolved if supermarkets issued two receipts for each transaction - one for the client and the other for the local authority. An alternative solution would be either for clients or the local authority to hold an account with a particular supermarket, so that, in effect, the supermarket was giving credit for the goods.
The longer term
In the longer term, problems relating to internet access and computer literacy will be eroded. There are several government strategies for reducing the digital divide, including initiatives to develop public internet access points and projects to 'wire up' disadvantaged communities. Other platforms, notably digital interactive TV, may overtake the personal computer as the principal means of accessing the internet from home in the next few years. Developments in database and interface technologies may radically change the home shopping experience for older and disabled people. The complexity of website use and navigation, and the difficulty of delivering a personalised service electronically, may be overcome through the development of the 'electronic personal sales assistant'.
Whichever approaches to teleshopping emerge over the next decade, they will need to take into account the specific requirements of older people and alternative payment methods. This will need co-operation from supermarkets, as well as social care policy decisions about subsidy and access.
About the project
The project was carried out in collaboration with Bristol City Council and the Dolphin Society, a local charity which provided the funding for the trials and Mary Breeze's post. The project focused on Bristol as a typical larger urban area faced with an ageing population and competing pressures on its social services. The models for home shopping will, to some extent, need to reflect the social, economic and geographical characteristics of the areas they serve - what is financially viable in a large urban area will not necessarily be so in a lower density, rural community or a small country town.
For more information about the project, contact James Barlow, Innovation Studies Centre, Tanaka Business School, Imperial College London, South Kensington Campus, London, SW7 2AZ, Tel: 0207 594 5928, Fax: 0207 594 5915, email: .