A Sustainable Approach to The cost to the health economy in the UK - PDF document

Tameside Specific Health/Social Care A Sustainable Approach to • The cost to the health economy in the UK is Telehealthcare in Tameside currently under immense pressure • What this means for Tameside and Glossop • Hospital in crisis Christine Craig • Drivers for change: Service Unit Manager - The Care Act 2015 Tameside Borough Council - Integration/Care Together 19 th May 2015 1 2 Population - Tameside How can Telehealth help? Tameside Statistics • Tameside population Timely, Accurate and Targeted Health Information • More frequent & regular information gathered Population 216,731 • Vital sign observations People aged 0-15 42,364 19.55% • • Tameside is made up of 9 Health questionnaires People aged 16-29 39,189 18.08% • Targeted self care advice given • Patient feels daily engagement with their care People aged 30-44 44,460 20.51% towns People aged 45-64 56548 26.09% Better Self Management Timely & Appropriate Care • People aged 65 and over 34,170 15.77% Patient has increased awareness • • Tameside’s Health Identifying trends allows early intervention to prevent & engagement of their condition Average life expectancy (Male) 75.97341 exacerbations • Greater likelihood of lifestyle • Maintain Patient in a low cost setting whilst improving care Average life expectancy (Female) 80.97166 changes being adopted • • Council’s drivers for change Prevent Patient presenting in practice in advanced condition Size of area in km2 103.1685 • Support better medication prescription & compliance Size of area in sq mi 39.82112 • Easily gauge the impact of medication change • Telehealth wellbeing Population per km2 2100.748 Population per sq mi 5442.614 Improved Health for the Patient Conditions stabilised, better health & less likelihood of exacerbations Fewer Unplanned Interventions Reduction in A&E visits and hospitalisations Improved Quality of Life Cost Savings • • Patient feels more in control Saving in reduction for non elective admissions • Patient and or Carer may feel less • Shift to less costly interventions (e.g. telephone anxiety consultation, nurse visit self care intervention instead of • Patient remains at home for longer GP, A&E attendance • More effective medication prescription 3 4 Telehealth Telehealth Concept The Telehealth function is commissioned by Tameside & Glossop CCG and this service provides equipment fitting and advice Telehealth ‘MyMedic’ services, technical triage and monitoring, and the provision of 24 hour help and advice. Medical interventions are provided by the NHS. The focus of this service is to provide medical screening in the patient’s home, and reduces the frequency of visits to the GP and hospital. Patient feedback Telehealth is a service to support patients with long term conditions (CHF and/or COPD) in Tameside and Glossop. The service uses Telehealth monitoring appliances to transmit daily information about a patient’s condition, including weight, blood pressure, oxygen levels and temperature. Responsible clinicians will monitor this information and provide immediate support where necessary. Telehealth enables individuals to manage their long term condition effectively at home, reduce exacerbations, and can result in an early diagnosis of unforeseen health related problems, as well as empowering patients to take a more active Triage & Clinical Monitoring role in their care. It is envisaged that this service will help to reduce unnecessary A&E attendances, hospital admissions, outpatient attendances and length of stay in hospital. Secure N3 IT & Here at the Community Response Service, we currently Communications technically triage 265 Telehealth units/patients. The MyMedics Network installed are split between patients with CHF, and/or COPD. 5 6 1

Infrastructure for Managing Mainstream The ‘MyMedic’ supports multiple languages, vital signs, devices and condition specific health interviews Telehealth Services NHS Tameside & Prioritised & appropriate clinical intervention: phone Medical Device Readings Glossop User Interface • Blood Glucose consultation, self-care advice, home visits, GP appointments • Text and audio etc. • Blood Pressure • Vocal prompts can be recorded locally • Weight • Language & dialects supported • Pulse • Large graphic colour display • Oxygen Saturation Patient referred for Clinical assessment of • Variable text size • INR Telehealth Service validated data • Pictures • Temperature • Peak Flow • ECG Community Response Technical triage validation Patient enrolled via online of all data web portal Community Response Patient data accessed via Information Exchange installation visit scheduled web-based triage software • Condition specific health questions & Tameside Council Managed Service ‘branching’ • Reminders • Self-care and advice Patient trained and Daily data collection: vital Anonymised data • Medication prompts equipment installed by on- signs and health question transmitted via secure Identifiable data hosted in • Repeats readings to Patient site visit responses telephone N3-environment 7 8 MyClinic supporting multiple Patients in one location. Telehealth Pilot E.g. Residential Care Home, GP Practice • Approval was given by PCT to pilot 60 Patents in October 2011 • Proposals for the future • Aim by March 2012 was for a further 145 Patients • Currently monitoring 265 Patients • Group Homes/Extra Care Housing • Residential and Nursing Care Evaluation of Pilot Patient Evaluation • GP Surgeries • Emergency admissions reduced by • Improved self-management of their condition • Pharmacies 35% • 83% of Patients reported improved quality of • A&E attendances reduced by 40% life • Outpatient attendances reduced by • 95% said the information given was easy to 20% understand • Length of stay reduced by 70% • 88% said equipment was easy to use 9 10 Present Times Versus Future Outlook Future Present Telehealthcare • People are living longer without family • People aged 60yrs plus account for 55% support of the NHS budget • Over the next 50yrs, over 65’s are set to • Of people in community hospitals, 40% double could be supported & cared for at home • An increased need for community based Joanne Strothers • There are 30% of older people in care/support residential homes that are • Higher expectations Telehealthcare Manager inappropriately placed • Want/need to remain independent, have • Accident rates for older people continue choices and maintain dignity Tameside Borough Council to increase (Source Department of Health) 19 th May 2015 11 12 2

Today’s Objectives My Right to Choose • To increase your knowledge of Telecare • To equip you with the knowledge of how the Service and Equipment can support individuals to remain at home • To give you information to enable you to offer choices to individuals 13 14 Telecare – The Facts Building Telecare The Preventative Technology Grant “Councils are expected to invest in providing choices, health, and wellbeing • There was an £80 million in grant finance over 2 years from 2006-2008 for a diverse range of Clients” • Tameside’s share of this grant was £383,537 • Designed to help local authorities with Social Care (Building Telecare in England DOH 2005) responsibilities, and their partners to address the challenges of a changing and ageing society • To support Service Users’ increasing independence, expectations, control, choice and dignity within their own lives 15 16 Telecare – The Facts Telecare – The Facts The Aims Getting the right balance • • Balance between the use of technology and continued human contact To remain at home for longer with safety and security • • Care must be taken to ensure that technologies do not control or isolate people To reduce inappropriate admissions to Residential Care and Nursing • Some care services will always be delivered personally Care • Human contact is imperative in maintaining quality of life • To encourage earlier/safer discharge from hospital to home • Technologies will compliment traditional forms of care • To allow more personal freedom and reassurance for Carers • To meet potential shortfalls in the workforce as complimentary care 17 18 3