Long-term Conditions and Telehealth in North Yorkshire & York Kerry Wheeler, Assistant Director of Strategy – Programme Le...
The big picture - NYY <ul><li>North Yorkshire has a population base of 794,532 </li></ul><ul><li>LTC affects a significant...
Why Telehealth? <ul><li>An enabler to support implementation of LTC care pathways - fragmented </li></ul><ul><li>Emerging ...
How did we start the Project? <ul><li>April 09 - PBC Consortia approached NYY to implement Telehealth across 4 Localities ...
Which LTC are part of the Telehealth programme? <ul><li>6,705  Heart Failure  patients and 11,505  COPD  patients in NYY, ...
Progress over last 12 months...... <ul><li>Commenced work with Clinicians on redesign of care pathways for COPD, Heart Fai...
Progress over last 12 months...... <ul><li>Community Staff all trained and largest referrers – clinical advocates </li></u...
Focus during 2011/12 <ul><li>Full deployment of units by March 2012 </li></ul><ul><li>Key Projects: </li></ul><ul><ul><ul>...
What are the benefits of Telehealth? <ul><li>Alerts clinicians to priority patients / early warning of clinical deteriorat...
The common questions – clinical engagement   <ul><li>What is the evidence for telehealth?  </li></ul><ul><li>What impact w...
Commissioning Telehealth... <ul><li>Clinical engagement pre-procurement </li></ul><ul><li>Dedicated management support to ...
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Kerry wheeler hull wsdan 30 june 2011

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Kerry wheeler hull wsdan 30 june 2011

  1. 1. Long-term Conditions and Telehealth in North Yorkshire & York Kerry Wheeler, Assistant Director of Strategy – Programme Lead for Telehealth
  2. 2. The big picture - NYY <ul><li>North Yorkshire has a population base of 794,532 </li></ul><ul><li>LTC affects a significant proportion of the total population; 176,000 people registered on QOF; 50,000 with Diabetes, COPD and Heart Failure </li></ul><ul><li>Patients with a LTC are more intensive users of healthcare services </li></ul><ul><li>NHS NYY estimates a 14% increase in the population by 2020, with more people living longer and an estimated 22% increase in those aged 65+ years / 50% over 85s. </li></ul><ul><li>Prevalence of LTC rises with age </li></ul><ul><li>Financial challenges in NHS </li></ul>
  3. 3. Why Telehealth? <ul><li>An enabler to support implementation of LTC care pathways - fragmented </li></ul><ul><li>Emerging (inter)national evidence base </li></ul><ul><li>Non-elective admissions increasing by 5-10% a year against a background of reduction in financial allocation; expectation that care is provided in a different way </li></ul><ul><li>LTC - frequent cause of admissions to hospital. Example: COPD spend is circa £10 million with £3 million on primary diagnosis; </li></ul><ul><li>Rurality of NYY leads to issues regarding access to services and efficiency of service delivery </li></ul><ul><li>“ Push” from NYCC – significant impact from telecare </li></ul><ul><li>Support from the SHA to act as a pioneering site for the region </li></ul>
  4. 4. How did we start the Project? <ul><li>April 09 - PBC Consortia approached NYY to implement Telehealth across 4 Localities (Whitby, Hambleton/Richmondshire, York & Selby) as part of phased approach within longer term programme. </li></ul><ul><li>June 09 – 120 units , 2 Suppliers, establishment of project team, internal steering group and executive board </li></ul><ul><li>Sept 09 - Commenced implementation through Community Staff. Early evaluation through YHEC showed positive impact </li></ul><ul><li>Dec 09 – Procurement of 2,000 Telehealth units for full scale roll out across NYY </li></ul><ul><li>April 10 – Commencement of 3-year contract with Tunstall Healthcare </li></ul><ul><li>September 2010 – Phase 2 monitoring commenced </li></ul>
  5. 5. Which LTC are part of the Telehealth programme? <ul><li>6,705 Heart Failure patients and 11,505 COPD patients in NYY, with an estimate of 1,000’s more undiagnosed. </li></ul><ul><li>LTC with trackable vital signs indicative of health deterioration; e.g. COPD exacerbation / reduction in oxygen saturation levels, heart failure decompensation / increased weight through fluid accumulation </li></ul><ul><li>Diabetes as a co-morbidity to COPD and Heart Failure </li></ul>
  6. 6. Progress over last 12 months...... <ul><li>Commenced work with Clinicians on redesign of care pathways for COPD, Heart Failure and Diabetes – July 2010 </li></ul><ul><li>Telehealth within pathways as a clinical tool (enabler) </li></ul><ul><li>Process about system change and selection of appropriate patients, not deployment of units </li></ul><ul><li>Pathways completed & signed off by PBC and Commissioning Executive in October 2010 – NICE and Map of Medicine compliant </li></ul><ul><li>Service specifications and KPIs included in contracts from April 2011 </li></ul><ul><li>By Locality – savings plan based on implementation of pathways and deployment of telehealth </li></ul><ul><li>Ongoing clinical engagement across all sectors </li></ul>
  7. 7. Progress over last 12 months...... <ul><li>Community Staff all trained and largest referrers – clinical advocates </li></ul><ul><li>47 out of 100 Practices visited to discuss Project. 85 Practices now with patients on telehealth units </li></ul><ul><li>7 Practices referring and directly managing Patients – 34 patients in total </li></ul><ul><li>As at 20 June 346 “live” Patients on units, almost 500 referrals </li></ul><ul><li>Monthly performance dashboard – as at end of May 2011, 54% reduction in non-elective activity (150 patients for 6+ months) </li></ul><ul><li>Alert rate to clinicians – 3% </li></ul><ul><li>Telehealth website – nyytelehealth.co.uk </li></ul>
  8. 8. Focus during 2011/12 <ul><li>Full deployment of units by March 2012 </li></ul><ul><li>Key Projects: </li></ul><ul><ul><ul><li>Deployment of 1,000+ units to COPD & Heart Failure Patients from York Trust </li></ul></ul></ul><ul><ul><ul><li>Deployment of 100+ units from Haxby Group Practice (2 nd largest Practice in NYY) </li></ul></ul></ul><ul><ul><ul><li>Rapid deployment of T-Health Project within Scarborough Trust – 100+ units to Heart Failure Patients </li></ul></ul></ul><ul><ul><ul><li>Support to Craven GPCC and Harrogate GPCC on delivery of QIPP plans </li></ul></ul></ul><ul><li>Project reports through Central QIPP Board at PCT </li></ul><ul><li>Work with LMC on QOF plus GMS/PMS incentives </li></ul><ul><li>Work with the Nuffield on independent evaluation of the Project </li></ul>
  9. 9. What are the benefits of Telehealth? <ul><li>Alerts clinicians to priority patients / early warning of clinical deterioration </li></ul><ul><li>Provides easily accessible, historical, and current trend data and health interview responses, to all clinicians involved in the patients care. </li></ul><ul><li>Supports clinical decision making and monitoring during changes in the patients therapy </li></ul><ul><li>Patients more in control and confident to manage their own condition leading to improved quality of life </li></ul><ul><li>Potential to support Early Supported Discharge Schemes from acute hospitals </li></ul>
  10. 10. The common questions – clinical engagement <ul><li>What is the evidence for telehealth? </li></ul><ul><li>What impact will this have on my workload? (3% crucial) </li></ul><ul><li>Will we get paid for the extra capacity required to do this – shift in workload? </li></ul><ul><li>How do I select the right Patients and set alert limits? </li></ul><ul><li>What are the costs for this? (either upfront or post PCT funding) </li></ul>
  11. 11. Commissioning Telehealth... <ul><li>Clinical engagement pre-procurement </li></ul><ul><li>Dedicated management support to take Project forward </li></ul><ul><li>Clear reporting/governance for Project to Board </li></ul><ul><li>Identify clinical champions </li></ul><ul><li>Good Comms/PR essential – mixed messages </li></ul><ul><li>Telehealth – clinical tool to facilitate service change </li></ul><ul><li>Prove not just another short term initiative </li></ul><ul><li>Patience! </li></ul>

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