Telehealth In Southampton - C Webb


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  • 35 years in NHS, latterly with a very forward thinking trust and city council
  • Centres of deprivation, high smoking rates plus history of BAT factory, docks Low levels of case finding until recently SUHT is regional centre and ‘attracts’ business
  • New trust formed from 2 PCT provider units Telehealth budget is a started budget – after set up 12 months the service is meant to fund from service budgets by re-aligning budgets The 2 JES look after all the equipment and in Southampton the installer is a joint funded position across telehealth and telecare
  • As service manager my driver was always – what could you use technology for
  • This project earned additional funding from the trust to improve the service
  • Finance is always difficult as telehealth makes savings elsewhere in the system and those people then claim it wasn’t the telehealth so they don’t have to give up budget.
  • Starts getting into COM care I think!
  • Telehealth In Southampton - C Webb

    1. 1. Telehealth in Southampton Mr C Webb
    2. 2. Brief CV <ul><li>Mental health nurse and CPN (1976 – 1989) </li></ul><ul><li>Mental health service manager - community and in-patients (1989 – 2002) </li></ul><ul><li>Social services (2002) </li></ul><ul><li>PCT long term conditions and equipment manager (2002 – 2011) </li></ul><ul><ul><li>COPD, cardiac, diabetes, continence, stoma </li></ul></ul><ul><ul><li>Equipment, wheelchairs </li></ul></ul><ul><ul><li>Telehealth & telecare </li></ul></ul>
    3. 3. Location
    4. 4. Southampton information <ul><li>240,000 population (12% over 65) </li></ul><ul><li>Centres of deprivation (91 st out of 354, 4 th most deprived in SE England) </li></ul><ul><li>37 GP practices </li></ul><ul><li>Large acute teaching hospital </li></ul><ul><li>86,000 people with a LTC </li></ul><ul><ul><li>Includes COPD/asthma, CVD & hypertension, diabetes, epilepsy & all severe mental illness </li></ul></ul><ul><li>28,000 on hypertension registers </li></ul><ul><li>Unconfirmed 4000 people with COPD </li></ul>
    5. 5. Solent NHS Trust <ul><li>£177 million </li></ul><ul><li>4,200 staff </li></ul><ul><li>2 cities – Southampton & Portsmouth, and elements of the South of Hampshire </li></ul><ul><li>£25,000 core telehealth budget (Southampton only) </li></ul><ul><li>Manage all telecare work for Southampton City Council and partially in Portsmouth </li></ul>
    6. 6. Drivers for change <ul><li>Personal interest </li></ul><ul><li>EU project application </li></ul><ul><li>Budgetary pressures on staff and resources </li></ul><ul><li>Increasing frailty & LTCs increased numbers and diagnostics in the population </li></ul><ul><li>Shortening of acute admissions and desire for more community care </li></ul>
    7. 7. Uses <ul><li>Anything that needs monitoring! </li></ul><ul><ul><li>COPD ✔ (full usage) </li></ul></ul><ul><ul><li>Cardiac ✔ (heart failure) </li></ul></ul><ul><ul><li>Continence ✔ (monitoring between clinics) </li></ul></ul><ul><ul><li>Asthma ✔ (paediatric) </li></ul></ul><ul><ul><li>Podiatry ✔ (wounds between visits) </li></ul></ul><ul><ul><li>Leg ulcers ✔ (size of wounds) </li></ul></ul><ul><ul><li>Diabetes </li></ul></ul><ul><ul><li>Pain </li></ul></ul><ul><ul><li>Terminal care </li></ul></ul>
    8. 8. Telehealth in the Solent’s Community COPD Team <ul><li>The main project aims were: </li></ul><ul><ul><li>To increase the use of telehealth within the Community Chronic Obstructive Pulmonary Disease (COPD) Team, </li></ul></ul><ul><ul><li>To explore how the team could work differently to provide an effective service for an increasing number of patients with this condition. </li></ul></ul><ul><li>To measure the efficacy, benefits and cost effectiveness of the technology in supporting patients with COPD. </li></ul><ul><li>To examine the impact of telehealth on patient experience and quality of life </li></ul><ul><li>To review whether the technology improves the ability of the patient to self manage </li></ul><ul><ul><li>Over 100 Docobo HealthHUBS are in use </li></ul></ul>Additional aims
    9. 9. <ul><li>Avoided admissions : 242 to the acute sector (Oct 09 to May 11). </li></ul><ul><li>Improved data collection and data content : </li></ul><ul><ul><li>A richness of data </li></ul></ul><ul><ul><li>A greater understanding of a patient’s condition </li></ul></ul><ul><ul><li>Earlier intervention in exacerbation </li></ul></ul><ul><li>An enhanced service without increasing the number of clinical staff. </li></ul><ul><li>An improved seamless pathway with allied community staff and general practice, to provide a more sustainable service </li></ul><ul><li>Improved patient experience of the service </li></ul><ul><li>Increased quality of life for both themselves and their carers, feeling more supported and connected to the team </li></ul><ul><li>Improved knowledge: supporting the patient to learn more about their condition </li></ul>Outcomes
    10. 10. Benefits 1 <ul><li>Patients / clients /carers </li></ul><ul><li>Contentment </li></ul><ul><li>Knowledge and awareness </li></ul><ul><li>Reduction in inappropriate admissions and GP attendances </li></ul><ul><li>Reduction in dependency and institutionalisation </li></ul><ul><li>Staff </li></ul><ul><li>Improved information </li></ul><ul><li>Improved work planning </li></ul><ul><li>Reduced travel </li></ul><ul><li>Appropriate visits / clinics </li></ul><ul><li>Improved satisfaction </li></ul>
    11. 11. Benefits 2 - overall <ul><li>Reduction in admissions to hospital </li></ul><ul><li>Reduced costs </li></ul><ul><ul><li>More patients managed, same staff complement </li></ul></ul><ul><ul><li>Reduced travel costs </li></ul></ul><ul><ul><li>Cheaper alternative & earlier treatments (at home) </li></ul></ul><ul><li>‘ Green issues addressed’ </li></ul><ul><li>Patients able to ‘do’ more for themselves </li></ul><ul><ul><li>Peer support </li></ul></ul><ul><ul><li>Socialise </li></ul></ul><ul><ul><li>Potential to work longer or again </li></ul></ul>
    12. 12. Barriers to change <ul><li>Finance </li></ul><ul><ul><li>For equipment </li></ul></ul><ul><ul><li>From savings elsewhere </li></ul></ul><ul><li>Information governance </li></ul><ul><ul><li>Sharing across organisations and even internally </li></ul></ul><ul><li>Culture </li></ul><ul><ul><li>Traditional working and clinical pathways </li></ul></ul><ul><li>Staff </li></ul><ul><ul><li>Mistrust of ‘NHS IT’ </li></ul></ul><ul><ul><li>Fear for jobs </li></ul></ul>
    13. 13. Planning for development <ul><li>Examine existing clinical & care pathways to consider where innovative technology (telehealth and telecare) can be used. </li></ul><ul><li>Re-align working practice to use telehealth & telecare. </li></ul><ul><li>Work with commissioners to re-align finance alongside the new clinical and care pathways. </li></ul><ul><li>All staff to be trained in the uses of telehealth and all new referrals to be assessed for telehealth via an ‘exclusion policy’. </li></ul><ul><li>A range of telehealth and telecare to cover as many patient groups as possible, (simple and complex) </li></ul><ul><li>Link with Single point of access and virtual ward case management </li></ul><ul><li>Purchase (100) additional units for the next expansion </li></ul>
    14. 14. Future aspirations <ul><li>Telehealth & telecare systems link across NHS, housing and social care </li></ul><ul><li>Central monitoring </li></ul><ul><li>Case management via central information centre </li></ul><ul><li>Assessors, therapists work directed via information and technology </li></ul>