Moira mac kenzie, Keeping it simple in Scotland


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Keeping it simple in Scotland
Telehealth & telecare-congres
2 - 3 maart 2011

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Moira mac kenzie, Keeping it simple in Scotland

  1. 1. The King’s Fund/University Medical Centre Utrecht International Congress on Telehealth & Telecare KEEPING IT SIMPLE IN SCOTLAND Moira Mackenzie Joint Improvement Team, Scottish Government
  2. 2. Impending Doom? Or Opportunity?Durer: The Four Horesment of the Apocalypse
  3. 3. A vision of the future?Kirsty McGregpr of Community Care Dec 2010
  4. 4. Telecare & Telehealth in Scotland:Background> Launch of both activities in 2006> Different approaches adopted e.g. funding, facilitation & support, evaluation> Small to medium projects but generally unconnected local/national developments> Confusion around terminology and accountabilities> Huge enthusiasm and ministerial support> Good progress made to date
  5. 5. Progress to Date: Telecare £20m development programme and facilitation provided by SG Aims: to help more people in Scotland live at home for longer, with safety and security, by promoting the use of telecare. provide the foundation on which telecare can become an integral part of community care services across Scotland
  6. 6. Initial Objectives Increase number of telecare service users to 75,000 by 2010, including 9,000 with a diagnosis of dementia Reduce avoidable admissions to care homes, and of unplanned admissions and readmissions to hospital Reduce the need for more expensive forms of intervention Reduce the pressure on carers Improve quality of life for service users
  7. 7. Measuring Progress Initial expectations set out in business case (2006-8) Telecare Strategy (2008-10) Subject to considerable monitoring & review since outset Gateway Review 2007 York Health Economics Consortium Evaluation 2008 Quarterly Returns from Partnerships Annual Progress Reports – Newhaven Research Contributions to other research e.g. Leeds University 2009, feedback from other evaluations Telecare Action Plan to 2012
  8. 8. Progress Across Scotland (Mar ‘10) Approx 180,000 people with telecare services in Scotland All 32 local partnerships making progress 29,117 people have received a telecare service as a result of TDP, over 2,000 with dementia diagnosis Approx £10m of TDP funding had been spent out of total £14m allocated (75%) at end March Indicative gross benefits estimated £48m Continuing positive feedback from Carers/Service Users
  9. 9. Progress Monitoring Results 2009/10 Partnership Partnership Outcomes Expectations AchievementsReduction in delayed discharges from hospital 967 611Reduction in the number of unplanned hospital admissions 1,088 2,793Reduction in the number of care home admissions 2,036 1,190Number of persons able to maintain themselves at home throughreceipt of a telecare service (2009/10 quarterly average) 10,085 Partnership Partnership Efficiencies Expectations AchievementsNumber of hospital bed days saved due to reduction in number ofdelayed discharges 10,674 7,013Number of hospital bed days saved due to reduction in number ofunplanned hospital admissions. 10,922 23,747Reduction in number of care home bed days purchased 43,313 205,308Number of nights sleepover care saved 16,902 12,895Number of home check visits saved 85,778 50,472Source: Newhaven Research (2010)
  10. 10. Innovation & Integration Demonstrators Monitoring ‘Health at Home’(A&B, Lanarkshire, Lothian) Preventing & Managing Falls(Falkirk, P&K, South Ayrshire) Development of local training & Awareness Raising Programmes(Fife, Edinburgh, Falkirk/FV) Housing & Care Models(Highland, Inverclyde, West Lothian) Promotion of telecare across different user groups
  11. 11. Progress: TelehealthHealth Boards prompted to fund telehealth via annualallocations. A Scottish Centre for Telehealth wasestablished as Advisory Body within NHS ScotlandAims- Facilitate the introduction of national telehealthservices- Assist health boards with telehealth pilot projects
  12. 12. Progress across Scotland (Apr 2010)Telehealth> Significant Stroke Management & Paediatrics Programmes> Support provided to Health Boards in their Telehealth projects> Awareness Raising> Review of SCT progress undertaken and move into NHS24 now complete> Telehealth Champions Network Launched in 2010> Strategic Framework for Telehealth published to 2012
  13. 13. Criteria used for identification of servicesfor national roll-out> Economics (cost effectiveness)> Practicability> Conformity with government objectives> Severity of disease> Service profile> Net cost to NHS Scotland
  14. 14. Telehealth Priorities to 2012 4 National Programmes: stroke, paediatrics, mental health & COPD/Pulmonary Rehab Underpinning Activities: Technology standards, Education & training, Stakeholder engagement, Convergence with telecare
  15. 15. Challenges Need for more co-ordinated strategy, leadership and investment at both local & national level, which actively addresses our wider service pressures & priorities In some areas there is still a project mentality instead of seeing a significant service redesign opportunity Equipment and data integration yet to be resolved Initially slow but gathering momentum – huge enthusiasm from carers and practitioners working with the technology Telehealth & Telecare at different stages, and need for integrated community based services & care pathways
  16. 16. Joining it all together Phase 1 (2006-9): Raise awareness/develop local & national expertise Phase 2 (2010-12): Joint strategic drive, strengthen underpinning Innovation infrastructure & expand/integrate national programmes (90% roll- out/10% innovation) = Robust Platform Phase 3 (2013-15): Health & Social Care integration. Increase Expansion scale of development to inform national expansion. Increase innovation/data integration & analysis.
  17. 17. An incremental approach to change Implementing joint governance and reporting framework, linking to wider agenda Merging Telecare & Telehealth under NHS 24 from April 2011 Integrated Education and Training approach Developing detailed proposals for 2013 onwards which inform integrated health and care models Ongoing capture and review of experience
  18. 18. and finally … The Evidence Challenge Good evidence for good outcomes Good evidence for efficiencies and savings BUT Multiple claims for the same savings Real or notional savings? Gross or net savings/costs?Conclusion – Must be ‘whole system’ Must be “greater than the sum of the parts”
  19. 19. And it has to be done to generate anyevidence!The Wright Brothers 1903