Master slide deck from the Health Sector Business Breakfast at West Cheshire College, 7 December 2017

1. Presentation 1Welcome
@Innovationnwc
Business Breakfast

2. Presentation 1
Welcome
Andy Seddon,
Senior Projects Officer
Cheshire West and Chester Council
@Innovationnwc
Business Breakfast

3. Presentation 1
Welcome
Inderjit Singh,
Commercial Programme Manager
Cheshire & Warrington
@Innovationnwc
Business Breakfast

4. Innovation Agency
Role of Commercial Team
• Collaborate with SMEs, voluntary sector, academia,
• Introduce technology and innovation into the NHS
• Facilitate in spread and adoption
• Result care and services are:
• better
• safer
• faster
• cheaper

5. ERDF programmes
• Commercial assistance for SMEs (also Clinical support)
• 12 hours of FREE support
• Support varies depending upon business needs
• Can include:
• Introduction to clinicians
• Support setting up pilots
• Evaluation & evidence
• Funding support
• Strategic advice

6. Companies
• Companies currently receiving support
Company Description
Passion for Life Device for snoaring and developing app for sleep apnia
Riverbank Pyschology Programme for developing positive mental health of children using technology
Prep 360 Preparing patients for surgery focusing on weight management, nutrition
Independence – Telecare Remote health check monitoring
UK HearingCare Hearing aid assessment and accessory supplier
HeadSalad Programme of well being and resilience for the mental health of children
MedtoTech Device for testing the full cascade of coagulation
Robotik Automated robots for medicine packing

7. Purpose of Event
• Opportunity for NHS colleagues to highlight some
issues and problems they are facing
• SMEs to make comments / suggestions for possible
solutions
• Network to develop relationships

8. The Cheshire Care Record
Bringing together health and social care data across
Cheshire
Patricia Reilly – Head of Informatics Engagement

9. Right Information, Right Person, Right Time
= Right Decision
Therefore why wouldn’t health and social care:
1. Share records, appropriately and securely, for the
benefit of citizens to improve safety, outcomes, quality
& efficiency
2. Ensure that their staff have access to shared records to
improve the care they provide to citizens
Sharing Information

10. • Initial plan to create the West Cheshire Care Record
• Extended to East Cheshire, South Cheshire and Vale Royal
• Focus on supporting provision of direct care
• Refreshed in near-real-time or as clinically appropriate
• Compliant with Information Governance standards
• Consent (implied to share/explicit to access)
Background

11. Objectives
Improve Quality/Safety/Efficiency/Staff Experience
• Reduce the need for a person to tell & retell their story
• Reduce the need to understand/navigate the care system
• Support efforts to reduce incidents of avoidable harm
• Reduce unnecessary admissions & minimise stay
• Avoid unnecessary/incorrect testing, diagnosis & treatment
• Reduce staff time spent hunting & gathering information

12. Overview

13. Technical Solution

14. 736,000 People

15. The Portal

16. Feedback
“So exciting…. utterly fantastic!
This is a really useful inter-agency
mechanism for gathering accurate
information quickly and securely”
“Excellent for inter-professional
communication, so useful for
referrals as clinicians can access
more of the whole picture of a
service user, which in turn can only
lead to a better understanding of
service user and ultimately
informing care“
“The Cheshire Care Record has
made being on-call in A&E and
MAU so much easier”
“Extremely helpful in
making the admissions
process as smooth as
possible”
“It is helpful as an extra source of
information to both validate what
patients are telling me and to
discover missing clinical data
which makes all the difference to
the patient episode”.
“Improves safe delivery
of care””

17. 1. Improved safety
2. Improved experience
3. Improved care outcome
……for the individual
Enables

18. Citizen Access……..
Over to you…….
Next Steps ……

19. Use of augmented reality in
supporting people who attend AED
with self harm.
Dr Cecil Kullu
Consultant psychiatrist
Associate medical director research
development and innovation

21. The AED and mental health
• 200,000 episodes of self harm presentations
to the AED every year in England.
• It accounts for one of the top five reasons for
AED Admission.
• Risk of suicide is 49 times greater for people
who present with self harm.

22. Figure
The Lancet Psychiatry 2017 4, 759-767DOI: (10.1016/S2215-0366(17)30367-X)
Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0
license Terms and Conditions
Mean cost of self harm is estimated at £809 per episode and approx £162 million per year
The Lancet Psychiatry
Volume 4, Issue 10, Pages 759-767 (October 2017)
DOI: 10.1016/S2215-0366(17)30367-X

23. AED environment and mental health
• Busy and pressured.
• Environment is not really designed to deal
with mental health crisis.
• Variations in standards of knowledge, practice
and care from hospital staff who have first
contact.
• Poor experience for people with mental health
problems.

24. AED and self harm
• Long waits.
• Very little information on what is likely to
happen and when.
• Very little help/support/guidance available
immediately for mental distress and to
manage symptoms.

25. National Guidance
• NICE guidance on management of self harm.
• Mental health care in emergency departments.
Mental health toolkit. RCEM-2017.
• Better services for people who self harm: quality
standards for healthcare professionals (Royal
college of psychiatrists 2006).
• Self harm, suicide and risk: helping people who
self harm. Report of working group, 2010.
RCPsych
• Feeling on the edge – leaflet, RCPsych.

26. Augmented Reality

27. Augment Reality
• Media and digital.
• Using experience of patients and clinicians to
inform use of technology in this context.
• Develop a mobile platform to deliver Information
and Support -alternatives to self harm and self
management techniques ( evidence based),
contact for immediate help, prepare for
assessment .
• Programmes delivered by people who have used
services.

28. Outcomes
• Reduced distress and agitation
• Reduced self harm in AED
• Better engagement with assessment and
treatment pathways.
• Optimal use of resources
• Reduction in risk of suicide

29. Presentation 1Business Breakfast
7th November
Dr Phil Jennings
Medical Director

31. UtilitiesComms
Office
Supplies
Legal
HRAccountancy
Website
Newsletters
Telephony
Signage / Information
Heating & Lighting
Waste
Maintenance
Gardening
Postage
Printing
Paper
Office Furniture
Filing / Storage
Property / Tenancy
Hiring & Firing
Bookkeeping
Partnership Agreements
Pensions
Payroll

32. Clinical Admin Self Care ?
Triage Information
Automation
Medication
Aids
Standard
Letters
Apps
Wearables
Long Term ConditionsSocial Prescribing

33. Challenges for CSUs in
supporting IT in an Accountable
Care System
Derek Kitchen
Managing Director
Thursday 7th December 2017

34. MIDLANDS AND LANCASHIRE COMMISSIONING SUPPORT UNIT 34
MLCSU… in numbers
34

35. 35MIDLANDS AND LANCASHIRE COMMISSIONING SUPPORT UNIT
Midlands and Lancashire CSU

36. Accountable Care Systems
• Multiple ACSs across our patch
• Each has its own challenges
• Legacy Systems, some need to change, improve interoperability and drive
improvements in delivering patient care
• Many challenges around old technology, end of life systems, resistance to change
and funding to name but a few
• Some scale:
2 Community Trusts 20,000 users
1 Acute Trust 1250 General
Practices
2 Mental Health Trusts 30 CCGs
Four third sector
organisations
NHSE & Private
Sector

37. Two questions….
• How can the supplier community assist us with addressing the
challenge of achieving effective health economy wide systems
integration and interoperability?
• How can the supplier community support CSUs to ensure robust
cyber security arrangements are maintained across their full
range of clients and underpinning infrastructures?

38. MIDLANDS AND LANCASHIRE COMMISSIONING SUPPORT UNIT 38
Areas for consideration
• Developing 5 year technology road maps
• Agreeing schedules for new software releases
• Closer supplier cooperation to ensure consistency of user experience
• Implementation across multiple organisations
• Partnership working with CSUs
• Innovative charging models
• Rapid CareCERT compliance with interdependency identification and close
cooperation between all suppliers

39. Chester  Ellesmere Port & Neston  Rural
Making sure you get the healthcare you need
How do we use innovation to
reduce cost pressures on CCGs?
Mathew Roberts
Project Support Officer
07th December 2017

40. Making sure you get the healthcare you need
West Cheshire CCG
NHS West Cheshire Clinical Commissioning Group (CCG) is responsible for commissioning
health and care services for the people of West Cheshire, using a £340m budget to
ensure high-quality, sustainable healthcare for our population of 261,000 people
We are responsible for commissioning:
• GP services
• Planned hospital care
• Urgent and emergency care
• Community health services

41. Making sure you get the healthcare you need
41
Our Programmes
Planned
Care
Starting
Well
Urgent Care
Mental
Health &
Learning
Disabilities

42. Making sure you get the healthcare you need
42
Planned Care
Planned care refers to services for people with long-term conditions as well as
planned hospital care
In 2018/19 our Planned Care programme will focus on;
Improved prevention and self-care management of long term conditions,
specifically:
• Cardiovascular disease, Diabetes, Cancer, Respiratory, Rheumatological
conditions.
• Avoiding unnecessary secondary care admissions of long term conditions

43. Making sure you get the healthcare you need
43
Starting Well
Starting Well Programme focus is on supporting babies, children, young people and
their families to have the best start in life.
In 2018/19 our Starting Well programme’s focus will include;
• Increasing the opportunity for primary school children (nursery – year 6) to be more
physically active during the school day
• Increasing patient empowerment and self-care.
• Improving the quality of life for young carers (6-18 years)

44. Making sure you get the healthcare you need
44
Urgent Care
West Cheshire’s urgent and emergency care services include emergency “blue light”
ambulances, Accident and Emergency (A&E), NHS 111 (non-emergency line) and out of
hours services which operate when GP practices are closed. In 2018/19 our Urgent Care
programme will focus on;
• Improving admission avoidance from care homes
• Supporting and improving falls prevention services
• Supporting the reduction of delayed discharges from hospital

45. Making sure you get the healthcare you need 45
Mental Health and Learning
Disabilities
Many people’s lives will, at some point, be touched by mental ill-health. In 2018/19 our
Mental Health and Learning Disabilities programme will focus on;
Mental Health
• Support the delivery of emergency and out of hours mental health services
• Improve timely access to appropriate services
• Improved delayed discharge from hospital
• Treatment and care in the best place
• Support transformation of CYP mental health services
• Avoiding admissions into secondary care services
• Community based support (following discharge)
• Improving dementia care particularly post diagnostic support

46. Making sure you get the healthcare you need 46
Mental Health and Learning
Disabilities
Many people’s lives will, at some point, be touched by mental ill-health. In 2018/19 our
Mental Health and Learning Disabilities programme will focus on;
Learning disabilities
• Improve timely access to appropriate services
• Improved delayed discharge from hospital
• Treatment and care in the best place
• Avoiding admissions into secondary care services
• Community based support (following discharge)
• Supporting the improvement of Learning Disability pathways and post
diagnostic support for ASD and ADHD services

47. Making sure you get the healthcare you need 47
Overarching themes
• Prevention
• Self-Care & Management
• Admission Avoidance
• Improving delayed discharge

48. Making sure you get the healthcare you need 48
• Financials restraints
• Interoperability of systems
• Resources & existing cultures
Obstacles and Limitations

51. • New Investments
– Novo Nordisk Diabetes Research Centre
– UK Life Sciences Discovery Centre
– QIAGEN/Health Innovation Manchester:
Genomics and Diagnostics campus
• Health Advanced Research Programme
• Manufacturing
• Data
• NHS Collaboration
• Skills

52. Presentation 1Thank you for coming!
@Innovationnwc
Business Breakfast