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1. OLDER AND BETTER: LIVING WELL AT HOME OR IN THE COMMUNITY RESHAPING CARE PRORGAMME

2. Margaret Whoriskey JIT TIM Eltringham, East Renfrewshire Trudi Marsha Lanarkshire

5. “ Most older people (89.5%) do not receive ‘formal’ care in NHS continuing care, a care home or a home care service organised by social work agencies.”

9. Percentage of Plans including Each Category

14. Anticipatory Care Planning and tackling polypharmacy Falls and fracture prevention Manage transitions through re-ablement, Intermediate Care and Virtual Ward alternatives to admission Manage flow of older people at A&E and in acute care Dementia whole system demonstrators Telehealthcare demonstrators – eg DALLAS LTC ehealth demonstrators

16. East Renfrewshire Reshaping Care for Older People Community Capacity Building

23. Logic model (draft)

26. RSVP “Wee Red Bus” hired by NHS Greater Glasgow & Clyde for 12 weeks to take patients to the Falls Clinic , including Jim who cares for his wife Helen who has Alzheimer’s “ Collaborative partnership working benefits all parties involved, maximises resources and ensures better results for older people” Meanwhile Levern Valley Older People’s Team refer Helen to VA Befriending Project for social support - on assessment it transpires that Jim also needs type of service of provided through ‘Chataway’ telephone befriending run & delivered by volunteers. Helen and Jim also hear about the RSVP Assisted Shopping Service using the Wee Red Bus, accompanied by volunteer buddies and start to take part Through their contact with RSVP Jim and Helen find out about support services available through the Carers Centre & Alzheimer’s East Renfrewshire Project RSVP start a weekly tearoom at underCOVER to encourage greater social interaction between people using the service and Jim and Helen come along VA Befriending Project Worker involved in setting up a seniors steering group to shape and develop use of the underCOVER building and Jim has agreed to become a member of the group Helen & Jim given information on the RSVP Medical Appointment Service run by ‘seniors’ volunteers using their own vehicles . Helen & Jim start to use the service for their GP appointments

27. Reshaping Care Older People Lanarkshire

29. Lanarkshire Community ACE Pilot

30. The Perfect Storm? Better Quality Care Less Resource Less Beds Less Doctors More Patients

31. Over 75 Admissions (Percentage Growth)

32. Over 75 Admissions (Percentage Growth)

33. Admission Avoidance Hospital at Home

36. Community ACE Team Crisis! GP ACE? First Assessment Second Assessment Within 1hr Treat Physio OT Homecare Equipment Referral Investigate Discharge MDT

45. Robopractitioner?