New care models: telemedicine – using

innovative technology to support the

delivery of care

Rachel Binks, Nurse Consultant – Digital & Acute Care, Airedale NHS Foundation Trust

Rachael Forbister, Telehealth Development Manager and Project Manager, NHS Sunderland CCG

Michael Bewell, Interoperability Engagement Lead at NHS England

Tim Ellis, Programme Director for New Technologies, NHS England

Enhanced Health in Care Homes - the art

of the possible….

Airedale & Partners Vanguard

Prison health care

Care in patient’s home

Nursing & residential care

End of life patients

24/7 clinical hub

Integrated Care hub

Gold Line

GP Triage

Teleconsultation

Why?

enhancing resident & carer experience

improving end of life

changing patient flow

reducing costs

Care Home Feedback

“It made me feel confident within my job so I could do the best I can for our residents…. It takes the pressure off us as we have access quickly to a health professional…” “The Doctor was fantastic. I would have called an ambulance and the resident would have endured an A&E visit which would have terrified her...” “Definitely reduced admission rates. Telemedicine is an asset to the home with benefits Out of Hours and at weekends”

GP Feedback

"Of all the changes in the 15 years I have been working this is the greatest change which has reduced workload I can remember.

I don't mind the extra "late" duty doc visit as this is more than made up in the drop in other visits. A big thank you to all involved."

internal analysis – data for all deaths of people who died in 2013/14

who were registered with an AWC GP

Approximately 160,000 people are registered with a GP in AWC

Total deaths 1244

Expected deaths 933 75% of all deaths

GSF code recorded 458

Known PPOD 367 A further 80 offered and deemed not appropriate to discuss, and 1 declined discussion

Achieved PPOD 212 58%

End of life - early outcomes

Place of death

National Data 2011 England %

Bradford and Airedale PCT

GSF register/ Gold Line 2013-14

Home 20.1% 20.3% 41%

Hospice 5.2% 3% ** 23%

Care home 17.8% 26.1% ** 22%

Hospital 54.5 % 48.2% 14%

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

Without TM With TM

Emergency Department Attendances

BeforeAfter

0.64 (45%) 0.35 (31%)

Cost

Per care home bed/yr Before TM After TM Difference

With telemedicine 1.13 0.78 -0.35

Without telemedicine 1.42 0.79 -0.63

0

0.5

1

1.5

2

2.5

3

3.5

Without TM With TM

Emergency Admission Rate (2012-2014)

BeforeAfter

1.07 (37%)

0.73 (32%)

Emergency (episodes)

Per care home bed/year Before TM After TM Difference

Without telemedicine 2.26 1.53 -0.73

CH without telemedicine 2.93 1.86 -1.07

Key

Care Homes Hospices Hospitals Medical Centres Own Homes Prisons

Replicable Model?

• 278 Nursing/Residential

Care Homes + further

100 in implementation

• Supporting > 10,000

residents

Building on our innovation

What will the future look like?

New models of care:

‘… in some places the

future is already

emerging, for example

in Airedale…’

Revolutionising ways of working

Lets not leave this to chance – We have a great opportunity to make a real difference…