NHS 24

The National Provider of Telehealth and Telecare

The Approach in Scotland

Prof George Crooks OBE

HelsIT 2012

Population: 5.2 million

Health devolved to Scottish Parliament

NHS Funding: £11.35 billion

All Boards funded directly from Scottish

Government

Public Service funded through taxation

From urban/post industrial cities to very

remote and rural and islands

Principles of mutuality, partnership,

performance

NHS Scotland

NHS Scotland:

14 Territorial Health Boards (“hands-on”

healthcare providers)

NHS 24 is:

A statutory national NHS Health Board

Provider of national Telehealth and

Telecare services to the population of

Scotland

Budget for 2011/12: £62 million

Clydebank

East Kilbride

Kilmarnock

Dumfries

Aberdeen

Melrose

Glenrothes

Regional Centres

Local & Remote

Centres

Dundee

Cardonald

South Queensferry

Inverness

Falkirk

Shetland

Orkney

Western Isles

Highland

Grampian

Tayside

Dumfries & Galloway

Ayrshire & Arran

Borders

Lanarkshire

Lothian

Forth Valley

Greater Glasgow & Clyde

Fife

Scotland

Telephone

Internet

Telemedicine

Mobile Devices

Digital Television

Telecare/ Home Monitoring

Telehealth – Health Services provided

using one or combination of:

In The Beginning

“Core” Unscheduled Care Service

National Telephone service (24 hours) # 08454 24 24 24

Unscheduled Care (Core Service)

Out of Hours: Nights, Weekends (118hr p/w) + Public

Holidays

Clinical triage, assessment, treatment and referral

PATIENT OUTCOMES: REFERRAL/TREATMENT PATHWAYS

local OOH Service 55% (Primary Care Emergency Service)

Ambulance 5%

A&E 5%

Overall Call Demand

Average Time to Answer

Access Service Level

Abandon Rate

% Priority Calls Within 20 Minutes

% Routine Calls Within 60 Minutes

% Clinical Calls Completed Outbound

Internet Visits

April 2010 – March 2011

1,462,342

4 seconds

93.6%

0.7%

99.9%

99.9%

25.4%

1,444,280

• over 1.46 million calls per year to unscheduled care service

• over 1.44 million hits to our websites www.nhs24.com and

www.nhsinform.co.uk

NHS 24 Performance 2011/12

Evolution!!

Internet

TV

Telecare

Face

2

Face SMS

Video

Mobile

Phone

11

• General Nurses

• Nurses with specialist qualifications e.g. paediatrics, diabetes

• Mental Health Nurses

• Dental Nurses

• Pharmacists

• Call Handlers

• Health Information Advisors

• Allied Health Professionals (Physiotherapists, Dieticians, Speech

Therapists, British Sign Language Advisors

for Mental Health)

•General Medical Practitioners*

Staff & Skills

•Unscheduled Care Service

•Emergency Dental Service

•Breathing Space Service

•Cognitive Behavioural Therapy Service

•MSK Service

•Helplines as required

•Health Information and advice

• Alcohol Support Service (Taking Measures)

• Co-location with Scottish Ambulance Service

• Academically accredited Telehealth Education & Training

programme for Nurse Practitioners

NHS 24 Telehealth Services

•NHS24.com

•NHS Inform

•Care Information Scotland

•Life Begins at 40

•MSK Service

•Social Media

NHS 24 Telehealth Services

•Perinatal Advisory Service

•Patient Reminder Service

NHS 24 Telehealth Services

•GP Appointments

•Repeat Prescription Ordering

•Seasonal Health Topics

•Health Encyclopaedia

•Health Questionnaires

•Health and Social Care Web Content

•Brief Alcohol Interventions

•Life Begins at 40

•Rheumatology Review (pilot)

•Travel Information

•Employment Information

NHS 24 Telehealth Services

Digital TV

•National Tele Stroke Service

•Mental Health Services

•Cancer Services

•Palliative Care

•Tele Neurology

•Tele Dermatology

•Unscheduled Care Adult/Paediatrics

•Tele Pulmonary Rehabilitation

•National V/C Network

NHS 24 Telemedicine Services

Tele Pulmonary Rehabilitation

Cost

Conventional Delivery £131

Tele Rehab Model £76

Scottish Centre for Telehealth

and Telecare

• National Telehealth & Telecare Programmes established by Scottish Government in 2006

• Parallel programmes but increasingly integrated activity

• SCT joined NHS 24 in April 2011

• Merged in April 2011 into SCTT within NHS 24

• Telecare Action Plan & Strategic Framework for Telehealth up to end March 2012

• Now a 3 year integrated, national strategy for Telehealth & Telecare

Keep

it

S I M P L E

OUR VISION IS THAT BY 2020:

Everyone is able to live longer healthier lives at home, or in

a homely setting. We will have a healthcare system where

we have integrated health and social care, a focus on

prevention, anticipation and supported self management.

When hospital treatment is required, and cannot be provided

in a community setting, day case treatment will be the norm.

Whatever the setting, care will be provided to the highest

standards of quality and safety, with the person at the centre

of all decisions. There will be a focus on ensuring that

people get back into their home or community environment

as soon as appropriate, with minimal risk of re-admission

Whole System

Demonstrator

• 15% reduction in A+E attendances

• 20% reduction in emergency admissions

• 14% reduction in elective admissions

• 14% reduction in bed days

• 45% reduction in mortality

From Supportive Self Management

To

Co Production

Do not use disease specific solutions

ONE

PROBLEM

SERVICE

REDESIGN

ICT

Education and Training

Themes from community

engagement

• Giving back

• Caring for others

• Recognising resilience

• Sharing skills and experience with others

• Connecting people and communities

• Technology

Service Model

Local community

The Scottish Assisted Living

Programme Board

SALP Objectives to 2015

• Scotland as test bed for innovative telehealthcare & telemedicine services/ products

• Centres of Excellence in place to support collaborative working

• Improved independence, health & wellbeing for at least 10,000 people with LTC and carers support

• First stage of National Info & Care Service for people with long term health & care issues

• Emerging public consumer market for THC

• Creation of new business & employment opportunities

Innovation Centre

for

Digital Health

• Funding

• University Led

• Industry Supported

• Delivery Organisations founding PARTNERS

European Engagement

Collaboration the Key to Success