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  1. Meeting the challenges of personalistion: A KPMG Perspective

  2. We can’t go on like this...... By the end of the 21st Century the UK will, if current trends continue, be spending over half its GDP on healthcare.

  3. Our population change challenges are very profound.... Projected % Population change in Scotland 2002 to 2027 Source: Annual Report of the Registrar General for Scotland

  4. The Challenge • In Scotland, it is estimated that around 1m people have at least one long term condition • By 2028 there will be 55% more people over 65 and double the number of over 85s • Today’s UK care market is estimated to be worth over £14bn pa, with over 24,000 public, private and voluntary organisations providing care for over 1.2m older adults • The future? • Over the next 20/30 years institutionalised care as we know it may all but disappear • Policy driven market will be replaced by client and technology driven services • People need help to plan, manage and select funding care themselves • Integration of teams – for example, joint community mental health teams, across health and social care • Transforming community services (TCS) - with formal vertical integration within health (acute and community) • Specific pathway integration – for example a COPD care pathway across health and social care where there is no formal organisational integration

  5. Personalisation – reflections on existing experience • Personalisation – personal budgets and/or personalised focused services? • Pace of change in matching supply and demand • Demand management – through re-enablement and technology • Implementation requires: • Integration of services, with service user at the centre of a joined-up care pathway • Service configuration to enable maximum proportion of people to live at home in a supported environment • Cost efficiency by managing provider market effectively and drawing on voluntary sector and new business • Choice to enable people to tailor their care packages to suit their circumstances

  6. Torbay Care Trust “I’ve seen the future. It’s Torbay” – David Nicholson, CEO, NHS England • Integrated health and social care teams. Care trust established in 2005. Single budget for health and social care. Increase in spending on intermediate care. • Results: • Reduction in hospital bed use – daily average from 750 in 1998/9 to 502 in 2009/10; • Low use of emergency bed days in patients aged 65 or over. 1920/1,000 population compared with regional average of 2698/1000 population 2009/10; • User and staff satisfaction have both improved. • Visiting other integrated healthcare providers around the world inspired innovation.

  7. Integration requires enablers – and the use of technology is key • Telehealth – equipment and services used to remotely monitor aspects of a person’s health in their own home. (KPMG LLP) • Telecare – a combination of remotely monitored passive alarms, sensors, other equipment and services to help people live independently. (KPMG LLP) • Assistive technologies – a product or service designed to enable independence for people with health and care needs, such as long term conditions (LTCs) or the frail elderly. (KPMG LLP) • Telecoaching – supports the practice of health care/social care, enabling self care, using one to one interaction, audio, visual and/or interactive communications. (Buying Solutions, UK) • Telemedicine - any application of information and communications technology which removes or mitigates the effect of distance in healthcare. (www.show.scot.nhs.uk/telemedicine)