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Use of Resources Mini-Summit

Use of Resources Mini-Summit. Workshop “a” – Assistive Technology. Presentation What is the opportunity? Questions What are the challenges that need to be overcome to succeed? What support & core skills does the workforce need to take this forward?

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Use of Resources Mini-Summit

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  1. Use of Resources Mini-Summit Workshop “a” – Assistive Technology

  2. Presentation What is the opportunity? Questions What are the challenges that need to be overcome to succeed? What support & core skills does the workforce need to take this forward? What kind of support is required from the regional infrastructure? Agenda

  3. “Assistive Technology” in the context of the Use of Resources Telecare and Telehealth

  4. 1st Generation - Responding to emergency situations Social Alarms - Giving 1.5m UK elderly and frail people the confidence to live at home Evolution of Telecare Response Centre Response Network User at home calls for help

  5. GP Bed Sensor Managed response Housing Services Social Services Voluntary services Neighbours, Carers... Telecare solutions – Home Risks Escalation Reassurance Response Centre Temp Extremes Smoke Intruder Inactivity Fall CO Gas Flood Lifeline

  6. Case Management Specialist Disease/ Care Management Specialist Disease/ Core Management Self Care Support / Management Self Care Support / Management Undiagnosed Security Inactivity Environment monitoring Falls Long Term Conditions where ‘vital signs monitoring’ offers limited help:Dementia Physically/Sensory Impaired Arthritis Mental illness Ageing Lifestyle Monitoring – Preventative Telecare monitoring using ADLife Undiagnosed Pre-LTC Healthy and Well Home-Based Monitoring

  7. Early discharge monitoring Outreach service Real-time alarms after transmission Temperature ECG Blood Pressure Pulse Oxymetry Breathing Rate Monitoring Centre Body Weight Glucometry Spirometry Telehealth Service Patient at Home Clinical User

  8. Current health interventions can control chronic conditions not cure Conditions where remote biometric monitoring devices can not help Conditions where remote biometric monitoring solutions can help MENTAL ILLNESS 10 million HEART FAILURE 0.5 million DEMENTIA 1 in 5 aged 80+ ASTHMA 3.7 million and 1.5 million children LEARNING DISABILITIES 1.5 million DIABETES 2.2 million diagnosed and 1 million undiagnosed ARTHRITIS 8.5 million COPD 1+ million** PHYSICAL DISABILITIES 10+ million 1 in 3 in the UK live with a Long Term Condition People in the UK living with a chronic condition* Source: *Chronic disease management”, Dept of Health, May 2004 **HSE web-site

  9. Telehealthcare Delivery Model Person Centred Services Alerts andReassurance Managed Response Social Care, Housing, Community Nursing, Friends, Family, Therapy, Meals, Voluntary Services… EmergencyResponse Response Centre Source: Tunstall

  10. The Business Case

  11. BACKGROUND 52% rise in 75+ and 76% rise in 85+ by 2025 Dependency ratio set to fall to 3:1 by 2025 from 4:1 Significant shortfall in both financial and human resources needed to provide support CSCI recommend greater use to be made of telecare OUTCOMES In May 2006 TeleG (Gloucestershire telecare project) was launched (using PTG) Analysis of the two year project has revealed actual net savings of £405,088 across 55 users Extrapolating these average savings, the external evaluator shows potential health and social care net savings of £4.27 millionacross 368 users £11.6 million across 2000 users Initial contributions to mainstream the service could be allocated pro rata 79% to Community adult care and 21% to health sector Evidence leads to mainstreaming service

  12. Background The demographic trend is acute in Essex (Tendring area has highest level of over 65s per capita in Europe) 17,300 people have dementia rising to 27,800 by 2025 This demand will require spend budgets to rise by a factor of three over next 10 yrs just to maintain services at current level. This is obviously not sustainable Outcomes £87m worth of Public Pledges 2009-10 of which £4m is dedicated to telecare equipment and support. Essex strategy offers telecare free to everyone 80+ Currently 31,337 service users (Aug 09) across 9 District / Borough Carelines 475 people issued equipment per month on average Major marketing campaign to advertise the offer to potential users and families Meeting the needs of a growing ageing populationTelecare offered free to everyone 80+

  13. Commissioning based comparison of support costs, 10% sample of 2,400 cases referred for assessment For all sample users £1 on Telecare is £3.58 saved in traditional care For all sample users with savings £1 on Telecare is £12.60 saved Savings accrue to following years 08-09 total costs £317 per user for 5,662 users Costs and Benefits

  14. Background By 2020 there will be 50% more people over 65, 54% more people with dementia If the general model of social care service provision remains the same, by 2020 NYCC will need 3,420 more domiciliary care packages and 1,817 additional places in care homes at a cost increase of £43m per annum in real terms by 2020 Outcome Today, telecare is available for all individuals needing Adult and Community Services support as part of the range of mainstream personalised solutions to suit their individual circumstances In the first year of the programme NYCC hassaved over £1 million Finance department has audited findings and approved future budget reflecting these gains North Yorkshire’s mainstreamed telecare approach

  15. In 2006/7 Care and Independence Overview and Scrutiny Committee examined the Implementation of Telecare in North Yorkshire. The report of the Chair of the Assistive Technology and Telecare Working Group 01/02/07 concluded that:- When Telecare has been implemented by authorities in a “big way” the evidence is the results can be quite startling, notably in terms of releasing hard pressed resources. Telecare must not seen as an alternative to human contact, nor is it seen as an opportunity topolice people. It is about supporting and managing risk, not about controlling behaviour. Members concluded, to gain the greatest efficiencies with resources that preventative use prior to the service user becoming critical will derive the maximum gains for organisations, users and carers. Scrutiny Committee gives Telecare mainstreaming the green light – 2007

  16. A Directorate survey carried out in Spring 2008 which had 96 respondents indicated the following outcomes. 86% - Telecare has helped me to carry on living at home 90% - Telecare equipment has given me more confidence/peace of mind 95% - Telecare equipment has helped me to feel safer 92% - Rated Telecare excellent or very good overall 86% - Rated the assessment excellent or very good 92% - Were happy with the installation Of the respondents, 80% lived alone and 45% were owner occupiers. Satisfaction survey

  17. The last 138 people assessed for telecare during the period of Sept 2008 were analysed. Some people were new to ACS and some were pre-existing with traditional support 7 cases were disregarded as outliers as it was felt they skewed the data too favourably thus final total is 131 people analysed Traditional packages were either the support that had previously been received (if pre-existing case) or for support to new people was based on care manager’s professional assessment of need if Telecare had not been available. Cost Benefit Analysis – 200838% saving in care packages

  18. The comparison was made between what a traditional care package would have looked like and what actual packages of care were including a Telecare solution. In 64 out of 138 (46%), traditional package would have been residential, EMI or nursing care In 74 out of 138, (54%), traditional package would have been care in the home. Preliminary financial analysis is indicating a gross average efficiency per person on an annual basis of between £1,756 and £12,246 per area, averaging out at £3,654 countywide a 38% reduction in care package costs. The range is between a 90% reduction in package costs and in some cases an increase if telecare added onto a residential package Additional detail

  19. Strong leadership/vision Clear 15 year commissioning plan 60+ case studies available Over 5,000 professionals and partners trained Embedded in performance management structure “Telecare enhanced care package” numbers performance managed on a monthly basis Disciplinary offence not to mention Telecare in an assessment process 12,265 telecare users (Aug 09) North Yorkshire County Council Success Factors “Here in North Yorkshire we have proven the case for telecare. It will continue to be a critical part in our commissioning strategy and our investment plans.”Seamus Breen, Assistant Director – Commissioning and Partnerships

  20. Blackpool PCT and “Vitalline” • They have run telehealth for over a year now, initially small scale 13 monitors • The PCT and Social services wrote up their findings and they have had a: • 75% reduction in hospital admissions, • 48% reduction in home visits by community matrons, • 85% reduction in GP contacts. • Mainstream progression • Now 30 monitors

  21. Background Leeds PCT has 12,500 registered COPD patients just above the national average. 8 telehealth monitors were rotated around 43 COPD patients 18 month trial funded by the Preventative Technology Grant Outcome Benefits to the patient 98% of patients found the telehealth monitors simple to use & very easy to understand The patients felt more empowered about their health Benefits to the NHS During the trial, 67% of COPD patients did not access hospital Speciality respiratory nurse home visits were reduced by 20-25% with peak periods of 50% With 8 telehealth monitors it was calculated that 172 home visits per year would be saved. With 50 telehealth monitors this would increase to 1078 saved visits Benefits to the Nurses More efficient visits to patients as nurses have triaged patients stats to give quicker diagnosis More COPD patients can be treated with the reduction in nurse home visits NHS Leeds – invest now to save in the long-term

  22. The trials go on, but some are not waiting Kent, Cornwall, Newham – (WSD participants) North Yorkshire & York Nottingham City South Tyne & Wear “…..industrial scale…..” Large Scale Telehealth Projects

  23. Presentation What is the opportunity? North Yorkshire – over £1 million of projected savings Questions What are the challenges that need to be overcome to succeed? What support & core skills does the workforce need to take this forward? What kind of support is required from the regional infrastructure? Agenda

  24. 6 point plan Business case Leadership challenge Local services – “fit for purpose”? Winning over the front line Partner plan Self funder plan Telehealthcare Service Development Plan Template

  25. Kevin.alderson@tunstall.co.uk 07740 578000 Mike.cooney@dh.gsi.gov.uk 07725 041008 We are ready to help

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