E n h a n c e d h e a l t h i n c a r e h o m e s Rachel Binks, Nurse Consultant - Acute and Digital Care Airedale NHSFT The Art of the Possible - Enabling Care Homes with Technology

E n h a n c e d h e a l t h i n c a r e h o m e s telehealth, e health, digital health…..  Telecare  Telecoaching  Telemonitoring Teleconsultation

E n h a n c e d h e a l t h i n c a r e h o m e s some people seem to do quite well without waiting for healthcare support…… a system designed by default

E n h a n c e d h e a l t h i n c a r e h o m e s

right care today Teleconsultation Prison health care Care at home Nursing & residential care Supporting end of life patients 24/7 clinical hub improving patient experience changing patient flow reducing costs Electronic shared record connecting primary & secondary care now connecting whole health & social care economy tomorrow -5% -14% -5% -14%

E n h a n c e d h e a l t h i n c a r e h o m e s Key Care Homes Hospices Hospitals Medical Centres Own Homes Prisons replicable model 361 Nursing/Residential Care Homes in implementation Supporting > 14,000 residents

E n h a n c e d h e a l t h i n c a r e h o m e s Provide, safe, effective high standards of care To support residents to stay at home Support residents/nurses/carers in the planning, and delivery of care Escalate to community teams out of hours aim of the service

E n h a n c e d h e a l t h i n c a r e h o m e s activity

E n h a n c e d h e a l t h i n c a r e h o m e s what would you have done?

E n h a n c e d h e a l t h i n c a r e h o m e s

actual GP referrals

E n h a n c e d h e a l t h i n c a r e h o m e s

care homes - call outcomes

E n h a n c e d h e a l t h i n c a r e h o m e s care homes – onward referrals

E n h a n c e d h e a l t h i n c a r e h o m e s innovation potential

E n h a n c e d h e a l t h i n c a r e h o m e s remote training and clinical support? Support for care home staff using the VTR Support for DNs and community teams – do they need to attend? Overview and clinical support of care home staff developing enhanced roles Remote out patient clinics

E n h a n c e d h e a l t h i n c a r e h o m e s what is the gold line? 24/7 service for any patient thought to be in the last year of life - and their carers Linked to entry onto Gold Standards Framework Mostly a telephone service with addition of video-consultation for a subgroup Designed with and for patients approaching end of life Developed in partnership Health Foundation shared purpose grant

E n h a n c e d h e a l t h i n c a r e h o m e s call outcomes Disposition after call, year ending Oct calls, 475 to report death, of the 6040 remaining:

E n h a n c e d h e a l t h i n c a r e h o m e s Avoidance Outcomes – Oct 2014 – Sept 2015Totals Admission Avoided118 A&E Attendance Avoided231 GP Visit Avoided438 Community Nurse Visit Avoided228 goldline impact

E n h a n c e d h e a l t h i n c a r e h o m e s National data England 2013 AWC 2013Bradford District 2013 Bradford City 2013 GSF/Gold Line Year 2013/14 All deaths in hospital % All deaths at home % All deaths in care homes % All deaths in hospice 5.5% % data from End of Life Care Profiles PHE and District wide reporting (CSU)

E n h a n c e d h e a l t h i n c a r e h o m e s patient and carer feedback

E n h a n c e d h e a l t h i n c a r e h o m e s

Other services delivered from the digital care hub GP Triage Intermediate Care Hub Acute Care Team Single Point of Access Complex Care Team Shared record Registered practitioners Visual contact

E n h a n c e d h e a l t h i n c a r e h o m e s Technology Enabled Health - the art of the possible…. questions ?