Health Technology & Supported Self-Care in Liverpool The International Technology Enabled Care Conference 2017 Carol Hughes Clinical and Operations Lead Liverpool Community Health NHS Trust Title of Presentation goes here

2011: Liverpool’s telehealth journey began Why Telehealth… 30% of residents in Liverpool have a long-term condition Aging population Resources being squeezed Need a method of looking after large cohorts of patients safely to help alleviate pressures on the health system So we introduced Telehealth in Liverpool 2011: Liverpool’s Telehealth Journey began… Obviously our nurses were very happy to start working with Telehealth! All clinicians loves technology and it’s very easy to use! Implementation was going to be easy, everyone would embrace it and we’d quickly recruit patients to use the service

No We didn’t monitoring understand hub our business Not enough patients Information governance No GP buy in Reality Check… Information governance challenges No GP buy in No hub Not enough patients We didn’t understand our business

Establish dedicated clinical monitoring hub Enhance offer to GPs Back to the drawing board Establish dedicated clinical monitoring hub Enhance offer to GPs Designed Primary Care Referral Pathway Back to the drawing board… Established the hub Enhanced offer to GPs Designed Primary Care referral pathway

1,600 patients Outcome Outcome… Too many patients Not enough staff System couldn’t cope 1,600 patients

“For the first time we feel in control” BUT… Back to basics Digital care plans redesigned Capacity demand management resolved Standard Operating Procedures defined Telehealth research published PROMS showed improvements Reputation grew – GPs wanted Telehealth Patient numbers increased safely Back to Basics… Care plan redesign Capacity demand management Reputation grew Patient numbers increased Positive Telehealth evidence Processes and SOPS defined Outcome GPs wanted Telehealth PROMS shows improvements Scaled up operations First time feels like we’re in control but… “For the first time we feel in control” BUT…

Measuring success TSA: Quality Standards Framework… Couldn’t measure our success in terms of quality We had had success at scale but we wanted more assurance Wanted assurance that all our quality standards and governance arrangements we robust We had NMC NICE etc. to guide us but felt we needed more Hence why we undertook TCA quality standards assessment – reviewed against industry standards for In February 2017 successfully accredited to the TSA Quality Standards Framework. This accreditation, borne out of whole system collaboration, provided patients, staff, the organisation, partners and commissioners with ultimate assurance that the service is safe, effective, caring, resilient and well led. Thus confirming that the long and difficult journey Liverpool has been on with Telehealth was moving in the right direction.

Research study: 22% to 32% reduction in hospital admissions & costs Today 50% reduction in use of healthcare services 950+ patients monitored each day 5,100+ 94% feel more control, confidence 44% have made lifestyle changes 72% believe their health has improved Today 950 live 5000+ PROMS Short report Research study: 22% to 32% reduction in hospital admissions & costs 94% would recommend to family & friends

Back to Basics Early Supported Hospital Discharge Enhancing support for Community Care Teams Telehealth+ embracing concept of Every Contact Counts Increasing Levels of Monitoring Early Supported Hospital Discharge The Future Back to the start Engagement with clinicians Some workforce modelling to support expansion Reviewing Care Plans to ensure they meet the need of service users Hopefully delivery at greater scale