Cathy Dorrian Service Development Manager National MH Programme Scottish Centre for Telehealth & Telecare, NHS 24

Overview of Presentation Background – SCTT & NHS 24 National Programmes Telemental Health in Scotland – multichannel approaches & examples Priority &Transferability……

Background - SCTT & NHS 24 SCT funded by SGHD - operational 2007 hosted by NHS Grampian Reviewed in 2009 and merged with NHS 24 in 2010 Telecare (JIT) joined SCT in 2010 – now SCTT New Strategy for 2012 – 2015 out for Consultation

Current SCTT National Programmes Mental Health Stroke and CHD Paediatrics LTC – COPD/DALLAS/Telecare DP National Infrastructure Project Education & Training

Telemental Health 2009 Review of Telemental Health in Scotland commissioned by SCT – Dr. Harry Miller Mental Health Team established in 2010 – Clinical Lead Dr. Stella Clark Nurse Consultant, SDM and Tony McLaren National Co-ordinator BS & LL Lucy Robinson from Geoff Huggins dept working with us to progress Commitment 6 from the MH Strategy (technology platform) – Project Ginsberg

The NHS in Scotland is facing growing demand for its services and NHS boards need to consider new models of care such as telehealth to help manage current and future demand. Targeted appropriately, telehealth offers the potential to help NHS boards deliver a range of clinical services more efficiently and effectively. NHS boards should consider the use of telehealth when introducing or redesigning clinical services.

NHS boards should: Ensure that telehealth initiatives are supported by business cases that consider the long-term clinical, organisational and cost benefits resulting from the use of telehealth.

internet TV telecare Face 2 Face SMS video mobile

Mental Health - Current Tel. Services Breathing Space – National confidential tel. service for people experiencing low mood, depression or anxiety. Live since 2004 – 7,000 calls per month Free National Telephone based Guided Self Help service – based on CBT & provided by a team of self help coaches. Fortnightly sessions over a period of 6-12 weeks. Workbooks/materials sent to patients or online. (No cost to Boards) Telephone based CBT on request by boards – patients work with qualified therapists. Fortnightly sessions over 4-12 weeks using workbooks/materials sent to patients home or download online. MH Nurses based at NHS 24

Current Mental Health Proof of Concept Studies using videoconferencing Teleneuropsychology Services Substance Misuse Services Dementia Services – Care Homes Prison Healthcare – Forensic Services –(NHSL) Police Cell Health – Custody Suites Training & Education – STRADA, BS

Abbeyfield Ballachulish 22 care home beds 2 intermediate care beds 2 respite beds Very sheltered housing Lunch Club Day Care

Outcomes from Dementia Clinics via VC 2 patients successfully withdrawn from antipsychotic medication. 2 patients managed solely with behavioural plans 2 prevented admissions No new prescriptions for antipsychotics – Difficult to calculate a cost saving but average stay in dementia assessment unit is 10 weeks and cost of admission to New Craigs is £290/day. Potential savings of £ One patient was admitted but possibly admitted later than she would otherwise had been and discharged earlier. Staff feel better supported and upskilled in recognising and managing psychiatric symptoms Palliative Care – supported Staff with end of life care.

Forensic Services – Scottish Prison Service NHS now responsible for Prison healthcare – Nov 2011 Feasibility Study – proof of concept Provide FS from the Orchard Clinic at REH to HMP Edinburgh & HMP Addiewell New VC kit installed in both prisons, staff trained, fortnightly MDT meetings, case reviews. Increased Consultant productivity, reduced travel time. Went live direct patient care (VC) HMP Edinburgh Sept 2012 Go live to HMP Addiewell Nov 2012 ?? Surgery Pods x3 for health screening e.g. hypertension (NHSL)

NHS Scotland – Digital TV Platform

Working to widen public access to NHS Scotland on new channels on digital TV NHS Scotland services on Freesat & Sky: Go to Channel 539 (Community Channel) Press RED NHS Scotland services on Virgin: Interactive Channel Also available to download as an app on android and i- phones by texting postcode or 'NHS24' to 61061

NHS Scotland - Digital TV Platform Service Delivery Benefits: Helping people to self serve Efficiency savings Fewer GP ‘no-shows’ Delivering services on popular devices Using trusted technologies to deliver health services for older people - TV Bridging the digital divide

Digital TV Platform – other opportunities?? Prison healthcare?? Online CBT? FV already using online CBT Access to AHP’s Access to Primary & Community Care and MH Services? COPD Development – being worked up Alcohol Brief Interventions – being worked up

Training & Education Working in collaboration with STRADA to deliver specialist SM training & education to SPS, NHS Boards, DAP’s & Police (ACPOS) via VC & webcasts Breathing Space – VC sessions/webcasts

Telephones??

Smart mattress technology….

Wireless patch for patient monitoring RESpeck Device – University of Edinburgh Wireless patch with a three-axis accelerometer Sealed case and self-adhesive pouch Measures chest wall rotations as the wearer breathes Provides a respiratory effort waveform, respiratory rate and patient activity data. Patches also available for BP/ECG recording.

Opportunities…..?? What is transferable for the Prison Population & Staff?? Prison solves problem of illegal mobile phones – see article CBT – FV using online CBT possible model for PHC via Telephone and Digital TV? Improving access to NHS 24 Tel. MH services? Improving access to other services eg. Dementia, Substance Misuse, Epilepsy, LD Tele-visiting for families CPD for staff – New to Forensic Course?

Discussion?? Questions?? Thank you for listening