How Sandwell & Staffordshire are leading the way in deploying video communications Mainstreaming the Use of Video alongside other technologies within Health, Housing & Social Care Alasdair MorrisonSharon Finney

Introduction An explanation of the application of video systems into people’s homes How using video as a single point of access, enables people to access a range of service provisions The application of video within packages of care and support as part of overall technology solutions Using video and other technologies as ‘enablers’ to achieve service re-engineering How financial efficiencies & better customer outcomes can be achieved by the use of video solutions

How Video Works In The Home Many ways to provide video in the home Computer Tablets Smart Phones Telehealth Systems Television Sandwell & North Staffordshire using televisions and software licences from the workplace A range of options can be used dependent on the patient / service user / tenant All options are encrypted and secure connections

Professionals utilise software licences in the workplace delivered through IT networks Local solutions can be provided to standalone PCs providing an internet connections is available In the home / dwelling, set top boxes are used to connected to people’s own television sets, allowing people to use a medium that is familiar to them Patients / service users / tenants have total control over the system and can choose when or if to accept of make video calls from their television How Video Works In The Home

Deployment of video in the home will traditionally start by connecting a person to a single service. These may include: - Healthcare (Secondary Care) Teams Reablement Services Alarm Receiving Centres Primary Care / GP Surgeries Befriending Services Support Services Social Care Services Housing Services Others Access to Services

The range of connections and accessible services is dependent on which services utilise video solutions as part of their service offer Control of which services can be called from the home and which can call into the home is managed by each organisation e.g. GPs versus Contact Centres The use of video is part of a complimentary package of care and support which has technology at its heart. It is NOT a replacement for traditional ‘hands on’ care. Access to Services

Adoption by Health, Housing, Social Care, 3 rd Sector organisations will increase as video becomes more popular Tenants / Patients / Service Users will then have a greater network of services they will be able to engage with and contact Access to new services / organisations can be provided remotely and in real-time The deployment of video will not only help to deliver more personalised services in to people’s homes, it will allow service providers / organisations to streamline and re-engineer their services

Applications - Sandwell Deployments are varied in Sandwell and cover a range of service options. Example of 3 of these are: - GP consultations / triage from practice in to residential homes Using video as part of a technology solution within LD supported housing provision to increase independence and reduce spend Enabling access and use of community facilities for those with hearing impairments

GP Consultations Video application provided to PCs in surgery allowing access to computer or television within the residential home Multiple tenants / residents can be provided with remote consultations / triage by the next available GP Residential home requests a ‘virtual consultation’ and awaits call from GP. Individuals can be triaged and decisions made on next steps. Web camera can be used flexibly where necessary Initial trial with 7 GPs and 2 residential homes saw a 75% reduction in home visits needed to be made by GPs.

LD Care / Support Packages 33 LD cases reviewed and provided with new packages of technology / care / support Over provision identified by service provider / landlord resulting in high cost packages of care and support in supported living schemes Reviews focussed on technology solutions in the first instance and provision of care and support following this Main focus on promoting tenants independence and promoting positive risk taking. Provides access to landlord in order to address tenancy and support concerns / issues

LD Care / Support Packages Total savings against budgets (old costs v new costs) for 33 cases over a period of twelve month: £514, Technology solutions concentrated on maintaining people’s independence and security whilst at home Traditional Telecare and alarm solutions provided - alarms, pendants, door contacts, pill dispenser, smoke detectors, GPS devices

LD Care / Support Packages Video solutions installed to provide face to face contact / support with responding officers at alarm receiving centre Reassurance / advice / support provided upon activation of any technology alert. Response officers available to attend but call outs have reduced significantly Tenants within supported living scheme are connected to each other in order to increase social contact and maintain relationships, reducing isolation

Accessing Community Facilities New Lifestyle / Leisure centre opened in Sandwell Focus on inclusion and accessible facilities for both able bodied and disabled users Video solution has been provided in the form of a tablet, linked to the Deaf Centre in the next town Profoundly deaf or those with a hearing impairment have access to a signer at the deaf centre to enable them to converse with the leisure reception staff The video connection can be provided with 2 minutes by reception staff who are able to speak to / advise the signer at the Deaf Centre and relay responses to the individual Video solution enables access to centre and overcomes communication barriers

North Staffordshire – Video Enabling Huge variations of care within nursing homes for residents. Mostly vulnerable people with complex needs / multiple conditions Introduced the Enhanced Primary Care Medical Service (EPCM) to improve the quality of care for residents Pilot site at Bradwell Hall is the largest Nursing Home in Newcastle, Staffordshire (171 Beds) The EPCM team identified a lack of geriatric clinical support during the MDT meetings

North Staffordshire – Video Enabling The Plan Identify Geriatrician to provide support Provide video links between Geriatrician and the nursing home Identify any further potential specialist support (Social Care / Dementia Advice) Adopt collaborative health / social care approach to shared funding

North Staffordshire – Video Enabling Implementation Agree scope and shared funding arrangements Identify / address Information Governance issues Engage IT to establish links across networks Install web based solution Mix of hardware – PCs and wireless tablets

North Staffordshire – Video Enabling Results of Virtual Link Pilot Time taken on clinical decision decreased by more than 2 weeks MDT identified unexpected benefit of accessing diagnostic test results in real time through Geriatrician All staff (100%) felt better supported to provide better quality care

North Staffordshire – Video Enabling Results of the overall EPCM pilot A&E attendances - 23% lower in the second half of 2012 compared to 2011 A&E attendance rate fell from 0.97 per bed per year in 2011 to 0.75 per bed per year in second half of 2012 A&E admissions – 29% less in second half of 2012 compared to 2011 A&E admission rate fell from 0.53 per bed per year in 2011 to 0.37 per bed per year in second half of 2012

North Staffordshire – Video Enabling Learning from the Pilot Wireless tablets utilised 3G connections and dependent on the signal, in some cases these only work intermittently especially in remote areas. Service now looking to test 4G Team identifed a further need to have a video link with Psychiatrist to offer further support Difficult to evidence technology reduced social care activity levels. The video solution was designed to be used as an enabler – allowing the team to contact the correct clinical support without delay

Summary It is clear that the use of video (whichever format) has the ability to re-engineer services and improve the delivery of these services Solutions can be delivered in small projects or designed to create wider networks to provide appropriate support to service users / patients depending on their individual needs Technology solutions have to be part of complimentary packages of care and support to maximise improvements / improve outcomes and create efficiencies within services Video is part of ‘digital approachs’ to care and support but need not be a barrier to adoption

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