1. Forget S.P.E.C.T.R.E, Mr Bond S.L.O.T.H is the enemy!
Professor James Ferguson,
Professor of Remote Medicine,
Robert Gordon University
Clinical Lead,
Scottish Centre for Telehealth and Telecare
Consultant Surgeon in Emergency Medicine,
NHS Grampian

4. The Enemy - SLOTH
Secret
League
Opposed to
Tele
Health and Care

5. ED Door to medical team time 30-day adjusted mortality
P <

6. The Healthcare Quality Strategy for Scotland: Effective
The most appropriate treatments, interventions, support and services will be provided at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated

8. Aim
Provision of rapid access to senior paediatric clinical support for unscheduled care cases by video conferencing, initially for clinicians in rural general hospitals (and selected “no pass” healthcare facilities).

9. Background
Instigated by The Scottish Centre for Telehealth and Telecare
Supported and funded by the North of Scotland Planning Group
One of the highest priorities from the North of Scotland Paediatric Sustainability Review by Dr Zoё Dunhill was to participate in the pilot
Project management provided by NHS24

10. Set Up - Users

11. Set Up – NHS 24

12. Set Up – Hospital response Recruitment of On Call Consultants

13. Set Up - Evaluation

14. Key Findings
Activity 230 calls from August 2013 until July 2014 approx 4 per week Confidence: Staff and parents Consistency Transfer support Local knowledge: Capacity and competence. Medico-legal Work arounds

15. Key Findings (cont)
Peer Review 5 Clinicians Rural GP Paediatric ED Consultant PICU Consultant General Paeds Consultant (DGH) General Paeds Consultant (Tertiary Centre)

16. Peer Review Improved care: 33% (Range 20% to 60%)
Avoided transfer : 25% (Range 15% to 50%)

17. “Veterinary” Paediatrics
Paediatric clinical examination made easy; 5th Edition, Denis Gill, Niall O’Brian. Churchill Livingstone 2007

20. KERR REPORT

21. Technology Enabled Care (TEC)
Integration of Health and Social Care

22. MACHIAVELLI
Let it be noted that there is no more delicate matter to take in hand, nor more dangerous to conduct, nor more doubtful in its success, than to set up as a leader in the introduction of changes.   For he who innovates will have as his enemies all those who are well off under the existing order of things, and only lukewarm supporters in those who might be better off under the new.   This lukewarm temper arises partly from the fear of adversaries who have the laws on their side and partly from the incredulity of mankind, who will never admit the merit of anything new, until they have seen it proved by events.   The result, however, is that whenever the enemies of change make an attack, they do with all the zeal of partisans, while the others defend themselves as feebly as to endanger both themselves and their cause. "The Prince"  Niccolò di Bernardo dei Machiavelli published in 1513  Born 3 May 1469 Florence, died 21 June 1527  Italian diplomat and political theorist

25. “Better an imperfect tool than no tool at all”
WAYNE BOBBITT