The telecare and telehealth innovations of the 12 WSDAN member sites
This edition of WSDAN progress provides a ‘pen picture’ of the telehealth/telecare innovations being developed within each of the 12 member sites in the management of people with long-term conditions. This reveals a mix of approaches from pilots aimed at a specific patient or disease group, to wider service-models and strategies:
Barnsley: Adult Services (LA), Care Services Direct and NHS Barnsley are developing joint working arrangements focusing on up to 200 Patients with COPD where both telehealth and telecare will be deployed and integrated into supporting care pathways.
Birmingham: Birmingham OwnHealth (BOH) provides telephone-based care support through care managers to over 2,000 people with long term conditions. BOH is provided through a strategic partnership including Birmingham East and North PCT, Pfizer Health Solutions and NHS Direct. The scheme has been up and running since April 2006; phase 2 of the project seeks to extend the OwnHealth service to 27,000 users by 2012.
Croydon: Careline supports individuals to live independently, safely and confidently in their own homes. The service currently consists of a remote monitoring alarm, a control centre and a response team. The scope of the service will widen by bringing in the Community Intermediate Care team to help maintain care in people’s own homes by preventing admission to, and supporting discharge from, hospitals as well as using the technology as a way to case-manage patients.
East Riding of Yorkshire: With a strategic objective to embed technological developments into its unscheduled care model, the site is developing neighbourhood health teams linked to an assessment officer in the local authority and the COPD respiratory team assisted by the use of risk-stratification of clients through the PARR tool. A telehealth pilot for COPD has commenced in two localities.
Hull: Hull’s strategic objective is to mainstream the use of telecare and telehealth with adult health and social care services and much work has been achieved in establishing an inclusive delivery partnership with a range of agencies, including Hull University. A number of telehealth units have been deployed.
Lancashire: Central Lancashire PCT is looking at equipping GPs with remote support for recording electrocardiogram (ECG) – a way of measuring and diagnosing any abnormal rhythms of the heart.
Leeds: Leeds is currently completing a pilot for COPD patients in conjunction with the community respiratory nursing teams, with the intention of extending the pilot for use with chronic heart failure patients. This project will be assisted by Leeds Teaching Hospitals as part of a RCT. Other key areas for consideration include diabetes, continuing health care, intermediate care and night services.
Leicester: Leicester began to mainstream an assistive technology service in May 2007 as part of social care packages for all client groups, enabling users access to a range of individually-tailored telecare products. In July 2008 an initial target group of 360 people with frequent hospital admissions (CHD, COPD, diabetes) were identified as potential telehealth users.
Lincolnshire: In addition to a history of innovation in the telecare field, Lincolnshire is seeking to gain funding for a technology-assisted medication compliance project to assist people to manage their medication; coordinate their medication reviews; and reduce medication wastage. Lincolnshire PCT also has a small scale telehealth pilot.
Norfolk: AT services in Norfolk aim to reduce unnecessary hospital admissions, develop LTC management, reduce the size of social care packages, delay the need for residential care, and improve service pathways. An Independent evaluation of the AT service, with 152 users, confirmed a positive impact on people’s safety, security and quality of life: 10.5 per cent of people reported avoiding hospitalization, 38 per cent delayed or avoided residential or nursing care, and 28 per cent experienced postponement, avoidance or reduction in domiciliary/ homecare packages.
Nottingham: This site will mainstream the use of telehealth through the deployment of monitors to around 800 people with long-term conditions such as COPD and congestive heart failure. This follows a successful 12-month pilot in 2007, which saw a reduction in hospital admissions, GP visits and matron and community nurse home visits, enabling primary and secondary care teams in Nottingham to make the best possible use of healthcare resources. A local randomised controlled trial has been established to evaluate impact.
Southampton: This site is running telehealth systems in COPD and CHD as part of an EU project. A diabetes project is seeking to enable improved monitoring of clients condition to prevent admissions. The site is also part of the PEACE project seeking to develop inter-operability between telehealth and telecare systems with out of hours and community alarm systems. The PEACE project is funded by the Assisted Living Innovation Platform (ALIP).
Nick Goodwin is a Senior Fellow at the King’s Fund and co-project lead for WSDAN