Presentation on theme: "Technologies for what purpose?"— Presentation transcript:
1Whole System Demonstrator programme Stephen Johnson Deputy Director – Head of Long Term Conditions
2Technologies for what purpose? The second half of the 20th century saw major improvements in communicable disease treatments and surgical advancesThe first half of the 21st century will see increases in non-communicable diseases and improvements in care of people with long term conditionsTechnology is readily used and accepted in the treatment of many acute interventions – CT, MRI, x-rays, etcBut can technology be used to improve the care of people with long term conditions?
3………….Yes, at least that is the claim, but where is the evidence? Back in 2006 it was recognised the evidence base was not as robust as we would have likedSo we secured funding and set out to fill that gapWSD was born (3 sites, 6000 people, 238 GP practices, making it the largest RCT of TH/TC in the world)2007 to 2008 sites were selected2008 – 2009 patients recruited (easy this RCT thing isn’t it!!)2009 to 2010 patient data collectedJan 2011, data to evaluation teamNow? – well now the data is being evaluated and peer reviewed prior to publication
4What will WSD tell us? Question 1 2 3 4 5 THEME Nuffield NO. PARTICIPANTS REQUIRED1NuffieldDoes the introduction of telehealth or telecare result in reduction in service utilisation and costs of care?5721 participantsCombined Model2UCLWhat is the effect on carer burden, self-care behaviours and quality of life? What predicts whether people will use the service as planned? What is the clinical impact?3445 participants470 informal carers3LSEWhat is the cost−effectiveness of the introduction of telecare & telehealth?Professional interviews4Man’rOxfordWhat are the service users, informal carers and health and social care professionals’ experiences of telehealth and telecare?234 interviews so far.Participants & informal carers.Health & social care professionals.5ImperialWhat organisational factors facilitate or impede the sustainable adoption and integration of telehealth/telecare?48 key WSD managers and commissioners in health & social services. Staff from 3 WSDAN sites and 3 non WSD related sites
5What have we learnt?Technology is only part of the story, you must re-design services to maximize the benefit of the technologyThat includes looking again at skill mix and facilitiesClinical engagement is essential, but takes timePatients are suspicious, and building trust takes timePatient data was not as good as we thought, disease registers were out of date of inaccurateSome population groups were very difficult to reachGood project/programme management is essentialWhat you do on a small scale does not necessarily scaleBut…………………………..
6If you get it right, and focus on the whole system Work across traditionalorganisationalboundariesBuild clinicaladvocacyRe-design carepathwaysShareInformationRe-trainstaffDevelop interoperablesystemsEducate patients andthe publicThe rewards are significant…………………..
7the key to success is service change not just introduce the “kit” and hope for the best! BUT
8Remember why we are doing this The number of people with long term conditions is growing (15.4m now, but up to 18m within 20years) and they account for 70% of spendPeople with LTCs live with their condition every minute of every day, not just the 3 to 6 hours they are with a professional8760 hours in a year, that leaves a lot of timeTelehealth and telecare should help more people to lead a better quality of life, be more independent and spend fewer days in hospitalRemind ourselves why here today – why focus so much energyFor starters – large and growing population – 15 million in this countryRange of conditions with differing severity – some have single condition can manage well, some have range of conditions that limit them and others have range of complex health and social care needs that severely limit their ability to cope
9What next?This will need significant leadership at all levels as well as raising awareness of what can be achieved and how to use the technology properlyBut to lead needs a direction - align incentives, re-train staff, develop interoperability, embed common standards and reduce high unit costsGovernment has already committed to support an industry led Code of Practice and invest in DALLASYet more could be achieved by encouraging “patient pull” (showing that there is an alternative to using traditional buildings), using the media to give sustained information and ensuring NHS is supported to change
10Head of Long Term Conditions Stephen JohnsonDeputy DirectorHead of Long Term Conditions