1. E n h a n c e d h e a l t h i n c a r e h o m e s Rachel Binks, Nurse Consultant - Acute and Digital Care Airedale NHSFT The Art of the Possible - Enabling Care Homes with Technology

2. E n h a n c e d h e a l t h i n c a r e h o m e s telehealth, e health, digital health…..  Telecare  Telecoaching  Telemonitoring Teleconsultation

3. E n h a n c e d h e a l t h i n c a r e h o m e s some people seem to do quite well without waiting for healthcare support…… a system designed by default

4. E n h a n c e d h e a l t h i n c a r e h o m e s

5. right care today Teleconsultation Prison health care Care at home Nursing & residential care Supporting end of life patients 24/7 clinical hub improving patient experience changing patient flow reducing costs Electronic shared record connecting primary & secondary care now connecting whole health & social care economy tomorrow -5% -14% -5% -14%

6. E n h a n c e d h e a l t h i n c a r e h o m e s Key Care Homes Hospices Hospitals Medical Centres Own Homes Prisons replicable model 361 Nursing/Residential Care Homes + 113 in implementation Supporting > 14,000 residents

7. E n h a n c e d h e a l t h i n c a r e h o m e s Provide, safe, effective high standards of care To support residents to stay at home Support residents/nurses/carers in the planning, and delivery of care Escalate to community teams out of hours aim of the service

8. E n h a n c e d h e a l t h i n c a r e h o m e s activity

9. E n h a n c e d h e a l t h i n c a r e h o m e s what would you have done?

10. E n h a n c e d h e a l t h i n c a r e h o m e s

11. actual GP referrals

12. E n h a n c e d h e a l t h i n c a r e h o m e s

13. care homes - call outcomes

14. E n h a n c e d h e a l t h i n c a r e h o m e s care homes – onward referrals

15. E n h a n c e d h e a l t h i n c a r e h o m e s innovation potential

16. E n h a n c e d h e a l t h i n c a r e h o m e s remote training and clinical support? Support for care home staff using the VTR Support for DNs and community teams – do they need to attend? Overview and clinical support of care home staff developing enhanced roles Remote out patient clinics

17. E n h a n c e d h e a l t h i n c a r e h o m e s what is the gold line? 24/7 service for any patient thought to be in the last year of life - and their carers Linked to entry onto Gold Standards Framework Mostly a telephone service with addition of video-consultation for a subgroup Designed with and for patients approaching end of life Developed in partnership Health Foundation shared purpose grant

18. E n h a n c e d h e a l t h i n c a r e h o m e s call outcomes Disposition after call, year ending Oct 2015 6515 calls, 475 to report death, of the 6040 remaining:

19. E n h a n c e d h e a l t h i n c a r e h o m e s Avoidance Outcomes – Oct 2014 – Sept 2015Totals Admission Avoided118 A&E Attendance Avoided231 GP Visit Avoided438 Community Nurse Visit Avoided228 goldline impact

20. E n h a n c e d h e a l t h i n c a r e h o m e s National data England 2013 AWC 2013Bradford District 2013 Bradford City 2013 GSF/Gold Line Year 2013/14 All deaths in hospital 48.336.045.950.414% All deaths at home 22.420.124.523.141% All deaths in care homes 21.633.219.019.722% All deaths in hospice 5.5%8.88.34.623% data from End of Life Care Profiles PHE and District wide reporting (CSU)

21. E n h a n c e d h e a l t h i n c a r e h o m e s patient and carer feedback

22. E n h a n c e d h e a l t h i n c a r e h o m e s

23. Other services delivered from the digital care hub GP Triage Intermediate Care Hub Acute Care Team Single Point of Access Complex Care Team Shared record Registered practitioners Visual contact

24. E n h a n c e d h e a l t h i n c a r e h o m e s Technology Enabled Health - the art of the possible…. questions ?