1. Technology Enabled Care Services in Nottingham City
Dave Miles
Assistive Technology Project Manager
Nottingham City Council / NHS Nottingham City CCG

2. Adult Integrated Care
As I’ve said the AT Project is part of the Adult Integrated Care Programme to deliver Coordinated Care in Nottingham supported by a single front door, self care and independence pathways. This slide illustrates the model of integrated care.
At the heart you have neighbourhood care delivery groups with GP support for multi disciplinary teams with care coordinators providing the joined up approach for citizens. You will still have specialist services such as heart failure, respiratory and diabetes but these might be included in the Care Delivery Teams at a later date. And supporting the whole set up is assistive technology.

3. Joint AT Strategy Endorsed by Health and Wellbeing Board 2012
Integrated adult care;
Joint commissioning for an integrated AT service;
Embedding AT;
Pooled resources;
Effective procurement;
Change management.
As I said in 2011 we decided to develop a joint AT Strategy across the Council and PCT and in 2012 this was produced following consultation with a wide range of stakeholders. This are the key objectives for the Strategy (which was signed off by the Council, PCT and Health and Well Being Board) including the development of a single AT service which is funded through pooled budgets.

4. Year Telecare Telehealth
July – Telecare Project February - Telehealth Pilot – 10 users
February users April – Telehealth Service Launch (300)
July – Service mainstreamed
1000 users October – 50 users
February – Stand Alone Project
November – Evaluation November – 63 users
May – Evaluation June – 50 users
2000 users
September – Expanded Service
March – AT Strategy
May – 3000 users February - Evaluation
December – AT Project, part of Adult Integrated Care
September – 4000 users October – 50 users
users
users users
This slide takes us through the Telecare and Telehealth timelines. Both starting life in This is when the Telecare Service (then a project) become operational and Telehealth started as a pilot. Since then they have taken different courses with Telecare growing steadily over the years whereas to be honest Telehealth has remained static. Over the years both services have had external evaluation carried out which have proved useful.
There has always been a joined up approach to service delivery. From the beginnings of Telecare health partners were included on the Project Board and health staff make up about 40% of referrers. I was involved in supporting the Telehealth role out and for a while one of my team provided the administration. In about 2009/10 we made proposals to join up the services but this wasn’t taken forwards. However in 2012 the Council and the PCT developed a joint strategy around AT and this lead to the AT Project we me taking the lead in December last year.
We have aspirations towards seeing 10,000 people supported by AT in the next 5 years and this Telehealth procurement is one phase of this.

5. October 2013 April 2014 April Separate Services Single AT Service Telecare - ASC & H referrers 5,000 users 8,000 users (City Council) - Telecare Team - Multiple Suppliers - 4,000 users ASC & H referrers AT Team Nottingham - Alert monitoring Multiple Suppliers City Homes - Equipment management Monitoring & response 10,000 users Equipment management Pooled budget Telehealth - H referrers New equipment (CityCare) - Single supplier - Nurse monitoring (September) - 50 users 300 users 2,000 users (CCG) Tenders Evaluation Telehealth patient research (PhD student
This slide shows the direction of travel from where we are today to where we want to be.
On the left you have the current separate services. The Telecare Service which has health and social care referrers, a supporting team, a wide range of equipment which has lead to a large take up, supported by Nottingham City Homes who provide equipment management and alert monitoring and response. You then have the Telehealth Service which is only health with one choice of equipment – the nurses do their own monitoring although Nottingham City Homes now do installations.
Over in 2015 is where we want to be with a single AT service which is funded through pooling budgets - with the service providing a portfolio of equipment, installations, alert monitoring and response. By 2018 we are aiming for 10,000 users. The agreed approach of the AT Steering Group and the Integrated Programme Board is for an initial stimulation of Telehealth through this current procurement. You will also note that we are planning some evaluation for 2 years – of the current services and then the impact as we move towards a single joined up service.

6. Integrated AT Service Referrer Citizen Adult Integrated Care
Mixed portfolio of equipment to manage health and social care needs.
Equipment management.
Alert monitoring and response.
Training, advice and information.
Local provision.
Pooled budget.
Citizen
Referral
Installation
Information
Information
This slide further illustrates how the single AT Service will look like. The intention is that there will be a single pathway for social care and health professionals who are supporting a citizen depending on the presenting risks, needs, health problems that citizen may have. They will make a referral into the Service and there will a single for the Citizen to be supported by the Service – installation, alert monitoring and response, etc. The Service will also provide training, advice and support in a joined up way. The Service will also be able to feed information into the Adult Integrated Care services to help support citizens better.
Adult Integrated Care

7. Care Homes AT Offer
Windy Ridge X