1. Tele-Health/Medicine Why am I speaking today? Why am I speaking today? LTCs – does what we do now work? system focus assess knowledge / learning styles care planning LTCs – does what we do now work? system focus assess knowledge / learning styles care planning If we started again?…..suspend disbelief If we started again?…..suspend disbelief

2. LTC(s) Complex LTC needs….. Complex LTC needs…..

3. Acute care Stroke…. Stroke….

4. Acute care Pneumonia….. Pneumonia…..

6. HMP Frankland Plus 7 more in County Durham by end 2009 HMP Full Sutton HMP Verne HMP/YOI New Hall HMP Manchester HMPs Garth, Preston & Wymott HMP – signed contracts HMP – under contract negotiation Isle of Sheppey (3 prisons) Isle of Wight (3 prisons)

8. Context QIPP / other National drivers QIPP / other National drivers Shifting the Balance of Care Shifting the Balance of Care Evidence base Evidence base Will incremental change suffice? Will incremental change suffice? Pilots, prototypes and issues of scale Pilots, prototypes and issues of scale Existing infrastructure Existing infrastructure

9. Issues Regional vs local ownership/implementation Regional vs local ownership/implementation Avoid incompatible systems within and across sectors Avoid incompatible systems within and across sectors Financial and contract modelling Financial and contract modelling Workforce Workforce Evaluation Evaluation Marketing and engagement Marketing and engagement

10. Issues Managing strategic relationships Managing strategic relationships Technical specifications Technical specifications Governance Governance The overall business case for change The overall business case for change

11. Its not about the boxes……

13. Work in progress – NHS Yorks and the Humber Meeting 4 th November - CEO Meeting 4 th November - CEO Start of a discussion, not the end Start of a discussion, not the end Work in hand, initially to clarify the questions that need to be answered Work in hand, initially to clarify the questions that need to be answered Pace…with care Pace…with care

14. An integrated solution Medical record shared Medical record shared New approach to LTCs New approach to LTCs New tools telehealth New tools telehealth telemedicine links with other sectors (One box per home, not many!)

15. Is this approach going to deliver? COPD COPD 840 people, 5 yrs 840 people, 5 yrs Current spend £22M Current spend £22M ?Future spend £8M…. ?Future spend £8M….