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‘Where is Shetland?’ Success and challenge for telecare in remote island communities

‘Where is Shetland?’ Success and challenge for telecare in remote island communities. Agenda. Where is Shetland? Where is Telecare? What about funding? What has been successful…& what hasn’t? What about Orkney & Western Isles? Where is Telehealth?. Where is Shetland?.

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‘Where is Shetland?’ Success and challenge for telecare in remote island communities

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  1. ‘Where is Shetland?’ Success and challenge for telecare in remote island communities

  2. Agenda • Where is Shetland? • Where is Telecare? • What about funding? • What has been successful…& what hasn’t? • What about Orkney & Western Isles? • Where is Telehealth?

  3. Where is Shetland? • close to Norway

  4. What does Shetland have? • oil • it’s own flag • 1 million migratory birds • not as many people • 900 community alarm clients • 300 smoke alarms • 100 other telecare devices

  5. How old is Shetland? • High rate of ageing population • 65+ will be 33% by 2030; 75+ will double • Life expectancy above national average (81.8 f, 76.2 m) • Lower CHD (32.3 per 100,000) than national avg (56 per 100,000) • In good position for technology development: • 40% of long term clients receive care in their homes today • Average care home stays have dropped significantly in 10 yrs • Dispersed communities, independent minded culture • Strong health and care partnerships

  6. How did telecare evolve? • Community Alarm service in place for 25 years • Some smoke alarms, detectors & sensors in early use • Calls taken by local hospital up to 2005, then by Tunstall • Internal study (2007/8) & evaluation (2009) • Project Manager hired in Jan 2010

  7. What was the project approach? • Collaborate & communicate • Diverse Project Board • Small but effective delivery team • Focus on high risk clients • Reach out to communities • Embed into standard services • Share successes

  8. What did we use? • Alarms: smoke, carbon monoxide, pillow • Sensors: bed, chair, mats, temp extreme, epilepsy, light • Detectors: door, falls, flood • Other: wrist watch, medication dispensers, beacons • Plus remote monitoring, standalone systems, voice recognition, & GPS

  9. What else did we achieve? • Cleaned up Swift & PNC6 • Setup a telecare flat for demos & training • Gained access to Tunstall Training Tool • Renewed Response Agreement with Tunstall • Finalised agreement with Fire & Rescue • Setup a ‘demo flat’ for training

  10. How did we fund it? • £120,000 award from TDP • Match funding from Social Care & Sheltered Housing • £2000 from Community Partnership for smoke alarms • £50,000 carried forward from 2009

  11. What did we spend? • Approximately £135,000 in 2010: • 72 telecare devices in 47 client homes • 300 people attended awareness sessions • 10 tenant pilot at a Very Sheltered Home • 6 standalone installs at a North Isles Sheltered Home • 250 Homelinks upgraded to Lifeline units

  12. What did we save? Approximately £142,000 in 2010: • estimated reduction of 17 A&E admissions • estimated reduction of 76.5 hospital bed days • estimated reduction of 495 care home days • eliminated costs of independent electrician • Community Alarm underspend of nearly £12,000, thanks to: • bulk order of Lifelines • recovery, repair & renewal programme • no coordinator for 3 months

  13. How do we fund it in the future? • Consolidate budgets into overall OT budget • Spread skills & knowledge • Review Community Alarm coordinator position • Consider 3rd OT Aide position • Sack the Project Manager!

  14. What are some Case Studies? • ‘Dindna wan tae budder onybody’ • ‘Dindna burn me tatties’ • ‘We live outside Shetland and the updates are giving us a great degree of comfort that our mother is safe at home’. • GPS system

  15. What surprised us? • Acceptance from elderly clients • Variety of work • Help from other PMs & technical reps • Ease of integration • Velcro

  16. What challenged us? • Social Work & Council resistance • Swift • Access to NHS data • Broadband & mobile phone coverage • Remote locations • Equipment and provisioning

  17. What’s on our wish list? • Better falls detection technology • More reliable bed sensors • Easier DDA pager system • Lower prices for some bits of kit • Wider dosage cavities on med dispensers • Hypoallergenic wristbands

  18. What’s next? • Training programme • Renew or retender central response service • Setup mobile ‘first response service’ • Review low-use Community Alarms • Broaden client base • Outreach, Rehab, Women’s Aid, complex conditions • Stock Control system

  19. What are we watching? • Reshaping Care for Older People • £70m for new care models • JIT ‘Telecare to 2012’ action plan • integration & convergence • Technology Strategy Board • Whole System Demonstrator (England) • Kent, Cornwall & Newham collaborative • new integrated models & evidence

  20. What about telehealth? • Project board • Funding • Equipment suppliers • Location rather than condition based (at first) • Establish scope, manage change • Emphasise: • improved access to service • reduced travel time • increased self management

  21. Who is involved? • Primary & Secondary care • Acute care, A&E • Physiotherapy, Mental Health, Rehab, Audiology • Medical Science, IT • Island communities

  22. What about Orkney? • 20,000 population • Before Jan 2010, limited to Sheltered or Extra Care Homes • Now have 340 dispersed alarms, 52 telecare users • 29 connected to dispersed alarms; others are standalone • Local response team in place • 6 person team (1 on at any time) • approx 70 responses/month • do installs, assessments, maintenance & checks • Excellent training, pricing & tech support from Chubb • Success with epilepsy & bed sensors, fall detectors, PIRs • ‘Demo flat’ for training & public awareness

  23. What are their challenges? • PM returns to regular post on 31 Mar • coordinator & admin to be in place • ideally, would like primes from each care group • Funding – end of JIT programme will be felt: • difficulty absorbing into existing budget • shared services to be discussed • may start non-sliding service charge (£2.50/wk) • Resistance from care professionals • Call support centre: • Community Service (day) & hospital (night) – not dedicated • tendering exercise being considered

  24. What about Western Isles? • 26,500 population • 950 clients; 840 dispersed alarms & 256 smoke alarms • Limited telecare kit: • 1 exit sensor, 1 falls detector • 2 heat detectors, 2 pressure mats, 2 meds dispensers • Good relationship with Tunstall; equipment & PNC5 • Exploring shared service with police • to avoid out of hours counter closure

  25. What are their challenges? • Lack of priority & sponsorship • Telecare Monitoring Group not as active; originally in place for: • new electronic Home Care Management system • Community Alarm asset mgt system • pilot for environmental controls • Service coordinator retires 31 Mar • post to be absorbed by Customer Service Team Lead • Inadequate volunteer responders & training • Telehealth development outwith telecare

  26. Thank you! keith.simpson@shetland.gov.uk Office: 01595 743 983 Mobile: 07775 407 625

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