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Edinburgh Telecare Development programme. Paddy Corscadden Telecare Development programme Manager. Aims. Background Project bid Project plans Progress to date Pro’s and Con’s Risks Lessons learned Future plans. Why use it ?. 1 person in 88 has dementia
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Edinburgh Telecare Development programme Paddy Corscadden Telecare Development programme Manager.
Aims • Background • Project bid • Project plans • Progress to date • Pro’s and Con’s • Risks • Lessons learned • Future plans
Why use it ? • 1 person in 88 has dementia • (about 7% costing about 17bn a year) • 600 older people have fallen in the UK in the last 24hrs • 16 % of the population is not in good health or with a limiting long term illness • About 30 % of older people are inappropriately placed • Scottish Executive Reducing places in long term care
Strategic Challenges - Demography Demographic Change in Scotland 1911-2031 85+ • Less than 2% of population • 20% of total bed days in NHS Lothian
By 2020 old age and ill health will require every school leaver to enter care roles • Shifted balance of care 16% to 27%, aiming for 40% • Reduced Care Home bed capacity • Improved delayed discharge performance • Dept of Health can’t say whether life expectancy is increasing faster than health expectancy.
Perspective • 5 reasons why people choose long term care • Carer exhaustion • Regular enuresis • Falls • Distraction burglary • Safety issues
1st generation equipment Not fit for purpose Excluding most vulnerable clients (and most costly to care for) Pre development
Project bid National development programme. OPCP (Live better in later life) Project award £685K (06-09) Match funding of £700k (06-09) Project board – decision makers Regular feedback to Scottish Government
Project plan • Infrastructure • Concept building • System mapping • Training • Dedicated resource to lead • Telecare champions at all levels
Infrastructure • Upgrade to 3g equipment • Upgrade to all Sheltered Housing • Telecare champions • Promo, Promo, Promo • Change and evolve • Outcomes
Concept building • Maldelvic Sq • Overnight programme • Falls programme • Telehealth • Builds enthusiasm and promotes successful change.
Telecare Equipment The central hub that detects all the wireless signals and dials out to Community Alarm Community alarm Picks up when you have had a fall and raise an alarm automatically Falls detector Detects when you have left bed and not returned. Turn on a light Raise an alarm Bed occupancy detector
Telecare Equipment • Can raise an alert and shut the cooker down. • Can be isolated Cooker isolator systems • Can be linked to cooker system and raise alarms to CAS Natural gas and heat sensors Flood and smoke detectors
Audio and visual prompt at medication time. Can be linked to CAS Medication dispenser • Detects when someone has left house and not returned- raise alert Wander alert • monitor arm and leg movements. • If a tonic colonic seizure is detected an alarm will be raised. Epilepsy monitor
Habit monitoring CAS Telecare Sending unit Call handling system Response Handling Health Care workers Family and Friends Info only Police CAS
Progress to date • Referral rates up 600% over the 3 years • Form 100 users to 2600 new users • Mainstreaming over next 2 years • Single shared assessments 85% • Robust multi-agency telecare provision. • Impact on bed days, etc
Partnership working • Health & Social Care • Social Workers • Occupational Therapists • Learning disability services • NHS Lothian • Occupational Therapists • Hospital medical / nursing staff (primary care) • Community based medical / nursing staff
Partnership working Cont.. • SFC • Assessment & Advice • Visiting Support • Sheltered Housing Support Services • Housing management • Housing Property Services • Charging Team • Supporting people team
Partnership working Cont.. • Registered Social Landlords • Medelvic Square (Cairn) • Margaret Blackwood • Edinvar • Telecare equipment providers / developers • Telecare Services Association • Accreditation • Joint improvement Team (JIT)
Pro’s • Spend to save • Need to change practice now – not in 15 years time. • Choice • Better evidence to support assessments
Risks -Technology From this (£2000) in 1983) 5 mega pixel camera WIFI GPS MP3 player Video camera Radio Video conferencing Internet Organiser Voice activation • To this (£500)
Con’s • 24/7 monitoring. • Loss of human contact. • Maintenance costs. • Charging for service.
Lessons learned • Not right for everyone • The more complex the client the more complex the package. • Capital investment needs some revenue investment. • Peoples needs change – technology highlights this – you can’t ignore it. • Staff skill mix
The assessment and response process are key to a successful service • Risk adverse society • It takes years, time and money
The future • Integration of telecare and telehealth • ADL monitoring • GPS technology
Points to consider • Telecare is just starting out • Can we afford not too use it? • What are the alternatives? • More care homes • More staff • More hospitals