How Sandwell & Staffordshire are leading the way in deploying video communications

1. Mainstreaming the Use of Video alongside other technologies within Health, Housing & Social Care How Sandwell & Staffordshire are leading the way in deploying video communications Alasdair Morrison Sharon Finney

2. Introduction • An explanation of the application of video systems into people’s homes • How using video as a single point of access, enables people to access a range of service provisions • The application of video within packages of care and support as part of overall technology solutions • Using video and other technologies as ‘enablers’ to achieve service re-engineering • How financial efficiencies & better customer outcomes can be achieved by the use of video solutions

3. How Video Works In The Home • Many ways to provide video in the home • Computer • Tablets • Smart Phones • Telehealth Systems • Television • Sandwell & North Staffordshire using televisions and software licences from the workplace • A range of options can be used dependent on the patient / service user / tenant • All options are encrypted and secure connections

4. How Video Works In The Home • Professionals utilise software licences in the workplace delivered through IT networks • Local solutions can be provided to standalone PCs providing an internet connections is available • In the home / dwelling, set top boxes are used to connected to people’s own television sets, allowing people to use a medium that is familiar to them • Patients / service users / tenants have total control over the system and can choose when or if to accept of make video calls from their television

5. Access to Services • Deployment of video in the home will traditionally start by connecting a person to a single service. These may include: - • Healthcare (Secondary Care) Teams • Reablement Services • Alarm Receiving Centres • Primary Care / GP Surgeries • Befriending Services • Support Services • Social Care Services • Housing Services • Others

6. Access to Services • The range of connections and accessible services is dependent on which services utilise video solutions as part of their service offer • Control of which services can be called from the home and which can call into the home is managed by each organisation e.g. GPs versus Contact Centres • The use of video is part of a complimentary package of care and support which has technology at its heart. It is NOT a replacement for traditional ‘hands on’ care.

7. Access to Services • Adoption by Health, Housing, Social Care, 3rd Sector organisations will increase as video becomes more popular • Tenants / Patients / Service Users will then have a greater network of services they will be able to engage with and contact • Access to new services / organisations can be provided remotely and in real-time • The deployment of video will not only help to deliver more personalised services in to people’s homes, it will allow service providers / organisations to streamline and re-engineer their services

8. Applications - Sandwell • Deployments are varied in Sandwell and cover a range of service options. Example of 3 of these are: - • GP consultations / triage from practice in to residential homes • Using video as part of a technology solution within LD supported housing provision to increase independence and reduce spend • Enabling access and use of community facilities for those with hearing impairments

9. GP Consultations • Video application provided to PCs in surgery allowing access to computer or television within the residential home • Multiple tenants / residents can be provided with remote consultations / triage by the next available GP • Residential home requests a ‘virtual consultation’ and awaits call from GP. Individuals can be triaged and decisions made on next steps. Web camera can be used flexibly where necessary • Initial trial with 7 GPs and 2 residential homes saw a 75% reduction in home visits needed to be made by GPs.

10. LD Care / Support Packages • 33 LD cases reviewed and provided with new packages of technology / care / support • Over provision identified by service provider / landlord resulting in high cost packages of care and support in supported living schemes • Reviews focussed on technology solutions in the first instance and provision of care and support following this • Main focus on promoting tenants independence and promoting positive risk taking. Provides access to landlord in order to address tenancy and support concerns / issues

11. LD Care / Support Packages • Total savings against budgets (old costs v new costs) for 33 cases over a period of twelve month: • £514,880.08 • Technology solutions concentrated on maintaining people’s independence and security whilst at home • Traditional Telecare and alarm solutions provided - alarms, pendants, door contacts, pill dispenser, smoke detectors, GPS devices

12. LD Care / Support Packages • Video solutions installed to provide face to face contact / support with responding officers at alarm receiving centre • Reassurance / advice / support provided upon activation of any technology alert. Response officers available to attend but call outs have reduced significantly • Tenants within supported living scheme are connected to each other in order to increase social contact and maintain relationships, reducing isolation

13. Accessing Community Facilities • New Lifestyle / Leisure centre opened in Sandwell • Focus on inclusion and accessible facilities for both able bodied and disabled users • Video solution has been provided in the form of a tablet, linked to the Deaf Centre in the next town • Profoundly deaf or those with a hearing impairment have access to a signer at the deaf centre to enable them to converse with the leisure reception staff • The video connection can be provided with 2 minutes by reception staff who are able to speak to / advise the signer at the Deaf Centre and relay responses to the individual • Video solution enables access to centre and overcomes communication barriers

14. North Staffordshire – Video Enabling • Huge variations of care within nursing homes for residents. Mostly vulnerable people with complex needs / multiple conditions • Introduced the Enhanced Primary Care Medical Service (EPCM) to improve the quality of care for residents • Pilot site at Bradwell Hall is the largest Nursing Home in Newcastle, Staffordshire (171 Beds) • The EPCM team identified a lack of geriatric clinical support during the MDT meetings

15. North Staffordshire – Video Enabling • The Plan • Identify Geriatrician to provide support • Provide video links between Geriatrician and the nursing home • Identify any further potential specialist support (Social Care / Dementia Advice) • Adopt collaborative health / social care approach to shared funding

16. North Staffordshire – Video Enabling • Implementation • Agree scope and shared funding arrangements • Identify / address Information Governance issues • Engage IT to establish links across networks • Install web based solution • Mix of hardware – PCs and wireless tablets

17. North Staffordshire – Video Enabling • Results of Virtual Link Pilot • Time taken on clinical decision decreased by more than 2 weeks • MDT identified unexpected benefit of accessing diagnostic test results in real time through Geriatrician • All staff (100%) felt better supported to provide better quality care

18. North Staffordshire – Video Enabling • Results of the overall EPCM pilot • A&E attendances - 23% lower in the second half of 2012 compared to 2011 • A&E attendance rate fell from 0.97 per bed per year in 2011 to 0.75 per bed per year in second half of 2012 • A&E admissions – 29% less in second half of 2012 compared to 2011 • A&E admission rate fell from 0.53 per bed per year in 2011 to 0.37 per bed per year in second half of 2012

19. North Staffordshire – Video Enabling • Learning from the Pilot • Wireless tablets utilised 3G connections and dependent on the signal, in some cases these only work intermittently especially in remote areas. Service now looking to test 4G • Team identifed a further need to have a video link with Psychiatrist to offer further support • Difficult to evidence technology reduced social care activity levels. The video solution was designed to be used as an enabler – allowing the team to contact the correct clinical support without delay

20. Summary • It is clear that the use of video (whichever format) has the ability to re-engineer services and improve the delivery of these services • Solutions can be delivered in small projects or designed to create wider networks to provide appropriate support to service users / patients depending on their individual needs • Technology solutions have to be part of complimentary packages of care and support to maximise improvements / improve outcomes and create efficiencies within services • Video is part of ‘digital approachs’ to care and support but need not be a barrier to adoption

21. Further Information Required? Any Questions ?