Tameside & Glossop CCG & Tameside MBC
Tameside & Glossop CCG & Tameside MBC
Digital Health Centre
Briefly describe the initiative/ project/service; please include your aims and objectives
Tameside and Glossop face a number of challenges that are shared by local authorities and healthcare providers nationally; an ageing population leading to an increased demand on services, in a highly constrained financial climate. The current annual funding gap across the local health and care economy is estimated to reach £70 million by 2020/21 if action is not taken. In a bid to reduce emergency A&E attendances and admissions for frail older people, as well as supporting care homes to improve quality by preventing the need for staff to leave homes understaffed to escort patients to hospital, we have developed a Digital Health service. This supports personalised care of older people within their own place of residence, improving care as well as reducing cost.
The Digital Health Centre (DHC) is a team of nurse specialists who provide advice and guidance to care homes and Tameside Council’s Community Response Service (CRS), which supports frail and older people living in their own homes. Operating 7 days a week, the DHC provides expert medical guidance and support via Skype to all of the care homes in Tameside and Glossop, and to CRS carers through handheld tablet devices.
What are the key achievements?
Since its full rollout to all 46 care homes across Tameside and Glossop the DHC has received 8,600 calls (between April 2017 to January 2019), avoiding 2,360 A&E attendances, 808 GP callouts and saved approximately 1,452 hospital bed days or 6.8 beds. This has delivered a financial benefit of £740,000. Further indicative savings against other avoided activity resulting from the DHC, for example community activity of GPs and nurses, is estimated at £134,000.
This successful impact was replicated by Tameside Council’s CRS. Of the 3,143 falls attended by the CRS in 2018 only 392 required an ambulance call-out, resulting in savings of £1,328,229. The CRS also reduced the need for interventions by the fire brigade following smoke detector activations (58 attendances for 4,105 smoke detector activations), and successfully managed 4,371 pill dispenser activations and 55,222 wander alert activations. Qualitative benefits of the DHC include the upskilling of care home staff to undertake basic observations on residents and improved patient choice on where they want to die at the end of life. The instant delivery of services also frees up time for GPs and care staff to carry out other duties.
What are the key learning points?
We are continuing to recruit and grow the service in collaboration with our partners to address the challenges of an aging population, most notably through our frailty programme, which aims to provide the CRS and Digital Health service to a significantly wider cohort of patients and service users. We have also integrated management of urgent GP calls into the DHC and have successfully transferred Telehealth Monitoring for Long Term Conditions into the service in March 2018.
The next stage of the DHC has been an exciting pilot with North West Ambulance Service called the Urgent Care Provider pilot. We have access to the 111 & 999 call stack and intervene where it’s safe to do so to avoid ambulances and further Emergency Department attendances. Since this service commenced in June 2018 we have steadily increased capacity within the team along with training and development. Thanks to this close partnership working, we have now picked off 200 Calls from the stack and prevented 120 ambulance call-outs. Up to December 2018 this has resulted in a further 80 patients being deflected from Emergency Department, allowing further savings for our wider health economy.