This report (Document “AI”) provides an update on the progress and changes to the Airedale and Partners Telemedicine Vanguard since 2016.  The Vanguard programme has now reached its conclusion and this report also includes the findings of the evaluation of the Telemedicine part of the Vanguard Programme.

Recommended –

That the findings of the evaluations be noted.

(Rose Dunlop – 01274 431915)

A report was submitted (Document “AI”) which provided an update on the progress and changes to the Airedale and Partners Telemedicine Vanguard since 2016.  The Vanguard Programme has now reached its conclusion and the report also included the findings of the evaluation of the telemedicine part of the Vanguard Programme.

Members were reminded that, in March 2015, Airedale and Partners was one of six ‘enhanced health in care homes’ Vanguards selected by NHS England as part of its New Care Models Programme.  The programme aimed to scale up the existing delivery of telemedicine to care homes in four CCG areas (Bradford City, Bradford District, Airedale, Wharfedale and Craven and East Lancashire).

A detailed presentation was provided to Members of information contained in Document “AI”.  In conclusion, Members were informed of the limitations of the data collected as part of the evaluation process which had reduced the number of care homes that could be analysed from over 200 to 141 and due to some of the small numbers used for the analysis, the findings were unlikely to have any statistical significance.  The evaluation of the 141 care homes, in the year following installation of telemedicine, showed a reduction in emergency hospital admissions of 3%, a small increase of 2% in the use of out of hours services and a reduction in the use of 111 calls by 4%.  The varying service models and local issues affecting the way in which telemedicine was used, as well as the inconsistencies of its usage across care homes, were also factors which needed to be taken into account when considering the findings.

The following responses were provided to Members’ questions:

·         Airedale and Partners had only evaluated the telemedicine aspect of the Vanguard Programme, which was one of the seven intervention areas.  Following a request from NHS England in 2016 to widen the delivery scope to include the full range of activity, it was decided that this should be undertaken by one CCG partner and was therefore led by East Lancashire CCG.  An evaluation of their findings was due to be produced.

·         The Vanguard Programme had not been decommissioned.

·         The evaluator had experienced difficulties in accessing care homes to discuss the use of telemedicine with staff.

·         East Lancashire, as part of their evaluation, would be able to demonstrate cost savings as they were replacing a whole system, but this had not been possible as part of the telemedicine evaluation.

·         The use of telemedicine had raised challenges around losing the personal touch for some patients.

·         The evaluation had not included tests to review how primary care was impacted by telemedicine.

·         When the partners had met to share learning, all commissioners took away learning about how to improve the use of telemedicine.

During the discussion, Members recognised that two years was a short timeframe for the evaluation but hailed the concept of telemedicine as a good way of incorporating technology to help deliver services.  Telemedicine was also considered a new way of working which would take time to embed but important to continue to avoid unnecessary emergency hospital admissions.

The Assistant Director, Operational Services provided a broader overview of where telemedicine fit into the whole system and stated that the evaluation report on telemedicine should not be viewed in isolation.  She spoke of other technology used within service delivery, such as Safe and Sound, which aimed to enhance, not replace, services and which helped people to live independently.  She stressed the importance of partnership working to proactively plan ahead and how vital it was to have sufficient staffing in care homes to make systems used within them work effectively.

Resolved –

(1)       That officers be thanked for the report (Document “AI”) and presentation.

(2)       That an item be added to the Committee’s work programme for 2018/19 on the development of digital health.

ACTION:       Strategic Director, Health and Wellbeing