11. Prison Teleconsultation
specialist opinion
nurse with patient
shared record
n = 20 prisons
up to 50% cases no
longer need transfer out
0
200
400
600
800
Number of Consultations
2011‐12
2012‐13
14. Patients at home
Long Term Conditions
SALT / Parkinson’s
Lee Silverman voice
treatment
1hr/day x 4days/week x
4weeks
15. Supporting people
at the end of life
supporting patients
(and carers) at home
supporting staff
delivering consultant
opinions to hospice
team
shared record
16. Results:
25 COPD patients at home
Bed Days used
0
50
100
150
200
250
300
Year pre post Year pre post
-29.5%
-36.5%
17. Other uses
handover to paramedics
use within the hospital
supporting clinical handover (HEE funding)
18. Current status…
20 prisons
30 care homes
+ 15 care homes
+ 50 care homes
60 @ home
1 hospice
e-learning
Customers, Partners….
19. What are the challenges?
technical (care homes)
tariff
scheduling
collaborative working
(community teams, GPs)
culture change…STILL
(evidence?)
the importance of scale
noise in the system
ED pressures
20. Final (obvious) thoughts
Redesign means deploying many new approaches
together
Focus on the right things – services not kit
Redesign means stopping something else
This is where the headroom comes from
Change in healthcare can be delivered