end of year report 2017-18 - sctt.org.uk · end of year report 2017–18 | 7 usage the development...

End of Year Report2017-18

2 | Scottish Centre for Telehealth & Telecare

At a Glance

7,500 new users of HMHM

1,200 Attend Anywhere

video consults

eConsult project

completed

4,100 citizens,

1 in 5 people over 75

use Telecare

Launch Digital Telecare

due Summer 2018

Scale up BP

67 active video

clinics

99% population

coverage for cCBT

Events 2 major

conferences

3,600 beneficiaries of learning

203 GP practices

End of Year Report 2017–18 | 3

IntroductionThis year has evidenced a significant leap forward in many of the activities that SCTT is supporting on behalf of the expansion of digital health and care in Scotland.

This progress has been built on hard work and sheer tenacity over many years. We know from our experience, that the transformation of services is not generally a simple or straightforward process, but we can clearly show it is achievable. It requires effort and commitment from a wide range of partners and interests, working collaboratively. For this, we continue to be grateful and appreciative of all our hard-working colleagues.

Technology Enabled CareSCTT continues to provide significant leadership and implementation support to the Scottish Government’s Technology Enabled Care (TEC) Programme.

The programme has supported the adoption and expansion of digital health and care services over a three year period, with over 70,000 people across our communities benefiting from this activity.

SCTT lead the service transformation programmes for Home and Mobile Health Monitoring (HMHM), Telecare and Video Enabled Services as well as delivering the cCBT programme and supporting a wide range of knowledge transfer events. Key deliverables in Year 3 (2017/18) of the programme have been:

a scale up of Home and Mobile Health Monitoring, with 7,500 new citizens using these services at a local level;

a further 13,000 citizens are in receipt of Telecare, with plans well advanced to launch the first Digital Telecare Service in June 2018;

67 services are using the Attend Anywhere video consulting system, with over 1,200 consultations undertaken.


Scale up BPThis programme has delivered the largest scale up of Blood Pressure Monitoring in Primary Care to date. It has generated improved outcomes for patients and better use of valuable resources within General Practice with:

4,100 citizens using HMHM to support blood pressure management;

203 practices engaged in HMHM activity over 8 Health Board areas;

In 3 Health Boards areas over half of practices are using HMHM.

The team have also been successful in attracting grant funding from the British Heart Foundation to undertake a programme of collaborative work, to support further development of the care model to inform our approach to national scale up.

7,500 new citizens benefiting from HMHM

13,500 beneficiaries to date

14 TEC Funded Partnerships integrating HMHM into routine care

70 different care pathways optimised by HMHM

Year 1

1931

4191

7446

Year 2 Year 3

HMHM Recruitment

Home and Mobile Health MonitoringHome and Mobile Health Monitoring (HMHM) allows citizens to better manage their own condition using digital technologies through real time information and data exchange.

The programme of work continues to deliver an important national contribution towards building capacity and capability into local service transformation and demonstrating the ‘once for Scotland’ benefits and impact of at scale adoption of HMHM.

Community of Practice

Our national community of practice, the HMHM Actions Group continues to grow. The group brings together partnership organisations from across Scotland to share, spread and disseminate knowledge on the adoption of HMHM. Throughout the year, SCTT have facilitated a series of workshops and events covering key themes of:

person centred service design;

business case planning;

harnessing the use of data for HMHM;

innovation & Next Generation Solutions.

SCTT has also established the National HMHM Procurement Collaborative to inform our journey towards a national procurement that will support further scale up and adoption.


National SymposiumThe second National HMHM Symposium event was held during Digital Health and Care Week 2017. This brought together academic colleagues, service managers and health and care professionals from across Scotland, showcasing real life examples of digital transformation in practice and the growing national and local evidence base for the use of HMHM.

Optimising Service PlanningWorking in partnership with the Information Services Division (ISD) of NHS National Services Scotland, information on the predicted prevalence of COPD, diabetes, heart failure and hypertension in the population of Scotland was developed and published. The long term predictions derived from this work provide a compelling case for the adoption of HMHM to help manage future demand and are an important resource for service planners. Work is underway to further refine the level of data analysis to develop projections down to Integrated Joint Board level.

This resource can be downloaded from sctt.org.uk/programmes/home-and-mobile-monitoring/long-term-conditions

2014100%

100%

200%

2019 2024 2029

Hypertension Diabetes Heart failure COPD

National Minimum Data Set As HMHM services continue to expand across Scotland, SCTT, working in collaboration with ISD, have facilitated the development of a National Minimum Data set for HMHM. Co-designed by TEC partners, the minimum data set is capable of being collected systematically across Scotland. Over time, this will allow data collection to become more straightforward and routine as new information systems are commissioned or developed.The use of a standard data set will also help support the creation of linked data sets. Enabling intelligent use of existing health and care data, linked to data generated from HMHM services, will allow direct assessment of service impacts and patient outcomes to inform future developments.

Predicted Increase in LTC Patients in 2029

The strength of the Action Group is that it brings together individuals and partnerships from across Scotland, each with their own expertise, experience and “know how”.


Video Enabled Health and CareAttend AnywhereAttend Anywhere is a video consulting platform that allows people in their own homes or remote locations access to a video clinic using a web browser or app on their own device. Launched in December 2016, early adopters began using the system in February 2017. From 27 consultations in the first quarter, the service now hosts around 600 consultations per quarter, with new services being established every week.

Services are in operation over 13 territorial Health Boards along with a wide range of Health and Social Care Partnerships and third sector organisations.

Support for Attend Anywhere is now embedded into “business as usual” activity within the National Video Conferencing Team, hosted by NHS Grampian. As well as supporting and administering the system, the team also provide a referral service where staff

Q1

27 106149

370

585

Q2 Q3 Q4 Q1

Attend Anywhere Consultations

2017 2018

Attend Anywhere: Begin a consultation

nhs.attendanywhere.com

Quick start

members can log a call on behalf of a member of the public.

User FeedbackUser feedback has been very positive with 98% of service users stating that they would use the service again. Key benefits included:

saved travel;

more convenient;

took less time;

less time to wait for an appointment;

saved money.

Significant benefits were also noted around not having to take

I feel this service is excellent. Quality of sound and picture/video was of very high quality. Saved me travelling and saved money. Highly pleased with this service.

Attend anywhere – begin a consultation

time off work, not having to take someone with them to the appointment and because of their condition it was safer/easier.


UsageThe development of new services is supported by the project team through a programme of individual support and knowledge exchange via a programme of monthly WebEx sessions and locally held events.

A comprehensive online resource centre is also available.

Over 120 clinics have been set up on the system, with 67 currently active. Active clinics cover a wide range of specialities across health, care and third sector services.

NHS Near MeNHS Near Me is an NHS Highland project that aims to provide NHS care as close as possible to patients’ homes. Funded by the TEC Programme and supported by SCTT, Phase 1 aims to reduce

the 10,000 patient journeys per year between Caithness and Inverness. Using a systematic approach and by developing the supporting processes and infrastructure, the aim is for NHS Near Me to become one of the normal ways in which outpatient appointments are delivered in Highland.

With funding only awarded in February 2018, significant progress has already been made:

4 clinics in respiratory, orthopaedics, stroke and rehab and rheumatology have been established;

2 clinic rooms in Caithness General Hospital have been set up to provide Attend Anywhere video links back to the clinician in Raigmore;

an NHS Near Me service model has been developed;

plans are in place to establish 20 clinics by May 2018.

In support of the Modern Outpatient Programme, it is anticipated that the service models will be made available to other health board areas as a template for developing their own services.

McMillan NursingGastroenterologyDiabetes

Rape Crisis

Paediatric Renal

Orthopaedics

Weight Management

Obstetrics

PharmacySexual Health

Stroke Rehab

Renal

Psychiatry

Respiratory

Paediatric Psychology

Oncology

Neurology

Sexual Health

CounsellingGeneral Practice

Paediatric OT

MS Support

Diabetes

Dermatology

Revive MS Support

Speech and Language

Rheumatology

Nutrition and Dietetics


TelecareThe Telecare Programme supports 26 partnerships to increase the number of citizens in receipt of Telecare Services.

Through a programme of collaborative working, events, workshops, action groups, on-line resources and social media activity, the team promote a ‘Once for Scotland’ approach. This has benefitted over 800 participants and supported the rollout of Telecare to 13,000 new recipients.

Analogue to Digital Telecare (A2DT)Telecommunication providers have indicated that analogue telephony services in the UK will be replaced by a digital service in the coming years.

As Telecare Services currently rely on analogue technology, SCTT is leading a TEC funded programme in collaboration with the Local Government Digital Office. This will ensure the sustained and safe delivery of future Telecare Services and exploit the opportunity for digital transformation.

The A2DT programme has made significant progress in 2017/18, working to the priorities identified in the Digital Telecare Roadmap 2017 sctt.org.uk/programmes/telecare/telecare-provision-analogue-digital.

17 partnerships are participating and the programme has moved

Supporting people to live independently and safely at home

1 in 5 people aged 75+ use Telecare in Scotland

TEC supported 32,000 new citizens using Telecare, 13,000 in the last year

from strategic planning to implementation. The initial focus for the year has been on establishing good foundations to test, evaluate and create the conditions to scale Digital Telecare. The first Digital Telecare services are now planned to launch in June 2018.

This implementation phase will provide:

a clearer understanding of the factors involved in a Digital Telecare Service;

guidance on how to safely transition from analogue to digital;

a Telecare community with increased skills and confidence to make informed decisions.


Deloitte Telecare Feasibility Report In response to the acknowledged variation in Telecare provision across Scotland, the Scottish Government and COSLA commissioned a feasibility study to examine a national approach to the delivery of Telecare services. A report was produced by Deloitte and published in November 2017: sctt.org.uk/programmes/telecare/telecare-expansion.

It estimated that by increasing the uptake of Telecare from 20% to 34% a benefit of around £200 million would be generated. Working with senior stakeholders across Scotland the report helped form the basis of activity for 2018/19.

This will include:

Develop an options appraisal to increase take-up of Telecare to 33% for the 75+/dementia cohort (due to evidence of greatest impact), exploring alternative models for delivery.

Commission an exploration of call monitoring and initial responder options building on the Deloitte Report and previous Farrpoint Feasibility Reports for Digital Telecare.

Telecare Data Collection & AnalysisActivity around Telecare data collection has focused on a ‘Once for Scotland’ approach to improve and standardise Telecare data collection. Strathclyde University have demonstrated how Telecare data can be effectively linked with other data sources and produced an online visualisation to demonstrate insights to support value based care. This can be viewed at phpstack-5673-364769.cloudwaysapps.com/telecare_v23

The Telecare Data Action Group, led by SCTT, developed a Telecare benchmarking collection template and definitions document. Benchmarking gives a clear picture of activity and where improvements can be made. Pilot testing has been complete with benchmarking ready to roll out nationally.

The necessary shift to digital Telecare presents a unique opportunity to establish robust and standardised data collection

processes from the outset. Future activities will explore how automation can support national data collection to help create efficiencies and support the use of data analytics within preventive and proactive care.

Online Telecare Self Check ToolThe Telecare Self Check Online Tool is a digital tool that was funded by the Scottish Government TEC Programme. The development was led by SCTT in conjunction with eight Health and Social Care Partnerships (HSCPs). The tool has been further enhanced over 2017 following user feedback.

The Tool can be accessed via the following link, or from NHS Inform:www.telecareselfcheck.scot

Working in collaboration with NHS 24 Partnership and Engagement Team the next step is to launch a supporting animation with a view to developing local and national campaigns to promote Telecare Services.


Overnight Support Overnight support (previously referred to as ‘sleepovers’) meets a range of needs for people who require support, reassurance and practical help during the night.

SCTT worked in partnership with The Improvement Hub (iHub), COSLA, Scottish Government and the Coalition of Care Providers (CCPS) to bring together stakeholders at three action-learning events, each focusing on a different topic. With

representation from 13 HSCPs and 16 organisations from the third and independent sectors, the group:

shared new models of care;

developed alternatives to overnight support;

developed an approach to support service redesign.

Robert Wallace (above) from Ayrshire shared his story of living independently.

The final report is due to be published in June 2018 with recommended next steps.

“As Robert’s independence grew so did his confidence and as his confidence grew so too did his independence”Member of staff from Roberts team

“We could not have achieved what we did without these action learning sets” East Renfrewshire HSCP

Next Generation SolutionsWith the introduction of Digital Telecare, there is an opportunity to develop HMHM solutions utilising the same systems. Termed ‘Next Generation Solutions’, the team are currently undertaking a programme of work to influence the market and shape the development of these technologies, with the aim of developing a multi-channel, integrated monitoring service supporting both health and care.


Digital Services and AppscCBTDepression and anxiety are two of the biggest public health challenges in Scotland costing the Scottish Economy over £10 billon per year and affecting as many as 1 in 5 adults.

With traditional approaches unable to meet the increasing demand for services, Computerised Cognitive Behavioural Therapy, cCBT, is being introduced across Scotland. This provides an at scale, high capacity technological solution for the treatment of depression and anxiety.

cCBT treatment is self-managed, completed in patient’s homes or community locations with evidence showing the clinical benefit to patients from the first session.

In Scotland cCBT is robustly evidenced to:

improve patient access to psychological therapies;

provide additional treatment choice and early intervention;

act as a first-choice treatment, a genuine alternative to anti-depressants;

support GP’s, mental health services in both primary and secondary care;

be delivered at scale.

Using a phased approach, with phase 2 funding provided by the Technology Enabled Care (TEC) Programme, cCBT is now available to 99% of the adult population in 13 of 14 Health Board areas. It is anticipated that full coverage will be attained shortly.

26,000 referrals to date, 870 per month

99% coverage of Scottish population

Adopting a systematic, “Once for Scotland” approach, the programme has achieved:

10,553 referrals in 2017, an increase of 3,000 on the previous year;

referrals coming from 23 clinical sources including GPs (85%), clinical psychology, mental health, occupational health, social work and acute services eg, diabetes;

patients waiting less than 5 working days before accessing treatment;

77% of patients state that they received the treatment they wanted and were satisfied;

suicide ideation of over 2,000 patients actively monitored per month and reported to clinical staff when required;

over 50 members of staff across the 14 territorial boards now have the expertise and skills to develop and run TEC services.

“This is the first national eMental Health delivery project that has had national impact at scale that has fostered collaborative working among all stakeholders to the benefit of the patients we serve.”Professor Kevin G Power Chair of Heads of Psychology Scotland

eConsulteConsult is an online triage and consultation tool that aims to reduce some of the pressures on Primary Care. It offers direct access to local self-management advice and GP services with the level of clinical governance expected by NHS Scotland. SCTT have successfully completed the trial of eConsult within a range of GP practices throughout Scotland. Information from the initial trial has supported the second phase of the study – an evaluation undertaken by Stirling University.

The research team worked closely with all the practices involved and have now published their findings. The report can be found at: sctt.org.uk/programmes/digital-services-and-apps/primary-care/econsult/

Following review by the Primary Care Digital Services Board in March 2018, the Board decided not to progress with eConsult at this time. The Board noted that online consultations need to be considered within a whole system context, working beyond just

General Practice. It is anticipated that learning from the eConsult project will help inform future developments in this area.

Mobile App QA FrameworkSCTT have supported the Scottish Government’s eHealth Mobile App Working Group in defining the Quality Assurance Framework for Mobile Apps for Healthcare Professionals. The group have now agreed a set of criteria and established a Quality Assurance

Panel that will be responsible for validating mobile apps prior to any endorsement or recommendation. The framework is split into three major parts (see below).

Work is currently underway to procure a solution which will allow the endorsed mobile apps to be accessed by healthcare professionals. This activity is being jointly delivered by eHealth and NHS National Services Scotland (NSS), with the aim of the developed platform being populated with quality assured apps by Q2 2018/19.

PaRT 1Compliance with Standards, Regulations and Legislation

PaRT 2adherence to NHS Scotland-

specific quality criteria.

PaRT 3 Impact Evaluaion

eConsult fits around content on existing practice websites

Mobile compatible so eConsult can be easily

accessed anywhere on the move



mPowermPower is a €8.7m, five-year EU Interreg VA funded project operating in the border counties of Northern Ireland, Republic of Ireland and Scotland. It will create a cross-border service for older people (age 65+) living with long-term conditions. Community Navigators will work with people referred from health and care services to develop wellbeing plans connecting them to activities in their community, as well as connecting them to technology to enhance support for health and wellbeing.

As the lead partner, NHS 24 are working collaboratively with health and social care services across the three countries along with the Scottish Council for Voluntary Organisations (SCVO) and the University of the Highlands and Islands. The project is also supported by Cooperating and Working Together (CAWT), a partnership between the health and social care services in Northern Ireland and Republic of Ireland.

Following completion of the planning and foundation stages, the project was formally launched by the Cabinet Secretary for Health and Sport, Shona Robison, in November 2017.

With support from the wider SCTT team:

landscape reviews of Video Conferencing and Home and Mobile Health Monitoring have been completed;

a report on International Practice on Digital Apps has been commissioned from the Digital Health and Care Institute;

SCVO have started mapping community and voluntary resources – forming the environment for the social prescribing activity in the project;

the mPower wellbeing plan has been developed and approved.


Whilst the majority of activities have been with European partners, we have also worked with stakeholders from Australia, Canada, New Zealand, Singapore and the U.S.A, demonstrating the high level of interest in Scotland’s digital health and care agenda.In preparation for the UK’s departure from the European Union in April 2019, the Team has continued to focus its engagement efforts on activities that will strengthen Scotland’s relationships with key European regions.

In working to implement our European Engagement Action Plan for 2017/18, we focused on 4 main areas of activity.

Global OutlookEnhancing our global outlook we:

share Scottish good practice and lessons learned in technology enabled care, digital health and integrated health and care via:

the EIP on AHA Repository ec.europa.eu/eip/ageing/repository_en;

the CHRODIS repository chrodis.eu;

the SCIROCCO project website www.scirocco-project.eu;

the TITTAN project www.interregeurope.eu/tittan;

organised 11 study visits to Scotland, hosting stakeholders from Catalonia, Denmark, Finland, Japan, Norway, Sweden, U.S.A. and Western Australia;

continued to facilitate the introductions for Scottish stakeholders to relevant international partners, to promote knowledge exchange and collaboration opportunities.

Relationships and Partnerships

To continue building our external relationships we have:

continued to represent Scotland in key European and international networks, actively participating in network activities, with a view to building strong, collaborative partnerships that will stand Scotland in good stead as we move towards BREXIT.

implemented a Memorandum of Understanding Action Plan between:

the Basque Cou

alonia and Scotland;

Developed new Memorandum of Understandings between

Odense University in South Denmark and the Digital Health and Care Institute

University of Adger in Norway and the Digital Health and Care Institute;

organised a wide range of study visits, dissemination events and webinars in conjunction with our partners;

progressed four new joint funding proposals.

International EngagementThroughout the year, SCTT’s International Engagement Team facilitated Scottish stakeholder involvement in a range of international knowledge exchange activities.


ReputationTo build our international reputation to support greater exports and inward investment in Scotland in the field of digital health and care we:

continued to raise Scotland’s profile internationally by presenting our successes and experiences at key events to influential stakeholders;

continued to work with Scottish Development International and the Digital Health and Care Institute to secure new inward investment opportunities with Japanese stakeholders;

identified funding opportunities for Scottish stakeholders, facilitating 10 new funding applications with one pipeline proposal approved for funding (ACT@Scale – www.act-at-scale.eu).

European UnionWe will remain a committed European actor, continuing to promote Scotland’s voice within Europe in the field of technology enabled care and digital innovation.

We continued to represent Scotland in the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA).

We worked with Scottish stakeholders to provide formal responses to six European consultations related to digital health and care, including consultations on European Commission funding programmes.

We continued to deliver the SCIROCCO project, funded by the EU Health Programme. This €2.2m 32-month project has developed an online tool for regions to self-assess the maturity of their integrated care systems. More than 40 regions world-wide used it to self-assess their maturity during 2017/18. www.scirocco-project.eu

We launched the EU Interreg VA Programme project, mPower, in June 2017.

In February 2018, the International Engagement Team was transferred to NHS National Services Scotland, where it continues to deliver on the Scottish Government’s agenda on international engagement.


Knowledge ExchangeUnderstanding digital health and care services relies upon sharing knowledge and lessons from implementation. It is an important aspect of continuous improvement activity.

Over 2017/18, SCTT facilitated and provided input to a large range of Scottish, UK and International events, supporting learning and knowledge transfer for over 3,600 people.

In addition, SCTT:

provided input to three undergraduate teaching programmes in Nursing and Biomedical Engineering;

presented at over 34 conferences and learning events.

and opportunities for digitally enabled services the focus of the day.

The morning session of the programme was webcast live and made available as an ‘on-demand’ resource following the event. The webcast is available to view at app.video3.co.uk (username: [email protected], password: welcome1234).

Alongside the programme, the exhibition area included examples of technology used in virtual clinics, supported housing, falls prevention and virtual reality. The event attracted 250 delegates on the day as well as 117 views of webcasts.

3,600 beneficiaries of learning and development activity

2 major conferences held

9 international study visits hosted

Scottish Digital Health and Social Care Learning Network The change in title for the event was agreed to ensure clear alignment with wider Scottish Digital Health and Social Care strategy and policy.Organised by SCTT, with support from Scottish Government Technology Enabled Care (TEC) and the Digital Healthcare Innovation Team, the 2017 event, was held at Queen Margaret University, Edinburgh. Attendees heard about progress on the national TEC workstreams, with good practice and new solutions,


Scottish Digital Health & Social Care Week and Conference The annual Scottish Digital Health and Social Care Week took place in November 2017, with the main Digital Health and Social Care Conference held in Strathclyde University. 360 people from a range of organisations including health, social care, housing, third sector, policy, research and academia attended the conference.

Members of the team were also involved in a range of events across Digital Health and Social Care Week. These included webinars, TEC workstream events, symposiums, project meetings, a design workshop and a breakfast club meeting.

Jointly organised with colleagues from the Scottish Government eHealth and TEC Teams, the 2017 Conference featured a theme of ‘Demonstrating Transformation Using Digital Health and Care’. Representation from all sectors involved in advancing digital health and care services continued to grow and was evident in the involvement by colleagues

from the Local Government Digital Office, the Digital Health and Care Institute, the Alliance and the Scottish Council for Voluntary Organisations in the Steering Group and conference programme.

The Cabinet Secretary for Health and Sport, Shona Robison, opened the conference and welcomed the delegates. The morning plenary session was made available as a live webcast and ‘on-demand’. This allowed a further 88 participants to take part. Planning is already underway for the 2018 event.

Higher Education - Embedding Technology Enabled Health and Care SCTT has continued to deliver lectures, tutorials and podcasts reaching over 750 people. This activity raises awareness about technology enabled health and care with academic staff and helps embed it into undergraduate programmes and CPD modules. This

activity has been supported by sharing resources directly with the academic staff and by increasing the number of Higher Education Institutions (HEIs) who participate in knowledge exchange events.

SCTT has also built new relationships with the Scottish College Development Network, presenting to the Care Strategy Steering Group; providing content for training programmes and delivering workshops on the topic of ‘Digital Futures’, at the inaugural conference for final year students.

SCTT Website and Social MediaOur principles of sharing good practice and good news, highlighting success and opportunities for discussion has been well received. Utilising social media to inform our stakeholders about new resources, events and opportunities for knowledge exchange has resulted in a steady increase in visitors to the website and followers on Twitter. Please visit us at www.sctt.org.uk and join us on twitter @NHS24_SCTT to become part of Scotland’s thriving TEC community.


Awards

Holyrood Connect Digital Health Award The Home and Mobile Monitoring team (TEC & SCTT/NHS 24)

Digital Health and Care Project Delivery Award cCBT

Digital Public Services Award Attend Anywhere Project Team

Team members were also shortlisted for:

The Scottish Health Awards – Innovation Award for Attend Anywhere The Scottish Health Awards – Integrated Care for Older People Award for HMHM Digital Health and Care Awards - Data Insight Award for Telecare

www.sctt.org.uk [email protected] @NHS24_SCTT

end of year report 2017-18 - sctt.org.uk · end of year report 2017–18 | 7 usage the development...

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