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Tuesday 4 November 2014
Professor Jane DacrePresident, Royal College of Physicians
Future vision forintegrated careThe challenges, the solutions and how we can make it happen
Outline
• The challenges• The solutions• Making it happen nationally• The RCP’s role
The challenges?
Hospitals on the edge?• 65% of people admitted
to hospital are over 65
• Third fewer general and acute beds over 25 years
• 37% increase in emergency admissions in 10 years
• Multiple complex conditions
Information silos and islands
• Plurality of isolated IT systems
• Culture • Style of clinical practice • Funding
The solutions?
The Future Hospital
Patient experience
Radical restructure of wards
Secondary care stretching out into the community
The Future Hospital
Information to enable integration
• Patient-centred electronic records
• Patient access
• Standards for clinical records
Information to improve efficiency
• Effective use of technology for care
• Information available to manage, research, commission
How do we make it happen?
Promoting what works
• Future Hospital demonstrator • Improve access to specialist care for
rural frail and elderly• Use of telehealth and triage algorithms
Search for patient, get automatic summary
National and local EHR elements
Single sign on clinical p
ortal in
use in
Ninewells H
ospital s
ince 2008 !
Cluster RCT results: nearly 1/3 of 280 dermatology
clinic visits would have been prevented using
telehealth
Eminovic et al. . Arch Dermatol. 2009;145(5):558-64.
Five-point plan for governmentFuture Hospital: More than a building
The hospital is an integral part of the community
Secondary care has a crucial role wherever patients are
Five point plan principles
• Stability and long-term vision• Removal of financial and organisational
barriers• Invest now to save later• Prioritise what works and improve what
doesn’t• Adopt the Future Hospital model as a
template
NHS – 5 Year Forward View• Local choice, national
standards • Invest in research and
innovation• Break out of artificial
boundaries• Use IT to transform care
The RCP’s role?
Helping to make it happen
• Influence – national and local
• Physician education and development
• Future Hospital network, good practice case studies, exemplars etc
• Engaging with specialties and partners
Professor Jane DacrePresident, Royal College of Physicians