A Digital 20:20 Vision

Justine Westwood, NHS 24 and SCTT

BACKGROUND• NHS 24 took on responsibility for SCT

in April 2010• SCT Strategic Framework 2010-2012• NHS 24 took on responsibility for

National Telecare Programme in April 2011

• Telecare Action Plan 2011-2012• NHS 24 Strategy Development 2012

CONTEXT• SGHD 2020 Vision• Quality Strategy• Digital World (SG Digital Strategy; NHS 24 Horizon

Scanning)• Public Sector Finances• Scotland and Health and Demography of Scotland• Christie Commission• SGHD e-Health Strategy (and emerging Citizens e-

Health Strategy)• Health and Social Care Integration• Manifesto commitments (cancer; health inequalities;

early years)• National Telehealth and Telecare Strategy

NHS 24 STRATEGY – RECENT PROGRESS IN PAST 3 YEARS

• Strong performance and delivery• Creativity and innovation• Expansion of and accelerating development

of channels and services• Unscheduled care OOHs now only one of a

wide range of services• Recognised as contributing more to NHS

Scotland and NHS Boards• Reputation of organisation positive

• Telestroke Networks – covering 11 Health Boards• Paediatrics – Unscheduled Care / Decision Support;

Maternity Telehealth• Long Term Conditions – Pulmonary Rehabilitation; Home

Monitoring• Mental Health – Forensic Psychiatry; Dementia Support for

Care Homes• National Infrastructure• Education and Training• DALLAS• Europe – Regional Telemedicine Forum; Momentum; CASA;

pipeline projects

SCTT – RECENT PROGRESS IN PAST 2 YEARS

1. Continue to improve, expand and develop services – expect continued growth in services and channels

2. “Multichannel NHS Services” – bigger than just NHS 24

3. Role of NHS 24

NHS 24 STRATEGY – KEY MESSAGES FOR NEXT 3 YEARS

KEY MESSAGE (1) – IMPROVE, EXPAND, DEVELOP INCLUDING…

NHS inform Care Information Scotland

CBT Living Life Computerised CBT

Taking Measures MSK

Patient Reminder Service Perinatal Advisory Service

Web cam Web chat

Life Begins @ 40 STV Health Centre

Digital TV SMS text

Facebook Twitter

• NHS in Scotland ‘going multichannel’

• More collective approach across NHS in Scotland (and Health and Social Care; and Public Services)

• More joined up, more focussed, collective effort and ownership

• NHS 24 vital player

• Supporting SGHD

KEY MESSAGE (2) – MULTICHANNEL NHS

SERVICES

internetTV

Telecare

Face2

FaceSMS

video

mobile

phone

• National Asset• Delivery of services• Leading• Facilitating• Resource supporting NHS Scotland• Horizon Scanning discipline• Research and Development• Academia and Industry links and partnership• Across Health and Social Care• Across Public Services• Europe• Enterprise• Innovation

KEY MESSAGE (3) – ROLE OF NHS 24

NATIONAL TELEHEALTH AND TELECARE STRATEGY

• Reflect Scottish Government’s 2020 vision• Identify vision for Telehealth and Telecare in Scotland• Proposed priorities of

– Health and Wellbeing– Empowering People– Improving Value

• Identify what success will look like

SCTT Action Plan will ….

• respond to the National Strategy clarifying the contribution SCTT can make;

• respond to the recommendations made by Audit Scotland;

• respond to the requests made by Health Boards and Local Authorities;

• progress well defined opportunities;

Scottish Centre for Telehealth and Telecare

Strategy 2012-2015

NHS LANARKSHIRE CLINICAL PORTAL

Sean Brennan, NHS Lanarkshire

LTC Info Hub and Clinical Portal Programme Manager

The world of Tannochbrae

VisitsGP/practice

nurse

Visits OutPatientsAttends A&E

Is visited at homeNurse or care worker

midwife etc

In-Patient

The world has changed

Visits OutPatients

VisitsGP/practice

nurse

Calls NHS24

Uses theHome HealthCare Guide

Calls OOHservice

Is visited at homeby GP, nurse, social

/ care worker,midwife etc

Visits thedentist

Attends as an Inpatient

Attends A&E

Calls 999

NHS 24online

Visits awalk-incentre

Goes to the Pharmacy

Business Drivers

Why the Clinical Portal ?

Poly-Record !

Illustration kindly provided by NHS Redbridge

Falling through the cracks

• Victoria Climbie – 12 chances to save her life in 10 months not taken

• Previous tragedies – the common threads are– Late intervention– Lack of information sharing– No one person with accountability– Over stressed front line workers

• Lord Laming re Victoria Climbie– (Recommendation 78) Within a given location, health professionals should

work from a single set of records for each child. (paragraph 11.39)– (Recommendation 90) Liaison between hospitals and

community health services plays an important part in protecting children from deliberate harm.

• Baby Peter Inquiry– “The Inspection found that record keeping is inconsistent

and sometimes of poor quality. This means that vital information which might help to form a complete picture of a child’s safety and welfare is not available.

Separate Applications with islands of clinical information

Presentation layer (Clinical Portal)

PAS

Diary

OCS

Plans

HEPMA LABS PACS MiDiS Cancer Diabetes

PAS

or

PMS

A Clinical Portal will pull together documents and data to create a complete record – regardless of where that information was a) created or b) stored. It will also enable seamless links to other clinical systems.

NHS Lanarkshire: Clinical Portal

• What is a clinical portal ?• What do clinicians want to see in their portal?• How will this be delivered and when?• How is clinical data captured in an increasingly paperless or

paperlight NHS?– Digital Pens– Tablets/Direct computer input– Other