Telemental Health - Forensic Network

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Cathy Dorrian
Service Development Manager
National MH Programme
Scottish Centre for Telehealth &
Telecare, NHS 24
Overview of Presentation
• Background – SCTT & NHS 24
• National Programmes
• Telemental Health in Scotland – multichannel
approaches & examples
• Priority &Transferability……
Background - SCTT & NHS 24
• SCT funded by SGHD - operational 2007
hosted by NHS Grampian
• Reviewed in 2009 and merged with NHS 24 in
2010
• Telecare (JIT) joined SCT in 2010 – now SCTT
• New Strategy for 2012 – 2015 out for
Consultation
Current SCTT National Programmes
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Mental Health
Stroke and CHD
Paediatrics
LTC – COPD/DALLAS/Telecare DP
National Infrastructure Project
Education & Training
Telemental Health
• 2009 Review of Telemental Health in Scotland
commissioned by SCT – Dr. Harry Miller
• Mental Health Team established in 2010 – Clinical
Lead Dr. Stella Clark
• Nurse Consultant, SDM and Tony McLaren National
Co-ordinator BS & LL
• Lucy Robinson from Geoff Huggins dept working with
us to progress Commitment 6 from the MH Strategy
(technology platform) – Project Ginsberg
The NHS in Scotland is facing growing
demand for its services and NHS boards
need to consider new models of care such
as telehealth to help manage current and
future demand. Targeted appropriately,
telehealth offers the potential to help NHS
boards deliver a range of clinical services
more efficiently and effectively. NHS boards
should consider the use of telehealth when
introducing or redesigning clinical services.
NHS boards should:
Ensure that telehealth initiatives are
supported by business cases that
consider the long-term clinical,
organisational and cost benefits
resulting from the use of telehealth.
internet
phone
TV
mobile
telecare
video
SMS
Face
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Face
Mental Health - Current Tel. Services
• Breathing Space – National confidential tel. service for people
experiencing low mood, depression or anxiety. Live since 2004 – 7,000
calls per month
• Free National Telephone based Guided Self Help service – based on CBT &
provided by a team of self help coaches. Fortnightly sessions over a period
of 6-12 weeks. Workbooks/materials sent to patients or online. (No cost to
Boards)
• Telephone based CBT on request by boards – patients work with qualified
therapists. Fortnightly sessions over 4-12 weeks using
workbooks/materials sent to patients home or download online.
• MH Nurses based at NHS 24
Current Mental Health Proof of Concept Studies
using videoconferencing
• Teleneuropsychology Services
• Substance Misuse Services
• Dementia Services – Care Homes
• Prison Healthcare – Forensic Services –(NHSL)
• Police Cell Health – Custody Suites
• Training & Education – STRADA, BS
Abbeyfield
Ballachulish
22 care home beds
2 intermediate care
beds
2 respite beds
Very sheltered
housing
Lunch Club
Day Care
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Outcomes from Dementia Clinics via VC
2 patients successfully withdrawn from antipsychotic
medication.
2 patients managed solely with behavioural plans
2 prevented admissions
No new prescriptions for antipsychotics
– Difficult to calculate a cost saving but average stay in
dementia assessment unit is 10 weeks and cost of
admission to New Craigs is £290/day. Potential savings of
£40600.
One patient was admitted but possibly admitted later than she
would otherwise had been and discharged earlier.
Staff feel better supported and upskilled in recognising and
managing psychiatric symptoms
Forensic Services – Scottish Prison Service
• NHS now responsible for Prison healthcare – Nov 2011
• Feasibility Study – proof of concept
• Provide FS from the Orchard Clinic at REH to HMP Edinburgh & HMP
Addiewell
• New VC kit installed in both prisons, staff trained, fortnightly MDT
meetings, case reviews. Increased Consultant productivity, reduced travel
time.
• Went live direct patient care (VC) HMP Edinburgh Sept 2012
• Go live to HMP Addiewell Nov 2012
• ?? Surgery Pods x3 for health screening e.g. hypertension (NHSL)
NHS Scotland – Digital TV Platform
NHS Scotland – Digital TV Platform
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Working to widen public access to NHS Scotland on new
channels on digital TV
NHS Scotland services on Freesat & Sky:
Go to Channel 539 (Community Channel)
Press RED
NHS Scotland services on Virgin: Interactive Channel
Also available to download as an app on android and iphones by texting postcode or 'NHS24' to 61061
NHS Scotland - Digital TV Platform
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Service Delivery Benefits:
Helping people to self serve
Efficiency savings
Fewer GP ‘no-shows’
Delivering services on popular devices
Using trusted technologies to deliver health services
for older people - TV
• Bridging the digital divide
Digital TV Platform – other opportunities??
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Prison healthcare??
Online CBT? FV already using online CBT
Access to AHP’s
Access to Primary & Community Care and MH
Services?
• COPD Development – being worked up
• Alcohol Brief Interventions – being worked up
Training & Education
• Working in collaboration with STRADA to
deliver specialist SM training & education to
SPS, NHS Boards, DAP’s & Police (ACPOS) via
VC & webcasts
• Breathing Space – VC sessions/webcasts
Telephones??
Smart mattress technology….
Wireless patch for patient monitoring
• RESpeck Device – University of Edinburgh
• •Wireless patch with a three-axis accelerometer
• •Sealed case and self-adhesive pouch
• •Measures chest wall rotations as the wearer breathes
• •Provides a respiratory effort waveform, respiratory rate and patient
activity data. Patches also available for BP/ECG recording.
Opportunities…..?? What is transferable for the
Prison Population & Staff??
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Prison solves problem of illegal mobile phones – see
article
CBT – FV using online CBT possible model for PHC via
Telephone and Digital TV?
Improving access to NHS 24 Tel. MH services?
Improving access to other services eg. Dementia,
Substance Misuse, Epilepsy, LD
Tele-visiting for families
CPD for staff – New to Forensic Course?
Discussion?? Questions??
Thank you for listening
cathy.dorrian@nhs.net
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