Cross-Cutting Telehealth Programme
Paul Marriott
TECS Lead Consultant
NHS England Strategic Clinical Networks.
TECS Clinical Advocate to NHS England &
AHSN NENC Telehealth Programme Lead
NENC
AHSN Programme of Cross-Cutting Themes
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Respiratory \ COPD
Fractures
Mental Health
AF
Medicines Optimization
Elderly Care
We are seeking to use new and existing technology to innovate, pioneer and
ultimately share with the health economy what we learn in using Technology
Enabled Care Services (TESC) in the pinch points within these and many
other clinical pathways across the North East and North Cumbria.
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The Resource and Team
Paul Marriott TECS Lead
Liz Allan
Pathway and Communications
Rachael Forbister
Sunderland CCG Pathway
Development
Jackie Smart
Florence Application
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Tripartite Programme and Partnership
North England TECS
Capability
Cross-Cutting Telehealth Programme
What is Technology Enabled Care Services TECS?
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Telehealth is the delivery of healthcare at a distance using electronic means of
communication usually from service user to clinician e.g. a service user measuring their
vital signs at home and this data being transmitted via a Telehealth monitor to a clinician
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Telecare is the continuous, automatic and remote monitoring of real-time emergencies
and lifestyle changes over time in order to manage the risks associated with independent
living
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Telemedicine is the delivery of healthcare at a distance using electronic means of
communication – usually from one clinician to another e.g. a non-specialist GP
undertaking an ECG on a patient suspected of heart disease and the transfer of that data
electronically to a specialist clinician for discussion/comment.
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E-Health is health services, information and education delivered or enhanced through the
internet and related technologies. E-Health encompasses Telecare, Telehealth and
Telemedicine
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M-Health is Mobile health monitoring where a patient can be monitored away from home
via mobile technologies 3G SMS and 4G and Apps
Whole System Demonstrator 1st & 2nd Generation Telehealth
2nd Generation Telehealth Added Cloud Services
Telehealth Clinician Led Not Procurement Led
“Practitioners are bloody minded and practice their own medicine
following their beliefs and clinical training. If something does not fit with
their medicine then they will simply not follow it.”
Dr Hussien El Shakankery GP
SCCG Urgent Care Clinical Lead
The Multi Matrix Telehealth Model Seeks to Cross the Whole Life
Perspective by Proportionally Matching Telehealth Systems with the
Patients Needs, Lifestyles and the Clinicians Medicine.
Death
Whole Life Perspective
Premature
Death
Irreversible Illness
Chronic Illness
Signs of Illness
Average Health
Good Health
Robust Health
Optimum Health
Conception
NHS Florence SMS Simple Telehealth System
SMS
Specialist Clinicians
Prompts and
advice
GP Practices
Community and Specialist
Nursing
Public Health
And the 3rd Sector
Local Authority Control Room and Adult Social Care
NHS
NHSFlorence
FlorenceSimple
Simpleand
andInstinctive
Instinctive
For Patients Who Can Not Use SMS There is a WHZAN
Solution
Annual Average Cost Per Patient by Generation of Equipment
Equipment
Type
1st Generation
Purchased System
1st Year
Capital
Purchase
Cost
Annual
Leasing Cost
£2000
Annual
Maintenance
Cost
Total
£1000
£3000
2nd Generation Leased
System
£1150
£1150
3rd & 4th Generation
Rapid Deployment
Leased System
£365
£365
SMS Florence System
NHS Owned
£45
£29
£74
Example of Current Telehealth Pathway Costs
Pregnancy Induced Hypertension
£1.20 First Week Subsequent Weeks £0.96p P/P
Gestational Diabetes
£4.72 P/P
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Some of the Current Pathways within the North East
Programme (there are now over 150)
Condition
Clinical Lead
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
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FT, GP
FT, GP
GP
FT, GP
FT
FT
FT
FT
GP and 3rd Sector
FT, GP
GP
GP
FT, GP, LA & PH
LA & PH
FT
FT
FT
Heart Failure, Angina etc.
COPD and Respiratory etc.
Hypertension
Diabetes
Gestational Diabetes
Pre Pregnancy HbA1c Family Planning
Parkinson’s
Rapid Discharge
Deprivation Medicine and Social Prescribing
Acquired Head Injury and Stroke
Primary Care Step Up Step Down
Care and Nursing Home
Weight Management
Smoking Cessation
Remote Wound Dressing Monitoring
Community Matron Case Load
Alcohol Induced Morbidity
FT = Foundation Trust GP = General Practitioner LA & PH = Local Authority & Public Health
Some the Recent highlights:
Over 150 live pathways developed spanning from Breast Feeding and Gestational
Diabetes to COPD, HF and End of Life.
Pregnancy Services commenced at City Hospital Sunderland and the pathway is now
live in 5 FT’s in the NE with 8 further FT’s scheduled to adopt the pathway and system
across the UK in Summer 2015. A recent CQC Report at City Hospital Sunderland
published 25th January 2015 stated that the “Telehealth Services were adjudged as
Outstanding.”
“The use of the Tele-health system in maternity services enabled women to monitor
blood glucose levels and blood pressure in their own homes avoiding unnecessary visits
to hospital.”
CQC City Hospital Sunderland January 2015
There has also been a cost saving in clinical practice identified with Pregnancy Services
of around £200 per patient per week. Patient satisfaction survey shows between 98%
and 100% approval.
Bringing the Partnership Together of Multiple Organizations Across the North
And
Combining the TECS I.P. of County Durham and Darlington NHS Foundation Trust
with its INR and Nutrition Programmes with that of the NHS England and AHSN
NENC Telehealth Programme we have a huge head start.
A Final Thought About Ascent of TECS in NE&NC
1st
Generation
Telehealth
2nd Generation
Cloud Based
Telehealth
3rd Generation
Mobile
Telehealth
4th
Generation
Linked to NHS
Spine
5th Generation
Wearable
Technology
And Beyond
Contact Details
Paul Marriott
TECS Lead Consultant NHS England Strategic Clinical Networks.
TECS Clinical Advocate to NHS England &
AHSN NENC Telehealth Programme Lead
NHS England Northern Senate
Waterfront 4, Goldcrest Way
Newcastle upon Tyne, NE15 8NY
Mob: 07779816519
paul.marriott@nhs.net
marriott.p1@sky.com
www.england.nhs.uk
AHSN North East North Cumbria
Biomedical Research Building
Campus for Ageing and Vitality
Nuns’ Moor Road
Newcastle upon Tyne
NE4 5PL
www.ahsn-nenc.org.uk
Workshop Activity
• Can you think of your area of work and specialism and write down the “Pinch
Points” or areas you think could benefit from the use of TECS (Telehealth)?
• Can we now use the remaining time to discuss your thoughts?