Telemedicine for care homes - scoping and implementation

Telemedicine for care homes - scoping and implementation 

Guides developed alongside a staged implementation of a Telemedicine Service Hub in the Hampshire and Isle of Wight STP footprint, which was fast tracked as a result of  Covid-19.

Telemedicine for care homes: a strategic scoping guide
Wessex AHSN August 2020

• This scoping guide goes through a process, and outlines the things to think about when developing a telemedicine service for care homes, allowing you to develop a service that works for you. It includes
• Guidance for scoping and planning
• Links to a range of resources to support and inform thinking
• Case studies from Hampshire Hospitals Foundation NHS Trust and West Hampshire CCG to show how this works in practice.

Telemedicine for care homes: a strategic implementation guide
Wessex AHSN August 2020

• This guide is aimed at a strategic level, to help develop and implement telemedicine services by collating in one place all the resources and lessons learned from service development in the Hampshire and the Isle of Wight STP.

Introduction to and spread of COVID-19 in care homes in Norfolk, UK

Introduction to and spread of COVID-19 in care homes in Norfolk, UK [Preprint]
medRxiv 2020.06.17.20133629; doi: https://doi.org/10.1101/2020.06.17.20133629

• Monitoring of COVID-19 in care homes in Norfolk highlights that counts of non-care workers had strongest relationships to any introduction of COVID-19. After a care home had at least one detected case, higher staff levels and more severe PPE shortages were most linked to higher case counts (p < 0.05). 
• They conclude that better managing aspects of staff interaction with residents and some working practices should help reduce ingression to and spread of COVID-19 within residential homes for the elderly.

Abstract

Care after Coronavirus: An emerging consensus

Care after Coronavirus: An emerging consensus [blog]
IPPR 22 May 2020

• A summary of the six key findings from a nationally representative poll sample of 2,475 British adults on their views on social care after the coronavirus.

1. There is a crisis in confidence in social care as a result of Covid-19
2. The public recognise that we need to spend more on social care in the future
3. They want care workers to receive a pay rise
4. They are sceptical of voluntary insurance and using personal housing wealth as a way of achieving that
5. They support an extension of NHS principles: ‘free at the point of need and taxpayer funded’
6. There is a growing cross-party consensus

Markets and modelling project

Markets and modelling project
LGA
The Markets and Modelling Project is designed to support councils, sub-regions and regions, to better understand the local care market. The CQC registered provider tool is available to all councils and can be downloaded from care homes and services in your home, along with the CQC tool user guide. This is an interactive map-based tool that provides quick and easy access for councils to help them analyse commissioning activity.

The project is part of Commissioning and market shaping resources from LGA. Other material include resources and case studies relating to commissioning and market shaping for adult social care; market shaping tools and guidance, resources around contingency planning and market sustainability.

Advance care planning: A quick guide

Advance care planning: A quick guide for registered managers of care homes and home care services
NICE, SCIE May 2019

• Managers of care homes and home care services have an important role to play in supporting people to consider advance care planning, and should receive training to enable them to do so. This quick guide includes Introducing advance care planning; Providing information; Helping people decide; Developing advance care plans; Recording and sharing advance care plans and Further information.

Role of comprehensive geriatric assessment in healthcare of older people in UK care homes: realist review

Role of comprehensive geriatric assessment in healthcare of older people in UK care homes: realist review
BMJ Open 2019;9:e026921. April 08, 2019. doi: 10.1136/bmjopen-2018-026921

• A realist review of the literature identified 30 articles which suggested comprehensive geriatric assessment (CGA) in care homes had three main components, all of which need to be in place to make CGA work. These are structured comprehensive assessment, developing a care plan and working towards patient-centred goals. Each of these required engagement of a multidisciplinary team.

Abstract

: Older people's pathway: CQC local authority area data profile

CQC local authority area data profile: Older people's pathway
CQC updated 21 March 2019

• Profiles for each Local Authority of care pathways for people aged 65 or over, including demographics, service provision, residential and nursing care home beds per population aged 65+, service provision, service user experience, activity (acute hospital, A&E attendance, emergency admission, length of stay, transfer delays, CHC activity). Includes activity data for care home residents.

Home care in England: views from commissioners and providers

Home care in England: views from commissioners and providers
Kings Fund 11 December 2018

• This report brings together findings from three Kings Fund reports examining the factors driving commissioning adult social care; the mechanisms of purchasing and delivery of home care and alternatives to traditional models of delivering care at home.

Framework for maximising the use of care homes and use of therapy-led units for patients medically fit for discharge

Framework for maximising the use of care homes and use of therapy-led units for patients medically fit for discharge
NHS England 18 December 2017

• This best practice framework aims to address two models and the implementation approach that needs to be taken by STPs and their Provider Organisations to address winter pressures.
• These models aim to describe ways of working to maximise the appropriate use of care homes and describe an operating model for optimising care of cohorted patients in Therapy-Led Units, who are Medically Fit For Discharge.

System Transformation and Care Homes: A discussion document

System Transformation and Care Homes: A discussion document
Good Governance Institute and Care England October 2017

• A discussion paper, developed through a literature review and desktop review of all 44 STPs, identifies the gaps in the STP process and how care homes can fill these gaps. Opportunities are illustrated through case studies from three of the vanguard sites – Airedale and Partners, Gateshead Care Home Project and Sutton Homes of Care

Local analysis of elderly care beds

Local analysis of elderly care beds
Which? October 2017

• Which? have used ONS and CQC data to estimate the change in number of care home beds required to maintain supply at the current level to 2022, for the population aged 80 or over in each Local Authority area.

Fire safety law and guidance documents for business

Fire safety law and guidance documents for business
Home Office

• This collection brings together all documents relating to fire safety law and guidance documents for businesses. 
• Includes fire safety risk assessments for healthcare premises and residential care premises.

Person-centred care for older people in care homes

Person-centred care for older people in care homes
SCIE, May 2017

• This resource covers the implications of the personalisation agenda for owners and managers of care homes. It summarises information, advice and guidance which will support care home owners and managers as they develop a person-centred (or personalised) approach to care in their homes.
• Includes links to key resources and evidence.

STPs: moving towards implementation -

Sustainability and transformation plans: moving towards implementation
Presentations from an event held at Kings Fund on 24 May 2017

• Scaling up prevention in Gloucestershire, Mary Hutton, Accountable Officer, NHS Gloucestershire CCG and STP lead, Gloucestershire STP
• Mental health across local areas: the experience so far, Claire Murdoch, NHS National Mental Health Director, NHS England
• Integrating mental health into sustainability and transformation partnerships, Chris Naylor, Senior Fellow, Policy, The King’s Fund, Holly Taggart, Policy Research Fellow, The Royal College of Psychiatrists
• Care homes from the periphery to the system: spreading new care models, Mark Adams, Chief Officer, NHS Newcastle and Gateshead Clinical Commissioning Group and STP lead, Northumberland Tyne and Wear and North Durham
• Transforming primary care in Dorset, Dr Phil Richardson, Director, Design and Transformation, 
• Getting people involved in shaping and improving health care locally, Dr Tom Nutt, Chief Executive, 
• Community hubs and transforming primary care, David Smith, Chief Executive, NHS Oxfordshire Involving people in decisions about their care , Mark Doughty, Patient and Senior Consultant, Leadership and Organisational Development, The King's Fund
• An accountable care organisation: a 20 year journey, Stephen Rosenthal, Senior Vice President, Population Health Management, Montefiore Health System
• Ribera Salud Group: from hospital to population health management, Alberto de Rosa, Chief Executive, Ribera Salud

A Teaching Care Home pilot

A Teaching Care Home pilot
International Longevity Centre UK, 25 April 2017

• The Teaching Care Home pilot set out to change and challenge prevailing perceptions around the workforce in care home nursing, recognising that the key to sustainability in the sector is through workforce training and development and through this delivering improved health and care outcomes for residents.
• The pilot is funded by the Department of Health and led by Care England.

Improving accountability in the provision of new models of care

Improving accountability in the provision of new models of care
National Primary Care Network, March 2017

• Report of a meeting focused on testing ideas described as accountable care systems, specifically concentrating on whole population budgets and metrics that may be used in the new care models that are prioritising primary care provision. 
• Contents include
• Population budgets
• A whole system approach to providing care
• New metrics for new care 
• Primary Care Home programme updatemetri

Framework for enhanced health in care homes (EHCH)

The framework for enhanced health in care homes
NHS England 29 September 2016

• The new model for care homes is based on activity from six vanguards, using a set of evidence-based interventions which are designed to be delivered within and around a care home in a coordinated manner in order to make the biggest difference to its residents.
• Within these six vanguard areas, care homes are working closely with the NHS, local authorities, the voluntary sector, carers and families to optimise the health of their residents. 
• See framework documents for all new care models here.

Read the summary by the Pharmaceutical Services Negotiating Committee here.

Managing Care Home Closures: a Good Practice Guide

Managing Care Home Closures: a Good Practice Guide
NHS England July 2016

• This Guide is designed to be used by all parties involved in planning and carrying out closure of care homes. 
• Includes a checklist of actions all organisations involved should consider in closure situations.
• See CQC Press release.

High Impact Change Model

High Impact Change Model
ADDAS, NHS England, LGA, DH 1 December 2015

• This model provides practical options to support local health and care systems particularly around patient flow and discharge and to assess how effectively current systems are working. It also encourages areas to consider new interventions to be introduced throughout the year.
• The tool identifies eight high impact changes:
• early discharge planning
• systems to monitor patient flow
• multi-disciplinary/multi-agency discharge teams, including the voluntary and community sector
• home first/discharge to assess
• seven-day services
• trusted assessors
• focus on choice
• enhancing health in care homes