Hampshire Hospitals NHS Foundation Trust (HHFT) are bringing forward the roll out of their new care home telemedicine service, in partnership with other local organisations, in response to the Covid-19 crisis. The service is based on an already successful model running in Airedale and will help care home staff care for residents in their homes, reducing the need for them to go into hospital.
Because of the speed of this roll out, some of the finer detail is still being established, so please be aware that some of this information is still subject to change.
What is it?
The telemedicine service will allow care home staff and residents to directly call a specialist clinical team at the Royal Hampshire County Hospital (Winchester), and vice versa, for instant advice. In the future this will also include the option to video call. This quick, personalised care will mean that more elderly people will be able to get the care they need in the safety and comfort of their own home.
The hospital hub will be located near to the Emergency Department and will provide specialist advice to homes between 8 am and 8 pm, 7 days a week. Once more staff have been recruited it will offer a 24/7 service. All care or nursing homes in the Mid and North Hampshire areas (which includes Winchester, Andover and Basingstoke), as well as all Hampshire County Council run homes, will be able to take part. Initially the service will be for individuals and care homes, but as it matures, loved ones who may be far away will also be able to participate in the calls.
The telemedicine service will also be able to prescribe medication and send the prescriptions electronically to a chosen pharmacy, negating the need to visit a hospital or wait for an out of hours GP to visit, making treatment or symptom control much faster.
Once the call is ended, the mutually agreed care plan will be securely emailed to the home and uploaded to the Care and Information Exchange (CHIE). This means that anyone who cares for the resident, like GPs and Community Teams, will be able to view the latest telemedicine consultation online.
Frailty is common. It is estimated that 1.8 million people over 60 are living with frailty in England, almost half of which are over 80. Based on population growth statistics, this is only going to increase. As our population ages, we will also see an increase in people living with complex, long term conditions.
The telemedicine service offers an innovative and effective means to care for people in the right place and at the right time – and in doing so lessen the burden on the overstretched Urgent and Emergency Care services. Evidence shows that attending or being admitted to a hospital setting can cause emotional distress, confusion and agitation to older individuals, which can lead to serious incidents like falls, infections and deconditioning. The telemedicine service is a route to safer and kinder care for the elderly and will also mean that more people will be able to pass away where they choose to.
Through being able to access clinical advice at any time of day or night, care home staff will be supported and reassured that they are not alone when helping poorly patients. There will always be someone on hand to help make decisions about what the best course of action is and the service will also help to free up their time to attend to other important tasks. Working together to make decisions will also help the staff involved to learn from each other, gain skills and experience, and foster relationships within the wider NHS family.
The first phase was originally planned to commence in August or September 2020, however since Covid-19, the start date has been brought forward and will be rolled out to care homes initially in North and Mid Hampshire, to those with all the pre-requisites achieved:
- Using ReSTORE2 in the home
- Access to a shared NHS.net email account
Guidance for Care Homes and GPs
It is recommended that to maximise the effectiveness of the telemedicine service, care homes and primary care should be using ReSpect and CHIE.
Key Resources and Documents:
Video training guide to Telemedicine service:
ReSPECT – Recommended Summary Plan for Emergency Care and Treatment:
The ReSPECT process is a new approach encouraging people to have conversations with health care professionals and create an individual care plan to try and ensure that they get the right care and the best possible treatment in an anticipated future emergency, in which they no longer have the capacity to make or express their choices and wishes.
The ReSPECT process enables informed discussions and is intended to respect both patient preferences and clinical judgement. ReSPECT is recommended by the ‘Resuscitation Council (UK)’. They have produced helpful material – leaflets, posters, implementation kits, patient guidance material, associated presentations, learning material etc, available here.
It is vitally important that all residents have an up to date ReSPECT form to enable them to receive the care they wish to receive (through from full active treatment to conservative management) in the setting of their choosing.
Below is an electronic ReSPECT form, which you can upload onto EMIS using the instructions.
CHIE – The Care and Health Information Exchange:
CHIE is a secure system which shares health and social care information from GP surgeries, hospitals, community and mental health, social services and others. CHIE helps professionals across Hampshire, the Isle of Wight and surrounding areas to provide safer and faster treatment by:
- Ensuring that residents only have to tell their story once
- Reducing delays to treatment
- Making sure the doctors, nurses and others involved in care know about a resident’s medical history
- Identifying diseases that residents may be at increased risk of developing in the future
- Displaying the medication residents are currently taking, their allergies, test results and other important medical and care information
- Providing access to GP information, including medical history, medications and diagnoses
- Providing access to discharge summaries from Hampshire Hospitals, University Hospitals Southampton and Portsmouth Hospitals Trusts
- Providing access to radiology and pathology reports from the above Trusts, including COVID-19 status
- Providing access to Community and Mental Health Service Information from Southern Health NHS Foundation Trust, Solent NHS Trust
- Providing access to Adult Social Care information from Hampshire County Council, Southampton City Council
For further details please visit the CHIE information website.
Health and care staff can see this information if they need to know about a resident’s previous history. If your care home is offered the opportunity to access CHIE, it is highly recommended that you accept it. CHIE will enable you and the telemedicine service to view a common data source and agree care plans based on this and other relevant clinical information.
To express an interest in signing up to access CHIE please contact email@example.com or call 0300 123 1519
The telemedicine service is part of a wider Digital Development Programme and care homes that participate will have the opportunity to also try other new initiatives, like Life Light software.
The scheme has been developed and endorsed by Hampshire Hospital Foundation Trust, Hampshire County Council, Wessex Academic Health Science Network, the Hampshire and Isle of Wight Partnership of Clinical Commissioning Groups (CCGs), West Hampshire CCG, Portsmouth City CCG, Southampton City CCG, NHS England and NHS Improvement, the Hampshire Care Association, Southern Health Foundation Trust, and the Hampshire and Isle of Wight Sustainability and Transformation Partnership.