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Nurse-led ‘telecare’ project has cut emergency admissions by third

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A project harnessing “telecare” technology and led by senior nurses in Yorkshire has reduced emergency admissions from care home by 33%, new research suggests.

The Quest for Quality in Care Homes initiative has involved 1,300 care home residents over the past five years in Calderdale, West Yorkshire.

“It has without a doubt enhanced safety for our vulnerable care home residents”

Katie Berry

It helped reduce emergency falls admissions by 7.7% saving more than £200,000, according to independent research by consultancy firm Ignetica.

The research was commissioned by technology company Tunstall Healthcare Group to analyse a series of large-scale care home initiatives to assess the potential impact of such a clinically-led approach at a national level for the NHS.

The scheme is a partnership between Calderdale Clinical Commissioning Group, Calderdale Council and Calderdale and Huddersfield NHS Foundation Trust.

The scheme supported care home staff through the introduction of telehealth and telecare approaches for residents, and a matron-led multi-disciplinary team to review and oversee patient care.

It focused on avoidable emergency attendances and admissions, particularly urinary tract and respiratory infections, falls and fractures.

“The technology has meant we are able to help more people return home rather than being readmitted”

Katie Berry

The technology included movement detectors sending alerts as soon as residents’ moved or when lack of movement might indicate a potential problem.

Bed occupancy sensors alerted the team when someone got out of bed, while exit sensors informed staff when patients were opening doors.

Residents also wore fall detectors around their wrist and “intelligent pendants”, which allowed them to call for assistance when needed. Staff carried a CareAssist – a pager-type device to receive the alert/alarm activations.

In the launch phase during 2014-2016, the CCG reported a reduction in emergency admissions from care home residents by a third and savings equating to around 7,000 bed days, according to the research.

GP care home visits were also reduced by 45% following the introduction of the Quest multi-disciplinary team, the study found.

If this kind of scheme were run nationally it could save the NHS £1bn, according to the analysis commissioned by Tunstall.

The analysis combined national government data and data from other regional initiatives that use telecare and telehealth enabled models, such as video based remote consultation technology in care homes by Airedale, Wharfedale and Craven CCG.

“The telecare service has been a really important part of what we have achieved”

Steven Cleasby

Katie Berry, a Quest nurse from Calderdale said: “This type of technology is massively important. It has without a doubt enhanced safety for our vulnerable care home residents.”

She recalled working with a woman who used to enjoy long walks but had recently required frequent hospital admissions after falls.

“We advised giving her a falls detector, so that rather than restrict her in doing something she enjoyed, she still had the freedom to walk about the care home and grounds,” she said.

“Staff and relatives had the reassurance that if she did fall, they would be immediately alerted,” she added.

Ms Berry said the technology was particularly useful in intermediate care wards, where acutely unwell patients go to recover before being discharged.

“The technology has meant we are able to help more people return home rather than being readmitted to an acute ward because of a fall injury,” she said.

Dr Steven Cleasby, chair of Calderdale CCG, said: “The telecare service has been a really important part of what we have achieved through the Quest for Quality in Care Homes project.”

“We believe NHS Calderdale CCG has led the way”

Belinda Coker

He said it had led to efficiencies in staff workload, reductions in falls and a general improvement in the quality of care.

Nearly 400,000 older people with multiple and complex long-term conditions live in care homes, noted Dr Belinda Coker, clinical director of Tunstall and a sessional NHS GP at the Hurley Clinic in South East London.

“Although they represent just 0.7% of the population, due to their healthcare needs, they use a disproportionately large share of the NHS’s resources,” she said.

“We believe NHS Calderdale CCG has led the way in showing that proactive management by highly-skilled multi-disciplinary teams using technology in care homes could deliver significant efficiencies and release major capacity while at the same time providing a high-quality service,” she added.

The findings of the analysis will be presented tomorrow at the Health Plus Care conference in London.

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