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East Midlands Regional Network Meeting - December 2017
Simple Shared Healthcare
08 February 2018
Firth Park Library played host to the December Regional Network Session dedicated to supporting the use of Flo, which enables attendees to share their experience and ideas, as well as promoting best practice in their areas.
The day began with Lisa Taylor and Karen Moore sharing developments across the wider Simple Telehealth community, including the latest additions to www.simple.uk.net, such as example pathways, case studies & blogs and emerging outcomes from across the UK. Lisa and Karen also highlighted the development of supported clinical networks across the community to enable the sharing of best practice regardless of geographical location; the first of these being maternity care focused with the inaugural national special interest group call set for February 2018.
Focus: Early pulmonary rehabilitation management of patients with Chronic Obstructive Pulmonary Disease following acute exacerbation in Sheffield Cath O’Connor, Clinical Specialist Physiotherapist in Sheffield, discussed her service evaluation of the implementation of Flo in early pulmonary rehabilitation management of patients with Chronic Obstructive Pulmonary Disease following acute exacerbation. Cath focused on patients who had experienced acute exacerbations of COPD (AECOPD), and were taking part in Early Pulmonary Rehab (EPR). In Sheffield, 1 in 3 patients admitted to hospital with AECOPD is readmitted, despite often being asked to participate in EPR; patients may not be receiving the support they require to successfully complete EPR, and this may be a factor in the number of readmissions. Cath, with some support from Karen, developed a pathway supporting this cohort of patients, which focused on symptoms before and after exercise to understand how the patient felt. Results from the evaluation showed that:
| Focus: Community Neurology Team – Improving adherence to physiotherapy in Stroke, MS, Parkinson's Disease and Head Trauma Following on from Cath, Ed Rimmer, a Physiotherapist within the Community Neurology Team at Nottinghamshire Healthcare Foundation Trust, discussed his plans for a project integrating Flo across several pathways. The team currently manages patients with a wide variety of conditions, including stroke, MS, Parkinson's Disease and head trauma. Given the range of conditions and the varied demographic of their patients, a diverse multidisciplinary team of healthcare professionals has developed. The team recognise that their patients can experience condition led challenges to adhere to prescribed medication and rehabilitation, noting the adverse effect that this reduced adherence has on the recovery of their patients. Therefore, Ed is leading the development of pathways aimed to support an improvement in both motivation and adherence to treatment. Ed hopes that Flo will also help patients to improve their confidence and ability to self-manage, reducing reliance on the team. The plan is to recruit a minimum of 20 patients over the course of 6 months, and then evaluate with both staff and patients with results informing the recruitment of more patients going forward. | Focus: Virtual Wards in Sheffield The session was led by Rebekah Matthews, Integrated Pathway Manager, who gave an overview of Sheffield Teaching Hospitals implementation of Virtual Wards and the “Okay to Stay” plan. The Virtual Wards demonstrated a decrease in admissions over winter months in 2015/16, leading to a pilot project being launched during winter 2016/17 aiming to improve the integration of health and social care, as well as reduce the number of inappropriate admissions. Patients over the age of 65 who scored the highest on the frailty index were targeted, and through the combined use of a person-centred care plan, the “Okay to Stay” plan & Virtual Wards unnecessary admission were again avoided. Patients on Virtual Wards are typically offered Flo to support awareness, both to the patient and clinicians of vital signs. The combination of being able to monitor patients remotely, and Flo’s prompt advice motivates patients to seek appropriate intervention at the right time, and that any admission that occur are necessary and appropriate. |
NHS England: Stoke-on-Trent rated Outstanding for diabetes services with Flo
NHS Stoke-on-Trent
Clinical Commissioning Group
5 February 2018
OUTSTANDING RESULT ACHIEVED FOR PATIENTS WITH DIABETES Flo cited in latest "Outstanding" rating by NHS England for Services for patients with diabetes in Stoke-on-Trent. “Because lifestyle is key to control of most adult diabetes it is a real partnership between clinicians and each patient. Education is vital, as a patient who is properly informed about their condition can more effectively take control and manage it.” Stoke-on-Trent and North Staffordshire are recognised as leaders in the way new technology is being used to help patients monitor and control a number of conditions including diabetes. Florence (or Flo) is a locally developed mobile phone based platform. It allows clinicians to communicate securely with patients to remind them to monitor their readings and take medication. It can issue advice and raise the alarm if a patient’s condition deteriorates. It can reduce the number of unnecessary appointments for patients whose conditions are stable, leaving more time for clinicians to focus on those who are struggling. Click for original article; https://www.stokeccg.nhs.uk/news-and-events/574-outstanding-result-achieved-for-patients-with-diabetes |
Successfully scaling innovation in the NHS - Flo
Innovation Unit and The Health Foundation have come together in the "Against the Odds" research project and identified 10 UK innovations which have demonstrated "successful scaling", one of which is Florence. From these case studies, they were able to highlight eight key enablers for scalability of new innovations within the NHS. Peered alongside other respected innovations such as Dose Adjustment for Normal Eating (DAFNE), Enhanced Recovery After Surgery (ERAS) , Implantable Cardioverter-Defibrillators (ICDs), Improving Access to Psychological Therapies (IAPT) and Rapid Assessment Intervention and Discharge (RAID) the report teases out key insights into Flo's adoption and spread.
You can read the full report here. Look out for Florence starts on pages 50, 51, 52, 53. |
Improving Patient’s Understanding: A Contribution from "All Together Better Sunderland"
NHS Sunderland
Clinical Commissioning Group
Rachael Forbister
TECS Programme Manager and Florence Enthusiast
26 January 2018
Supporting our patients confidence to access tools aimed at improving their self-management is paramount as a vital first step toward patient engagement and health literacy. At NHS Sunderland we have developed a number of resources and we are now delighted to be able to share them with the Simple Telehealth Community. In 2017 we were able to access NHS England’s New Care Models Programme funding, and chose Flo as the ideal subject matter given the progress we have already had in Sunderland. This funding facilitated the production of patient leaflets that have been designed to be used with, and are applicable to, a multitude of patients and conditions. It is with great delight that "All Together Better Sunderland" is able to share this resource for use within the Simple Telehealth Community. Please feel free to adopt and use these leaflets to support your patients, we hope that you all get great benefit out of them and a big thank you goes to Hannah Mountford at Simple Shared Healthcare for the fantastic content. |
The King's Fund; “Florence is a low-cost, low-risk innovation with a strong track record.”
Adoption and spread of innovation in the NHS
16 January 2018
This latest independent publication by Ben Collins of The King's Fund discusses the challenges of innovation adoption in the NHS and draws on “eight examples of successful spread of innovation”. We’re delighted that our own Simple Telehealth Community of Practice including, ‘Florence’ and ‘Annie’ have been selected as one of the eight examples. Some of our favourite quotes from the study;
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NHS England's "Challenging Health Inequality" report cites Flo as 'Soft Tool' for intervention
Flo identified as tool to reduce health inequality in England through self-management The "Challenging Health Inequalities" October 2017 report compares emergency admissions and unplanned hospitalisation inequality throughout England, and has identified Flo as a successful intervention tool in supporting the reduction of health inequality. # TotallyUnique |
NHS Western Isles take top QuDoS Accolade
#NHS Western Isles #TotallyUnique |
Igniting Clinical Innovation
06 November 2017
Inaugural Shropshire & Wales Regional Network Event
The Shropshire and Wales Regional Network has recently become the latest collaborative event facilitating the sharing of best practice amongst the Simple Telehealth Community, hosted by Powys Teaching Health Board (PTHB) at The Victoria Memorial Hospital in Welshpool on 26th of September 2017.
Lisa and Karen kick started the day by offering an insight into developments; an overview of all things Flo! Attendees welcomed an update on various new and exciting developments.
Vic Deakins, Head of Therapies and Health Sciences, and Kath Lloyd, Service Development Manager for Therapies and Health Sciences, from Powys Teaching Health Board (PTHB), shared their experiences and learning from the beginning of their journey with Flo in October 2016. In just 12 months, a number of pathways have been developed, including diabetes, pulmonary rehab, and falls prevention.
Following a quick break for lunch, Niall Salisbury, Florence Telehealth Administrator from Shropshire Doctors Cooperative (Shropdoc), spoke to the room about a new innovative model of care recently launched. Shropdoc is offering a managed service to their local GP practices to administer and monitor patients referred to them for Flo’s support with their COPD, hypertension, asthma, diabetes, as well as offering some support for lifestyle and medication reminders. To expedite the referral process, Shropdoc have developed a secure EMIS form, designed to facilitate simple and quick referrals using a process familiar to the clinician. Patient evaluation questions are integrated into all of the protocols in use, and so far Shropdoc has seen positive patient feedback which they hope to continue to build on. Additionally, Niall is responsible for producing Shropdoc’s monthly “Florence Telehealth Newsletter”, with the Regional Network event being featured in October’s edition. | Kath Fackrell, Voluntary Services Coordinator at Shropshire Community Health NHS Trust, also took some time to discuss some future plans around supported early discharge at the Princess Royal Hospital in Telford supported by Flo. The idea was inspired by an existing supported discharge protocol in use in South Tyneside which previously saw the team awarded as winners of the ‘Regional Enterprise Collaboration’ award as part of the Charity Achievement Awards (read more about this here). Patient feedback in South Tyneside was positive, with 97% of patients stating they would recommend Flo. Given this success, Kath is hoping to replicate a similar project with patients from her area, and is well on the way to achieving this. We are looking forward to hearing more about this project once it is up and running, and hope that it will be as well received as its counterpart in South Tyneside.
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Innovative Clinicians Drive 20x Growth in Maternity: Supporting Mums and Mums-to-be
23 October 2017
Driven by the growing independent evidence base underpinning a Totally Unique approach, diverse clinical teams continue to innovate with Flo, adapting and adopting her as an integral tool, to help their patients to self manage better.
Maternity continues to be an area of creative innovation with clinicians inspired to integrate Flo into new pathways beyond their primary implementation; since 2012 patients supported by Flo within maternity pathways has increased steadily and in 2016 we saw almost a 20 times increase in use of Flo than in 2012!
Click image to enlarge
Pregnancy Induced Hypertension (PIH) and Gestational Diabetes Mellitus (GDM) In 2012, Flo’s support was focused towards mums-to-be diagnosed with either pregnancy induced hypertension (PIH) or gestational diabetes mellitus (GDM) with organisations in the North East delivering compelling evidence that Flo’s integration has been beneficial for staff, and most importantly patients. Patients reported:
Clinical Outcomes:
Cost Effectiveness: Based on Sunderland City Hospital’s pilot project using Flo for PIH & GDM, some estimated cost savings were calculated by the team. These were done by comparing the treatment and contact Flo patients received, compared to the normal non-Flo care pathway (for example number of appointments etc.).
The West Cumbria Antenatal Service have delivered some solid outcomes from their implementation of Flo within their outpatient pathway supporting mums to be with type 1 diabetes, or those who develop GDM:
As well as great clinician outcomes, patient feedback was also positive:
| More Clinical Innovation Moving forwards into 2017, the number of maternity pathways supported via Flo continued to diversify: Breastfeeding support Similar to PIH and GDM, Flo’s development towards supporting mums with breastfeeding emerged from an innovative pathway developed in the North East, and recognising the impact has now been adopted in other maternity units across the country, increasing the number of patients supported; emerging as the 2nd most commonly accessed maternity pathway. Outcomes reported by mums of improved reassurance and support but that those supported by Flo for breastfeeding support were more likely to continue breastfeeding at 6 weeks when compared to those mums without Flo’s intervention. Type 2 Diabetes in Pregnancy Sandwell and West Birmingham Hospitals are developing an innovative pathway for mums-to-be already diagnosed with type 2 diabetes pre-natally. The pathway reinforces support to self manage whilst receiving a new treatment regimes due to pregnancy and offers opportunities of timely intervention and reassurance for mums to be outside of the traditional clinic environment aiming to deliver improved clinical outcomes and more efficient use of capacity. Scottish Health Boards have embraced the opportunity to support women pre and postnatally and have developed a range of emerging new pathways, below.
Pathways helping mums become more aware of their baby's movements during pregnancy, improving awareness of their own daily movements and what normal level of movement is to be expected; and if necessary who to contact and when to support intervention.
Pathways supporting new parents and their babies. Flo offers relevant, timely advice and guidance to support parents and their babies in having the best start in life.
Pathways adapted from best practice smoking cessation design, tailored towards key techniques helping expectant mums quit smoking. |
Seven months of Flo in Powys; 'Florence and the [Telehealth] Machine'
NHS Wales Powys Teaching Health Board Seven months after receiving training on Flo, this is a fabulous video summary of how Flo has helped with weight management, diabetes and respiratory patients in Powys, Wales. We hear from a number of patients and staff about their experience and how they plan to expand the use of Flo.
#Wales #Powys #Diabetes #Weight Management #Respiratory #TotallyUnique |
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