Patient Recruitment Consent

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Patient Recruitment / Consent

• Martin Scarfe, WSD Programme Director, Newham PCT
  / LB Newham

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About the programme

• Help frail and vulnerable people live
  independently and with dignity by helping manage
  the risks of daily living
• Empower people with long term conditions to
  understand and manage their own health
• Department of Health funded programme to examine
  statistically the benefits from the use of
  telecare telehealth

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About the programme

• Two year research project
• Four clinical areas to be covered
• Diabetes
• Heart failure
• COPD
• Frail elderly
• Aim to provide national business case for
  telehealth telecare roll-out

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Why?

• Ageing population
• More people with long term health conditions
• Reduce the burden on health and social care
  services

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Newham a diverse London borough

• One of the most deprived areas in the UK
• Population of 278,000 - GP registered population
  of 330,000
• 2nd most diverse population in the UK - over
  100 languages spoken
• 8.5 of the population aged 65
• 17.3 of the population have a limiting long term
  illness
• Highest death rate from stroke and COPD
• Highest diabetes rate in the UK
• 2nd highest CHD rate in London

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Telecare and telehealth in Newham

• 2,400 people have some form of telecare
• Telecare services recognised at 2008 London
  Health and Social Care awards
• Innovative Health and Social Care Technology
  winner
• EU eInclusion Award Winner
• Telehealth technology piloted ahead of the trial
  roll out

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Delivering the trial

• 2,000 local people will be using telecare and
  telehealth technology
• Identified through patient social care records
• Health and social care professionals trained and
  enabled to provide care supported by technology
• Information integration to enable sharing of
  appropriate patient information deliver better
  services for local people
• Introduce integrated care pathways develop
  business case for their effectiveness

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Telecare supports the frail elderly

• Combination of alarms, sensors other response
  equipment
• Supports carers and people living alone
• Monitors lifestyle changes over time
• Raises a call for help in emergencies e.g. a fire
  or flood
• Not intended to replace human contact
• Alarm calls monitor response
• 24/7, 365 days a year
• 51,000 calls in 2007/08

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Telehealth self-management of long term health
conditions

• Not an emergency service
• Provides an early warning if readings go outside
  normal range
• Allows early intervention e.g. change of
  medication

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Potential of telecare telehealth

• Help people and their carers live independently
  and reduce
• Numbers admitted to residential care and nursing
  homes
• Emergency hospital bed days and admissions
• Accident and emergency attendances
• More clinically effective and cost effective ways
  of meeting health and social care needs in the
  future

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Patient Recruitment / Consent

• Consent to Get Consent
• Patient Consent
• Patient Recruitment
• After Recruitment

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Consent to Get Consent

• Targets, Plans, Outcomes, Objectives
• Blueprint
• Ethics Approval ?
• GP Approval
• SSISA Subject Specific Information Sharing
  Agreement

Ethics Approval
GP Approval
SSISA
Targets Plans
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Patient Consent
GP authorises
Reply ?
EMIS search
2nd Letter
Hospital search
Reply ?
Merged Data
1st Letter
GP review
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GP authorises
Reply ?
EMIS search
2nd Letter
Hospital search
Reply ?
GP review
1st Letter
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Patient Recruitment
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Ethics Approval
GP Approval
SSISA
Targets Plans
GP Consent X 2
GP Consent X 2
GP Data Search
Hospital Search
Social Care Search
Patient Letter 1
Patient Letter 2
GP Phone Call
Patient Consent
Patient Call / Visit
Patient Assessment
Install Equipment
Equipment Use
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Ethics Approval
GP Approval
SSISA
Targets Plans
GP Consent
GP Data Search
Hospital Search
Social Care Search
GP Consent
Patient Letter 1
Patient Letter 2
GP Phone Call
Patient Consent
Patient Call
Patient Assessment
Install Equipment
Equipment Use
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Ethics Approval
GP Approval
SSISA
Targets Plans
GP Consent
GP Data Search
Hospital Search
Social Care Search
Patient Letter 1
Patient Letter 2
GP Phone Call
Patient Consent
Patient Call / Visit
Patient Assessment
Install Equipment
Equipment Use
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After Recruitment

• Assessment, Monitoring and Response (AMR)
• GP involvement / data sharing
• User Groups
• Newham
• Evaluation
• Sustainability

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Patient Recruitment

• Dos
• Think about who will carry out data gathering
• Plan the process. Walk through it
• Manage it

• Donts
• Expect Others to commit to your timescales
• Expect a Plan to be the end of the process
• Ignore the people
• They are GPs, Nurses, Practice Staff
• WHO HAVE A DAY JOB !!!!

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• martin.scarfe_at_newham.gov.uk