Telehealth Service Review: Key Timelines
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Telehealth Service Review: Key Timelines Date Key Activity 2016 March- During 2016 NHS Kernow undertook a six-month review, which October included a six week period of engagement, of the Telehealth service which is provided by Cornwall Partnership NHS Foundation Trust (CFT). The evidence examined included reviewing local and international research on different models of Telehealth; reviewing the service activity and data; patient satisfaction surveys; alternative service models and the effectiveness of the service in reducing hospital stays and appointments. An outline of the 2016 review is available at Appendix Eight. 1 In November 2016, NHS Kernow’s Governing Body reviewed the November broad range of supporting evidence gathered through the engagement process and service review and felt the service did not have significantly robust clinical evidence to demonstrate effectiveness; did not represent value for money and did not demonstrate the desired outcomes that we would expect to see. The Governing Body’s decision was also made with a view to re-invest in more evidence- based self-management support options for people living with long- term conditions following the disinvestment from the Telehealth service. In accordance with NHS Kernow’s contract with CFT, 12 months’ notice was served. 2017 w/c 19 & 26 CFT sent out letters to patients confirming the close of the Telehealth service. They sent a further letter on behalf of NHS June Kernow confirming the rationale and the end date of the service. 1 July CFT commence active discharging of individuals off the service. The plan for timescales with discharging individuals was shared with NHS Kernow. 6 July NHS Kernow issues a statement outlining information on the service review, cease and exit planning media statement to GPs, HOSC, MPs, media, LMC, website. Telehealth Service Review: Summary for Consultation 11 July Briefing shared with Cornwall Health Overview and Scrutiny committee and telephone call with council’s governance officer. 14 July CFT provide NHS Kernow with a GP Cluster list of Telehealth patients and the roll out plan for discharge for each Practice. Each GP Practice receives a list of all their patients currently under the care of Telehealth. As each Practice cohort is addressed they will receive a further more detailed list of each patient and the up to date risk classification and a suggested on going care plan. Numbers of individuals against each alert risk was presented as below: Total Numbers of People on Telehealth 720 Numbers of people classified as ‘low’ risk 291 (No alerts* over 28 days) Numbers of people classified as ‘lower’ risk 343 (0-15 alerts* over 28 days) Numbers of people classified as ‘higher’ risk 40 (16+ alerts* over 28 days) Number of people in care homes 46 NB: * The rationale for the rating of the risk and number of alerts sat with CFT June-August Following the distribution of NHS Kernow communications to patients informing them of the service cease we received 21 contacts (four of which progressed to formal complaints and one was legal correspondence) from patients who were either unhappy about the decision to decommission the Telehealth service or were unsure about what was happening with the equipment, some who had had their equipment collected and did not know who was taking over their care or wanted to know what was happening next. These calls were a mix of individuals feeling concerned about what was happening to them post Telehealth and some who were requesting batteries, some had already had equipment removed but weren’t informed of next steps, etc. Several MP letters were also received requesting further information. 11 August NHS Kernow decided to undertake a consultation exercise to address the concerns raised by several individuals and to retake the Governing Body decision made on 1 November 2016 2 Telehealth Service Review: Summary for Consultation 18 August NHS Kernow formally requested that CFT stop the removal of Telehealth equipment whilst the consultation phase is underway. 21 August CFT confirmed that there will be no further Telehealth equipment removed from this date 31 August NHS Kernow sent letters via a Commissioning Support Unit to everyone on Telehealth (approx. 700) outlining the previous service review in 2016 and informing them of the upcoming six week consultation. The letter further informed individuals that no further equipment would be removed. August- In response to letter 31 Aug above and consultation letter with September survey NHS Kernow received: -3 emails from patients/carer in strong support of the Service -1 phone call outlining negative views of service -3 patients/carers requested equipment be returned -1 carer requesting monitoring resumes -5 notifications of deaths and request to remove equipment -2 requests to remove equipment as no longer required -3 stating they did not want to have equipment back/for monitoring to resume -3 requesting info on next steps -1 requesting new batteries 31 August There has been a steady reduction in the numbers of people being on Telehealth since the disinvestment decision. This decline was before CFT commenced active discharge from July. At the time of the 2016 service review the numbers on the service were 900 and just before active discharge they’d dropped down to 700. CFT’s data on numbers of people still with equipment and being monitored: Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Telehealth Concurrent Users 800 792 789 774 767 701 494 387 14 September CFT confirmed that 387 people are currently on the service and that 350 people have had their equipment removed. Out of these 350 people who have had their equipment removed our records show that a total of four people would like their equipment returned and one would like monitoring to resume. CFT informed us that they had 16 requests from people who wish their equipment is returned. Therefore, a total of 20 people had requested equipment return. 19 September NHS Kernow and CFT Directors of Finance agreed three principles: 1. NHS Kernow will wish to formally rescind its notice re the Telehealth Service so that an open and transparent consultation 3 Telehealth Service Review: Summary for Consultation on the proposed service change can be undertaken. 2. Cornwall Partnership NHS Foundation Trust will accept that, should NHS Kernow Governing Body decision be to disinvest the Telehealth service, the contractual notice period will be amended to four months from the date that the decision is formally notified to the Trust. This is contingent upon continued agreement that any financial variation will reflect releasable costs only and that any costs of staff change will be appropriately recognised. 3. Cornwall Partnership NHS Foundation Trust and NHS Kernow will work together to jointly understand and agree releasable costs if the service is disinvested. 19 September Start of six week consultation-press launch: NHS Kernow issued a press release and provided an opportunity for the media to speak to NHS Kernow’s chairman, Dr Iain Chorlton, about the consultation and staff and public events. www.kernowNHS Kernow.nhs.uk/news/2017/09/share-your- thoughts-about-the-telehealth-service Dr Chorlton spoke to reporters from BBC Radio Cornwall and Pirate FM and NHS Kernow’s communications team sent recorded audio to a reporter from Heart FM to use in its bulletins. We also answered specific questions about the consultation from a number of media outlets. The press release and interviews generated the following media coverage: 19 September Heart FM. Audio recorded by NHS Kernow was sent to Heart FM reporter to use. Clip unavailable. Pirate FM: www.piratefm.co.uk/news/latest-news/2383398/patients- urged-to-debate-cornwalls-telehealth-service/ 21 September BBC Radio Cornwall www.bbc.co.uk/programmes/p05f3tr6 29 September Cornwall Live: www.cornwalllive.com/news/cornwall-news/nhs- kernow-telehealth-legal-action-553148 2 October Staff consultation event: Peninsula House, Saltash, 2.00 – 5.30 pm 3 October Staff consultation event: Sedgemoor Centre, St Austell, 8.00 am – 1.00 pm 3 October NHS Kernow’s Governing Body confirms the decision regarding the Telehealth Service will be made in public at its December meeting 4 Telehealth Service Review: Summary for Consultation on 5 December 4 October Staff consultation event: Fraddon Village Hall, 2.00 – 6.00pm 5 October Staff consultation event: Marazion Community Centre, 12.00 – 6.00 pm 6 October ITV West Country: www.itv.com/news/westcountry/2017-10- 06/nhs-in-cornwall-forced-to-re-think-plans-to-cut-patient- monitoring-service-after-threat-of-legal-action/ 19 October NHS Kernow issues another press release to remind people about the consultation and how they could have their say. This generated further media coverage: 19 October, Pirate FM: www.piratefm.co.uk/news/latest- news/2407810/what-do-you-think-of-cornwalls-telehealth-service 23 October Cornwall Reports www.cornwallreports.co.uk/one-more-week-to-have-your-say- about-cornwalls-telehealth-service 24 October Patient consultation events: St John’s Hall, Penzance, 10.00 – 11.30 am 24 October Patient consultation events: Cudra WI Hall, St Austell, 2.30 – 4.00 pm 26 October Patient consultation events: John Betjeman Centre, Wadebrige, 10.00 – 11.30 am 26 October Patient consultation events: The Public Hall, Liskeard, 2.30 – 4.00 pm 25 October Cornish Times www.cornish- times.co.uk/article.cfm?id=112395&headline=Views%20sought%20 on%20NHS%20service%20facing%20axe§ionIs=news&search year=2017 30 October Telehealth staff consultation event: Telehealth offices, Threemilestone, Truro, 2.00 – 5.30 pm 1 November End of six weeks consultation 1 November 324 people currently on Telehealth 1 to 14 Telehealth Consultation Report collated and submitted to the 5 Telehealth Service Review: Summary for Consultation November Commissioning Priorities Group (CPG) for consideration 16 November CPG meeting takes place and confirms it will recommend Option Three to the Governing Body 27/28 Telehealth briefing to MPs, Overview and scrutiny Committee, Local November Medical Council to inform them of the recommended option that is being taken to Governing Body on 5 December.