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Harnessing Health in Older Age - 17 November


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Harnessing Health in Older Age - 17 November

  1. 1. Harnessing Health and Wellbeing in Older Age #HHNolderage17
  2. 2. Harnessing Health Network Sue Henry
  3. 3. Innovate Collaborate Rock the boat Share Facilitate dicussion Support
  4. 4. Purpose of today…………………………. Share our collective ideas for change Learn from each other Create momentum
  5. 5. Presentation 1 Harnessing Health in Older Age Dr Liz Mear Chief Executive, Innovation Agency @mearliz
  6. 6. AHSNs • 15 Academic Health Science Networks across England • Licensed and funded by NHS England, NHSI and Office for Life Sciences • Promoting innovation in healthcare • Single structure to improve outcomes • Promoting economic growth in regions and for UKPLC
  7. 7. Presentation 1 European Reference Site for Active and Healthy Ageing Reference Sites are inspirational ecosystems, delivering creative and workable solutions that improve the lives and health of older people. These solutions can be scaled-up and replicated across the EU to maximises outcomes and reduce the risks associated with investing in innovation.
  8. 8. Test Beds • Testbed - combinatorial innovations • LCIA – helping elderly people to live at home
  9. 9. Digital health innovations – created in the North
  10. 10. Mobile ECG 256 potential strokes avoided Potential saving £5.6m in NHS resources
  11. 11. Presentation 1 Preventing strokes • Using AliveCor Kardia and Diagnostick • Rolled out nationally to all GP surgeries • Working with local infrastructure – sports clubs and Firefighters • Recruiting AF ambassadors in NWC – people who have experienced AF or close to someone with AF partner - Stroke Association
  12. 12. Falls prevention two Assessment FRAX & eFI Cohort Selection Intervention Phase 1. Bone Health Programme • Amgen Programme 2. Exercise Programme • Standing Tall (or other) 3. Patient & Professional Engagement and Education • Steady On • ENSAFE • Admiral Nurses Delivered by Geriatricians GPs, District Nurses, Community Physios Evaluation Ongoing Patient Safety Monitoring
  13. 13. Falls Prevention • Bone Health Programme Two AHSNs stratification of patients at risk of fractures • Exercise Programmes All four AHSNs are delivering Exercise programmes, some supported by digital technologies. These include programmes such as Standing Tall • Patient and Professional Engagement and Education All four AHAs are delivering Patient and Professional Engagement and Education programmes that include; Steady On, ENSAFE and Admiral Nurses
  14. 14. Steady On! “The fear of falling is terrifying, but I now have a way of getting upright if I’ve fallen and know I’ve a service I can turn to. I learned more in an hour than I thought possible and feel less anxious and much more contented.” Service user QTUG Quantitative Timed Up & Go
  15. 15. Working towards a common outcomes framework Outcomes could include 1. A 30% reduction in falls within the geographical footprint 2. A 20% reduction in avoidable hospital admissions 3. A 20% improvement in the patient’s confidence in their own safety from harm due to falling 4. Looking for additional funding from a range of sources
  16. 16. Presentation 1 PR for innovation … 2
  17. 17. Innovation Scouts Champions of change • Learning from innovation leaders • Creating a culture of innovation • Part of the AHSN Network for co-creating new technologies & systems • Work together to understand challenges & cultural implications needed to increase the adoption of innovations • The surgical team at Liverpool Heart and Chest Hospital now use 3D printed organs to practice operations because the scout programme introduced them to companies with expertise • liz.mear@innovationagencynwc.nhs.uk
  18. 18. Perfect storm- Perfect solutions? Dr Ruth Hussey CB, OBE
  19. 19. UNITED NATIONS Population ageing is poised to become one of the most significant social transformations of the twenty-first century, with implications for nearly all sectors of society, including labour and financial markets, the demand for goods and services, such as housing, transportation and social protection, as well as family structures and intergenerational ties. Estimated 962 million people aged 60 or over in the world - 13% global population (2017). Population aged 60+ is growing at 3 % per year. Europe has the greatest percentage of population aged 60 or over (25%).
  20. 20. Perfect storm or great opportunity? • Population is changing – relative reduction in working age population • Health needs are changing - multiple illnesses • Technology and cost of care are changing – digital and science driven – genomics, robotics, AI, driverless cars • Public sector changing – austerity, expectations An opportunity to celebrate ageing well….......
  21. 21. Perfect solutions? The future is here – no time to wait
  22. 22. Five things to pave the way • Midlife to later life – redefining work – paid and unpaid • Midlife prevention • Flip the health and care system – seamless, organised around individuals not institutions - Home is part of the care system • Intergenerational and flexible solutions • Re-define and share risk, empower staff and users
  23. 23. Different Skills
  24. 24. Atul Gawande – Being Mortal • “The problem with medicine and the institutions it has spawned for the care of the sick and the old is not that they have had an incorrect view of what makes life significant. The problem is that they have had almost no view at all. Medicine’s focus is narrow. Medical professionals concentrate on repair of health, not sustenance of the soul. Yet - and this is the painful paradox - we have decided that they should be the ones who largely define how we live in our waning days.” • “Our ultimate goal, after all, is not a good death but a good life to the very end.” • “You may not control life's circumstances, but getting to be the author of your life means getting to control what you do with them.”
  25. 25. Why Ageing Well Makes a Big Difference Sheila Bersin MBE
  26. 26. Harnessing Health Network Harnessing Health and Wellbeing in Older Age Edge Hill University, Ormskirk, 17th November 2017 Systems Leadership for healthy older age Debbie Sorkin National Director of Systems Leadership, The Leadership Centre Debbie.Sorkin@leadershipcentre.org.uk @DebbieSorkin2
  27. 27. You can still act in a perfect storm Take your authority and use Systems Leadership approaches Systems Leadership: The collaborative leadership of a network of people in different places and at different levels in the system, creating a shared endeavour and co-operating to make a significant change. The basics: Relationships, influence, trust: “Systems move at the speed of trust” Starting small in real work Partial, clumsy and emergent/evolving solutions Going slow to go fast – allow for dynamic and changing situations Focus on the long haul: creeping transformation New ways of working and collaboration Think system, not organisation The questions: What do we want life to be like for older people in our place? Who else needs to be in the room?
  28. 28. Things to do, ways to work • Be on the lookout for work avoidance: doing the wrong thing busily (or expertly). So get real: choose your battles and identify an issue where you can do real work based on common purpose. • Focus on relationships, broader connections/networks. Listen and observe – and be willing to cede leadership • Don’t feel the need to follow traditional power structures - Work with a coalition of the willing and meet offline/informally. This is about movements, not meetings • Use fail-safe experiments, prototype and tweak: you’re looking for progress, not a solution. Keep the focus on new ways of working • Engage with other sectors beyond the obvious: housing, planning/ built environment • As long as you’ve got a shared purpose, you can start small and take the scenic route: and keep going even if it takes longer than you think: it really is possible to see change for the better
  29. 29. There are lots of places around the country using Systems Leadership to do things differently: either to support health and wellbeing in older age, or in analogous ways Our Place (Cheshire West & Chester) got away from council-based solutions to issues of social isolation; Nightingale (London) brought in a nursery school on- site to a residential care home and has obtained CCG- funded primary care services; Calderdale trained schoolgirls to carry out research to support service re- design New Outlook and Nehemiah Housing Group (Birmingham): partnership between housing association and small local home care provider: emphasis on wellbeing/prevention Building Active Communities (Derbyshire): collaboration between CIC, public health and Age UK Social connection and participation Housing Activity
  30. 30. And it’s increasingly common where public health, the NHS, the voluntary & community sector and social care interconnect Vale of York Pioneer undertaking RCT of Personalised Health Coaching; findings include better self- management of long-term conditions and significant reduction in presentation at A&E/hospital admittance Enhanced health in care home Vanguards: partnerships between health and social care, including 24/7 Goldline, video conferencing, dedicated outreach teams: all sites have seen fewer ambulance call-outs, hospital admissions and bed days Solihull Together: joint working between CCG and local authority; led to (amongst other things) more integrated dementia and MH services Self-management Keeping people out of hospital Dementia care
  31. 31. Thank you. Debbie.sorkin@leadershipcentre.org.uk @DebbieSorkin2
  32. 32. What would be your ‘something new’ idea • Use stickies on table to write down your ideas • You can have as many as you like • Can be simple • No idea is a bad idea • When you’ve finished writing your ideas down bring your stickies out to the front
  33. 33. Choose the ideas you’d like to work through
  35. 35. 1 idea to feed back to the main group Anything you will go back to work and do differently NOW Fab Change Week –any pledges?

Notes de l'éditeur

  • Debbie uses Alivecor Kardia and Diagnostick – picked up 5 positive readings and relayed results to people so they can take them to the GP.

    Now developing AF ambassadors in association with Stroke Association – people who will be given a Kardia and will be trained and asked to test 20 people.
  • We have majored on AF since we were set up in 2014; we have run public awareness campaigns at football and rugby clubs; distributed portable ECG devices to GPs; recruited a cohort of AF ambassadors – volunteers who’ve been given an AliveCor and asked to carry out 25 screenings each. And we have supported the introduction of genotype guided dosing of warfarin in 2 hospital clinics.
  • Debbie uses Alivecor Kardia and Diagnostick – picked up 5 positive readings and relayed results to people so they can take them to the GP.

    Now developing AF ambassadors in association with Stroke Association – people who will be given a Kardia and will be trained and asked to test 20 people.
  • E Frailty

    Under Development by:

    Dr Sarah De Biase, Improvement Academy, Y&H
    Dr Joanna Collerton, Frailty Programme Lead, AHSN NENC

  • What is it?
    A hands-on service combining education and community collaboration, with one-to-one home assessments, structured sessions and events.

    How we helped
    We have supported the spread of the service by funding the adoption in more than 40 residential homes throughout Lancashire.

    STEADY ON! Has shown positive feedback from residents regarding their health and mobility, plus a reduction in problems with anxiety and depression
    30 per cent reduction in ambulance service call outs over a 12 month period
    Preliminary findings regarding A&E admissions during current phase of service delivery has reported a similar reduction
  • Through the Scouts network, 3D Lifeprints was introduced to Liverpool Heart and Chest Hospital who are now going to commission 3D printing of organs.
    This came about after the Scouts were taken on a tour of Alder Hey’s Institute in the Park, and Liverpool Heart and Chest scout Mark Jackson was impressed by the impact of 3D printing. Surgeons at Alder Hey have used 3D prints to plan surgery – reducing the time spent in theatre, which saves time and money; improving outcomes for patients; used to help inform patients and families and explain what will happen.