‘NHS Skype doctors and nurses’ prevent thousands of avoidable hospital trips

NHS doctors and nurses are using Skype to help older people get faster care, reduce avoidable ambulance call-outs and help people stay out of hospital.

The on-call Skype NHS team takes around 8,000 calls a year from wardens working in sheltered accommodation, care home staff and community teams looking for expert support for their residents.

Previously, they would have had to call an ambulance, but in the last two years they have prevented 3,000 avoidable visits to A&E and freed up 2,000 GP appointments by solving problems via Skype, meaning elderly people get the right support in their own home, avoiding the disruption – and in some cases distress – of an emergency hospital trip.

The scheme in Tameside, in Greater Manchester, is part of a programme of integrated services being rolled-out across the country as part of the NHS Long Term Plan, with smart use of technology enabling quicker, more personal care delivered as efficiently as possible.

Quicker care has made the service more effective and efficient, freeing up £1.3m and hundreds of hours of NHS staff time, to care for patients with urgent needs.

The scheme is one part of the delivery of the NHS Long Term Plan which commits to improving care home residents’ health care, joining up health and social care services and providing improved, convenient care through digital technology.

Prof Stephen Powis, NHS England Medical Director, said: “Putting every person’s individual care needs at the centre of joined-up services, supported by smart technology, is the heart of our Long Term Plan for the NHS.

“What matters most to every patient and their family is that they get the right treatment, at the right time, so integrating services – across communities and between councils, carers and hospitals – is not only good for the people we care for but a more efficient use of NHS resources.”

Peter Grace, a registered nurse who works taking calls in the digital centre, said: “By setting up a direct link between services and the doctors and nurses at the hospital’s digital health team, we were able to offer guidance, advice and reassurance as well as being able to see the patient on Skype.

“Extending this to housing wardens, working with the council, has taken the project to the next level as now we can also help with issues in sheltered accommodation such as falls.”

Tameside has integrated its combined £1bn NHS and local council budget over the last three years, as part of Greater Manchester’s devolved health and care approach, breaking down organisational barriers to develop solutions to health and social care issues more easily.

Working together and with patients, carers and local groups, health leaders in the area have developed:

  • The digital health and community response teams helping avoid unnecessary admissions
  • The ‘Extensivist team’ – GPs and clinicians working closely with high need patients reducing A&E attendance by 58% within the cohort of patients that the team sees
  • A £1.3m funding boost to the voluntary sector to provide 2,500 social prescribing referrals a year
  • Home First, led by their Integrated Urgent Care Team seven days a week to help people get home in a timely way once medically fit

Steven Pleasant MBE, Chief Executive of Tameside Metropolitan Borough Council and Accountable Officer for NHS Tameside and Glossop Clinical Commissioning Group (CCG), said: “One of the most important changes to how we operate in the Tameside integrated care system is that we can risk share. We can move money round to support other organisations make savings around areas like prescribing and free up investment for preventative care.

“But it’s our culture that has changed – it’s about working as one team with no emphasis on the organisation you’re employed by – and empowering the workforce with permission to innovate. We’re totally open to change and with the back-up of an extensive leadership training programme we’re striving to develop the next generation of leaders from every level all the organisations.”

Trish Cavanagh, Chief Operating Officer at Tameside and Glossop Integrated Care NHS Foundation Trust, said: “The strategic plans we have developed are aimed at improving access to care for people and looking to provide care in more innovative ways – including using technology to support this. In some circumstances this reduces the need for people to attend the hospital but they are still able to access expert advice in a timely manner.”

Jon Rouse, Chief Officer of the Greater Manchester Health and Social Care Partnership, said: “Tameside’s pioneering work is an example of what happens when you bring together teams from the NHS, local authorities and care home providers and give them the freedom and resources to develop new ways of doing things.

“Greater Manchester has a long history of collaboration between the 10 council areas. It is that focus on working across organisational boundaries to best serve the needs of ordinary people that will help them to live independently as long as possible and receive care when they need it.”

Across the country, 14 areas have Integrated Care Systems (ICS) which join up NHS and local government services simplifying systems between GPs, hospitals, councils and charities and improving lives.

The Tameside and Glossop Care Together integrated system is part of Greater Manchester’s devolved integrated care system. It includes NHS Tameside and Glossop CCG, Tameside Council, and Tameside and Glossop Integrated Care NHS Foundation Trust as well as close work with the voluntary sector and charities. The Hospital Trust provides community services as well as acute.