Tuesday 4 November 2014

Professor Jane DacrePresident, Royal College of Physicians

Future vision forintegrated careThe challenges, the solutions and how we can make it happen

Outline

• The challenges• The solutions• Making it happen nationally• The RCP’s role

The challenges?

Hospitals on the edge?• 65% of people admitted

to hospital are over 65

• Third fewer general and acute beds over 25 years

• 37% increase in emergency admissions in 10 years

• Multiple complex conditions

Information silos and islands

• Plurality of isolated IT systems

• Culture • Style of clinical practice • Funding

The solutions?

The Future Hospital

Patient experience

Radical restructure of wards

Secondary care stretching out into the community

The Future Hospital

Information to enable integration

• Patient-centred electronic records

• Patient access

• Standards for clinical records

Information to improve efficiency

• Effective use of technology for care

• Information available to manage, research, commission

How do we make it happen?

Promoting what works

• Future Hospital demonstrator • Improve access to specialist care for

rural frail and elderly• Use of telehealth and triage algorithms

Search for patient, get automatic summary

National and local EHR elements

Single sign on clinical p

ortal in

use in

Ninewells H

ospital s

ince 2008 !

Cluster RCT results: nearly 1/3 of 280 dermatology

clinic visits would have been prevented using

telehealth

Eminovic et al. . Arch Dermatol. 2009;145(5):558-64.

Five-point plan for governmentFuture Hospital: More than a building

The hospital is an integral part of the community

Secondary care has a crucial role wherever patients are

Five point plan principles

• Stability and long-term vision• Removal of financial and organisational

barriers• Invest now to save later• Prioritise what works and improve what

doesn’t• Adopt the Future Hospital model as a

template

NHS – 5 Year Forward View• Local choice, national

standards • Invest in research and

innovation• Break out of artificial

boundaries• Use IT to transform care

The RCP’s role?

Helping to make it happen

• Influence – national and local

• Physician education and development

• Future Hospital network, good practice case studies, exemplars etc

• Engaging with specialties and partners

Professor Jane DacrePresident, Royal College of Physicians

the.president@rcplondon.ac.uk