Lessons from Europe a Scottish perspective Professor

Lessons from Europe – a Scottish perspective Professor George Crooks Donna Henderson NHS 24

• NHSScotland – – £ 12 billion 14 Health Boards 8 Support Boards 32 Local Authorities – Integrated delivery – Moving towards social care integration

OUR VISION IS THAT BY 2020: • Everyone is able to live longer healthier lives at home, or in a homely setting. • We will have an integrated health and social care system, with a focus on prevention, anticipation and supported self management. • When hospital treatment is required, and cannot be provided in a community setting, day case treatment will be the norm. • Whatever the setting, care will be provided to the highest standards of quality and safety, with the person at the centre of all decisions. • There will be a focus on ensuring that people get back into their home or community environment as soon as appropriate, with minimal risk of re-admission.

“The Scottish Governments international activities make crucial contributions to sustainable economic growth. We are committed to ensuring Scotland is a great place to live, work, learn, invest, visit and do business with”

http: //www. sctt. scot. nhs. uk/programmes/ european-projects/

Key Objectives • Actively engaging with European institutions to the benefit of Scotland other countries of Europe. • Building relationships and partnerships to learn from others, share best practice and collaborate on areas of mutual interest. • Enhance Scotland’s reputation in Europe and by so doing create further opportunities including securing inward investment and generating economic growth. • Influence and secure funding from relevant EU funding programmes to benefit Scotland by supporting the delivery of key national strategic initiatives.

Key Components of Engagement EUROPEAN PARTNERSHIPS RESEARCH, INNOVATION & DEPLOYMENT EXCHANGE AND LEARNING

Key Ambitions “Deliver Government Policy” • Raise the Profile of Scotland • Raise the Profile of NHS Scotland • Promote NHS Scotland as a leader in the provision of Telehealth and Telecare Services • Develop Networks and Partnerships to share best practice and knowledge • Secure Funding for the NHS and Scotland

EUROPEAN PARTNERSHIPS EIP on AHA Action Groups Reference Sites

+2 Healthy Life Years by 2020 Triple win for Europe Health & quality of life of European citizens Sustainable & efficient care systems Growth & expansion of EU industry Action Groups Integrated care for chronic conditions, inc. telecare (B 3) Better management of health: preventing falls (A 2) ICT solutions for independent living & active ageing (C 2) Preventing functional decline and frailty (A 3) Age-friendly cities and environments (D 4) Reference Sites Improving prescriptions and adherence to treatment (A 1)

European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) Action Group Focus Scotland’s Commitment Represented by A 1 Adherence & Medication Pharmaceutical Care for Long Term Conditions Scottish Government A 2 Falls prevention National Falls Programme Scottish Government A 3 Frailty Acute Focus on Frailty JIT B 3 Integrated care ICT enabled integrated health and social care NHS 24 C 2 Independent living Living it Up NHS 24 D 4 Smart cities and communities Dementia Enabled Communities The ALLIANCE

Political added value of the EIP • inspire for policy action Joint Action on Chronic Diseases and Healthy Ageing (28 countries + 5 networks) • support from the ground High level conferences (e-health, Gastein Forum, Conference of Partners, Frailty and Adherence Conferences) • identify good practices working in real life • develop policy on active & healthy ageing • mobilise efforts & resources Alignment of priorities in Horizon 2020, CIP 2013, PHP 2013 etc. Reflection process of the MS: Towards modern, responsive and sustainable health systems

NHS SCOTLAND Is already committed through EXISTING strategies and actions to support the objectives and challenges set out in the EIP

RESEARCH, INNOVATION & DEPLOYMENT

European Funding Streams • Competitiveness & Innovation Programmes (CIP) – Designed to support the European Digital Agenda, including healthcare. – Focus on scaling existing services/pilots and building the evidence base for telehealth and telecare deployment in Europe. – SCTT in 3 current projects : United 4 Health; Smartcare; Master. Mind. • FP 7 Projects – Focus on research and innovation in health and/or ICT innovation at development stage. – SCTT in 2 current projects: UNWIRED Health; e. SMART. • Thematic networks projects – INTERREG IVC, CIP, Public Health Programme. – Focus on sharing results and knowledge across the EU and the use of digital technologies to improve local service delivery. – SCTT in 3 current projects: CASA, Momentum, ACT

United 4 Health (CIP) • • Timeline: January 2013 -December 2015 Total budget Scotland: € 1, 556, 478. 00 European funding: 50% of budget Strategic fit: Support health and social care integration (ICT solutions for the management of people living with long term conditions in home settings, deployed at scale; costeffectiveness) • Project impact: +7000 patients with one of the three conditions (COPD, diabetes and heart failure) • Scottish partners / implementation sites: – NHS 24 (overall coordinator & lead for Diabetes workstream); – 3 Health Boards (NHS Ayrshire & Arran; NHS Greater Glasgow & Clyde; NHS Lanarkshire) – 7 Local Authorities (North, South & East Ayrshire Council, East Renfrewshire & Renfrewshire Councils; North & South Lanarkshire Council)

Smart. Care (CIP) • • Timeline: January 2013 - February 2016 Total budget Scotland: € 1, 457, 195. 00 European funding: 50% of budget Strategic fit: Support health and social care integration (role of ICT to support integrated care; focus on falls prevention and management; Living it Up) • Project impact: 10, 000 people (8, 000 patients ad 2, 000 health professionals) • Scottish partners / implementation sites: – NHS 24 (project partner) – 3 Health Boards (NHS Ayrshire & Arran; NHS Greater Glasgow and Clyde; NHS Lanarkshire) – 7 local authorities (North, South and East Ayrshire Council, East Renfrewshire and Renfrewhsire Council; North and South Lanarkshire Council)

Master. Mind (CIP) • • Timeline: March 2014 - February 2017 Total budget Scotland: € 804, 632. 00 European funding: 50% of budget Strategic fit: Enhance wellbeing; support health and social care integration (computerised Cognitive Behavioural Therapy programme to treat people with depression and anxiety) • Project impact: 800 people • Scottish partners / implementation sites: – NHS 24 (project partner leading the worksteam on benefit of c. CBT) – 4 Health Boards (Fife, Shetland, Lanarkshire, Grampian)

UNWIRED Health (FP 7) • • Timeline: January 2014 -December 2016 Total budget Scotland: € 788, 356. 30 European funding: 75% of budget Strategic fit: Support economic growth; support health and social care integration (mobile e. Health services for patient empowerment; pre-commercial procurement process) • Project impact: Patients and health professionals • Scottish partners / implementation sites: – NHS 24 (project partner) – NHS Greater Glasgow and Clyde

CASA (INTERREG IVC) • • Timeline: July 2012 - December 2014 Total budget Scotland: € 155, 377. 00 European funding: 75% of budget Strategic fit: Exchange learning; develop and embed good practices (study visits /secondments) • Project impact: Understanding of health and social care systems and innovative services in other countries that can be applied to improve health and social care delivery in Scotland • Scottish partners: – NHS 24 (project partner)

Momentum (CIP) • • Timeline: February 2012 - December 2014 Total budget Scotland: € 17, 001. 00 European funding: 100% of budget Strategic fit: Exchange learning; develop and embed good practices on telemedicine services in Europe • Project impact: European Blueprint for Telemedicine Deployment at Large Scale • Scottish partners: – NHS 24 (project partner)

ACT (Public Health Programme) • • Timeline: February 2013 - December 2015 Total budget Scotland: € 68, 534. 00 European funding: 60% of budget Strategic fit: Exchange learning; develop and embed good practices on care co-ordination and telehealthcare services • Project impact: “Cook book” (indicators that have influence on the outomes of care coordination programmes and telehealth services) • Scottish partners: – NHS 24 (project partner) – West Lothian CHCP, supported by ISD

Horizon 2020 • • Timeline: 2014 -2020 Total budget : (80 billion EUR) – 488 m EUR 2014 – 492 m EUR 2015 Objectives: – Health, demographic challenge and well-being – Active and healthy ageing, independent living – Sustainability of healthcare systems Scotland’s participation in 2014: – 10 proposals submitted – 2 proposals through to the second stage: • PIEM 3 (Scottish Government, NHS ISD, University of Glasgow) – an Integrated European Evidence-based Model for the Management of Multimorbidity (Total budget: € 6 m) • Health. Match (NHS Scotland, JIT) – matching stratified populations to available services based on combined criteria, inc quality and cost-effectiveness (Total budget € 4 -6 m) – 1 winning proposal • Cracking the language barrier (NHS 24) – to improve machine translation of health text substitute translators for public health information (Budget for NHS 24: € 547, 425) • Identified priorities for 2015: – PHC 25 – Advanced ICT Systems and services for integrated care (Expected budget: € 3 -5 m) – PHC 28 – Self-management of health and disease / decision support systems based on predictive computer modeling used by the patient (Expected budget: € 3 -5 m)

Ambient Assisted Living Joint Programme • Timeline: 2015 • Total budget: € 1 -7 m (AAL Association + EC); 60% of eligible costs for SMEs, up to 50% for large companies, local authorities, health trusts, up to 100% for charities • Objectives of the 2015 Call: Living active and independently at home – the contribution of ICT / technologies to integrated solutions for supporting active and independent living of older adults in their homes” – Deadline: 28 May 2015

Public Health Programme • Timeline: June 2014 - 2020 • Total budget: € 449, 4 m (EC DG SANCO) • Objectives: – Health promotion, disease prevention, healthy lifestyles environments; – Cross-border health threats; – Innovative, efficient and sustainable health systems; – Access to better and safer healthcare • Scotland’s participation in 2014: – SIMPATHY – Stimulating Innovation Management of Polypharmacy and Adherence in Older People – Partner: Scottish Government – Expected budget: € 66, 000

INTERREG EUROPE Programme • Timeline: 2014 - 2020 • Total budget: € 359 m (DG Regio) • Objectives: Knowledge Exchange, dissemination and embedment of good practices (research and innovation, ICT) • First call for proposals mid February 2015

EXCHANGE AND LEARNING Thematic Networks Memorandums of Understanding

We have: • Developed networks with senior officials and key individuals across Europe • Secured Scottish input into the EIP Strategic Plan • Active membership in the EIP Action Groups • Secured membership of a number of European organisations • Hosted the inaugural European Telemedicine Conference • Hosted the International Integrated Care Conference 2015

Hosted Exchange Visits - 2014 • Basque Minister for Health & Minister for Social Affairs and Welfare & senior officials; • Danish Regions and service providers • Catalan Health Ministry • Norwegian Government and municipalities • Swedish municipalities • Flanders Government and SMEs • Polish National Health Insurance providers • Veneto Region • 1 CASA project Study Visit – 70 participants from 11 regions

MOUs and Action Plans • Catalonia • Basque Country • Greece • Norway • South Denmark • Kent!

Lessons Learned

Lessons learned Political • Ensure you have politcal support and buy-in at a local level • Be aware of the politics – at Member State, Region and local levels • European Commission - rules of engagement Networks • Cultural differences – rules of engagement • Understand what motivates others • Prioritise your involvement

Lessons learned European funded projects • Be clear about your strategic priorities before you engage • Choose your project partners wisely • Learn how to say NO (politely)! • Speculate to accumulate - you need to invest resources • Don’t expect a high level of success! • There’s never enough time…. start early • Engage early with local stakeholders – you need them to deploy

SCTT European Engagement Team • European Strategic Leadership – George Crooks / Donna Henderson • European Engagement Manager – Janne Rasmussen • European Service Development Manager Andrea Pavlickova • European Project Co-ordinator – Victoria Hunter • European Finance Manager – Morag Keith • European Project Managers – Pamela Rennie / Marlene Harkis / Michelle Brogan / Chris Wright

Support available to Health & Social Care Partnerships • Awareness raising - European digital health and care agenda and funding opportunities • Signposting partnerships to relevant funding opportunities • Matchmaking – linking Scottish partners with suitable European partners • Advice and guidance – development of funding proposals – European project management

Thank you! http: //www. sctt. scot. nhs. uk/