Post on 05-Dec-2014
description
The future of healthcare and the implications for the built environment Candace Imison March 2014
Rising life expectancy
Rising numbers of older people
% Increase last 20 years
0-64
65-84
85+
1989/90-2009/10
An ageing and more demanding population
NHS Spend
Source: DH - Departmental Report 2006
133% by 2035
Population lifestyles present significant risks to their health
5
Behaviour change is not easy
Growing numbers of people with long term conditions and multiple conditions
Rising care needs
Significant growth in need for informal care
But - more people living on their own
! A “cure” or “vaccine” for certain cancers.
! An increase in the number of lifestyle drugs available
! Devices that have the capacity to replace or integrate with human tissue
! Biosensors that allow continuous monitoring of a patient
! Pharmacogenetics support more effective treatments
! In the longer term stem cells provide capacity to replace or repair organs
Increasing capacity to diagnose and treat
Continuing and rapid technological advance
! Continuing growth in
computing power,
intelligence and access
! The world of Big Data
! Shift towards smart phone/
tablet and apps from PC
and web
! Current digital divide
presents challenges
Ubiquitous access to the internet
Technology could support service transformation
! Reactive to proactive ! Help patients help
themselves and each other
! Personalised services ! Care to health and
wellness ! But ! One size does not fit
all ! Caring still counts
Virtual visits – remove geographical barriers to access
Health care can be done at a distance with video conferencing and remote monitoring of blood sugar, blood pressure, heart rate, and other health data.
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The home as the locus of care
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Hospital of the future?
The hospital - part of a wider web of patient focused care
Home
Health and social care centres close to home
Community care centres heart of the community
Specialist care centres on central city sites
Self care Monitoring Automated treatment Information and advice NHS Direct
Social care Primary care Outreach care
Basic diagnostic services Day interventions Minor injuries Nurse led inpatient care Intensive rehabilitation Chronic care management
Home Nursing homes
Pharmacy Cyber café Health kiosk
Surgeries Drop in centres Healthy living
centres
Resource centres
Community hospitals
DTCs Secondary care
Tertiary care Planned interventions Emergency care Complex diagnostic Treatment & inpatient care
Adapted from:Building a 2020 vision - The Nuffield Trust (2001)
Bromley by Bow Health Centre
More integrated community based models of care
High tech
Automated pathology, digital imaging, telemedicine, IT links
Bringing health care into the heart of the community:
A new relationship with the public: Welcoming, therapeutic environment, integrated with other public services
Mobility centre for intensive care
rehabilitation
Consulting Basic diagnostics Day interventions
Nurse led inpatient care
Minor injuries
Child development centre
Hospices and nursing homes
Mental health resource centre
Education, leisure
Advice
Day centres for older people
Alternative health care providers
A new relationship with the environment Sustainable systems: water, energy, recycling, waste, emissions, bio-diversity
Adapted from: Building a 2020 vision - Nuffield Trust (2001)
Older people’s vision
› Connection
› Control
› Personal
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