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A new collaboration between Care City and GaitSmart aims to improve the lives of those at falls risk by bringing gait analysis and remote exercise prescription, delivered by healthcare assistants and remote physios, to local GP practices.

Care City is one of five National Health and social care test beds, and is the only one in London. It spans four boroughs, Barking & Dagenham, Havering, Redbridge and Waltham Forest. The Care City Innovation Test Bed seeks to test a combination of devices and software alongside new approaches to service delivery and patient participation, to assess whether we can measurably improve the wellbeing and resilience of older people with long term conditions, older people with dementia, and their carers.

Falls cost the NHS at least £2bn. Falls prevention is therefore vitally important, both for patients and for the healthcare system. Care City is now working with GaitSmart, as part of the NHSE Test Bed to trial the introduction of gait analysis with personalised exercise prescription inside health and care services. In just 10 minutes, the process can identify issues with a person’s gait, allowing a proactive intervention to reduce risk of falls, long before they arrive in A and E.

During the assessment, six small sensors are applied by elasticated retaining straps to the pelvis, thighs and calves and the patient walks a few metres in a straight line. The resultant GaitSmart report contains kinematic data that identifies any movement issues, as well as the severity of those issues. The GaitSmart report is shared with a remote physiotherapist who creates a personalised exercise plan to target the problem areas. The personalised exercise plan provides exercises and daily activities that can easily be performed by the patient in the everyday lives that can help strengthen the gait of the patient and reduce their risk of falling. The patient’s gait is then re-tested on a monthly basis so that they can see their improvement, receive progressive exercises and activities and are motivated to continue with their exercise treatment.

John Craig, Chief Executive, Care City commented “This new approach to reducing falls risk puts the tools to assess gait (the way in which you walk and run) in the hands of our primary care system, enabling them to find people with gait issues, and help them, quickly and affordably, before their mobility deteriorates. The long-term vision is to give citizens an understanding of their own mobility, enabling them to exercise cheaply and easily - independently or socially - while benefiting from expertly calibrated exercises. We hope to keep more people more mobile for longer, reducing their risk of falls.”

Steve Goode, Head of GaitSmart clinics and client development commented “Every year, three million people over the age of 65 will experience a fall costing the health service in excess of £2.3bn. The GaitSmart system allows us to identify these patients quickly and easily, ascertain any areas of concern and to provide personalised exercise plans, to help improve or rectify the problem.”

Feedback to date shows that patients value the experience of GaitSmart gait analysis. It is quick, easy and can be conducted locally by someone the patient may well already know and puts the tools to managing their own health, in their own hands.

Community pharmacists are working with their local hospital to find and treat AF and prevent stroke

We are delighted to launch our new Atrial Fibrillation Pathway at this year’s EXPO 2017. The Pilot Model finds people with undiagnosed AF in local pharmacies, reduces appointments and waiting times to treat them, and offers a cost-effective way to prevent 1600 strokes across England.

An irregular heartbeat, clinically referred to as an Atrial Fibrillation (AF), is the most common heart rhythm disturbance. Half of people in London with AF are unaware they have the condition, or that they face a five times higher stroke risk as a result.

Care City is one of seven National Health and social care test beds funded by NHS England and is the only one in London. Working with local pharmacies, it is trialling early testing of AF using a KardiaTM Mobile handheld mobile device from AliveCorTM, which can spot AF in 30-seconds. Those with an abnormal result receive a rapid referral to a One Stop AF Clinic at Whipps Cross University Hospital where a patient will undergo minimally invasive diagnostic tests and meet with an Arrhythmia Nurse to discuss the result and, if appropriate, receive treatment. The whole process takes 2-3 weeks, compared to a national average of 12 weeks at present. The Pilot is a collaboration between Care City, North East London Local Pharmaceutical Committee, Barts Health NHS Trust, Waltham Forest CCG and Sonar Informatics.

Nearly 700 patients have already been screened for atrial fibrillation as part of the Care City’s NHS England Test Bed since it launched last year. Of these, approximately 7% were identified to have Atrial Fibrillation. Independent evaluators from University College London, say “Preliminary health economic modelling indicates that combining innovative screening for atrial fibrillation in community pharmacies for the 65s and over with a rapid access clinic offers a cost-effective strategy, reducing strokes at a comparatively low cost. If replicated across England, an estimated 1600 - 1700 strokes would be prevented per year.”

The Health & Care Innovation EXPO taking place on 11th and 12th September at Manchester Central is the only major conference in England focused on innovation across all aspects of health and social care. It unites NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media and will explore the most important developments across health and social care.

John Craig, Chief Executive, Care City commented “We’re proud to launch our new AF Pathway at EXPO and show how we’re collaborating with technology and all levels of the health and care community with a common endeavour to assist patients to pro-actively manage their health and ultimately save lives. The data we collect from this testing, will indicate how many people use the service, leave with a diagnosis and start treatment. It will also help us understand whether the service is good value for the NHS and whether adopting this one stop shop approach further across the UK is an effective and viable option.”

Emily Hough, Director of Strategy at NHS England commented: “It is great to see combinatorial innovation in action in Care City as they bring together new technologies with changes in the way care is offered to patients.  This new enhanced AF pathway should lead to earlier diagnosis and treatment, ultimately offering improved outcomes for patients.  We look forward to continuing to support Care City, and thinking about how we can scale this approach if it does deliver improved outcomes for patients at the same or less cost.”

KardiaTM Mobile from AliveCorTM is one of a number of sophisticated innovations that the Care City Test Bed is collaborating with to support people with long term conditions, dementia and their carers.

  • The Canary Care monitoring and notification system aims to provide round the clock reassurance to family members whilst allowing older or vulnerable people to stay at home.
  • GaitSmart’s gait analysis tool applies micro sensor technology to movement, identifies areas of issue in the patient’s mobility and provides personalised exercise programmes.
  • The HealthUnlocked Social Prescribing tool enables health professionals to signpost or prescribe local support services and other beneficial resources that relate to holistic needs or conditions
  • Join Dementia Research supports local people to register their interest in participating in dementia research and allows them to be matched to suitable studies in their area and wider afield.
  • Kinesis QTUG™ is a fast and efficient tool for identifying older adults at risk of falling, using precise and accurate body movement sensors.
  • St Bernard’s GPS based Emergency Location Service aims to reassure both the individual and their carer/s and family.

Care City will be exhibiting in the Test Bed Zone Bed Zone at EXPO 2017.

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