Independence is important to all of us – but as we reach a certain age or develop a medical problem and the threat of a care home looms, it becomes a jealously guarded treasure.

The ability to stay in your own home is beneficial for all sorts of reasons. Now, there’s a new technology being tested in Dorset and you don’t even need to be able to use the internet to take part. But does it work, asks
Rachel Rowe.

So who is Lilli?

Dorset Council is working with a technology company called Lilli on a three month trial using assistive technology in homes. Having been completely unnerved by an Alexa device in a friend’s home recently, I’m sceptical – and like most people, wondering where my information is going. Dorset Cabinet Lead Member for Health Cllr Piers Brown explained: “The Lilli technology consists of some very discreet sensors that are placed around a person’s home. They simply detect movement around the house. The data collected from the home is transmitted to a team of occupational therapists working in the social care department at Dorset Council. Using artificial intelligence and cloud technology, the team are able to monitor trends and overall health with that person.” I’m still left wondering whether this is all a bit too intrusive but I’m reassured by Piers. “The sensors are very discreet. You barely know they are there. It’s not like one of the pendants that older people are given to wear- and then of course are not
wearing it when they fall over.” All the data is handled securely by Dorset Council and the project has to undergo a
rigorous assessment to ensure a person’s information is handled in confidence before it can start. The technology does not ‘observe people’, it simply detects movement – or a lack of it. And one of the things that fascinated
me was how it can detect a problem before it happens.

It’s all in the hips

Fractured hips are one of the biggest causes of someone over 50 losing their independence. They result in decreased physical activity, losing the ability to go out and socialise, having to move to residential care – and
research shows one in three adults aged over 50 dies within 12 months of suffering a hip fracture. And that’s before anyone starts talking about the cost to the NHS and hospital bed occupancy. But what if that could be prevented? That’s where technology like Lilli comes in. When the occupational therapy team are monitoring
the data, they can pick up when someone’s balance is deteriorating and do something about it before they fall. A
therapist could introduce a few exercises to help that person, or place an appliance in the home to support them.

Staying out of care homes

The Lilli technology can also detect a urinary tract infection (UTI) before it happens just by monitoring the number of times someone uses the loo. Given a simple UTI in an elderly person causes dementia-like confusion and can lead to them falling at home, there are huge opportunities for the occupational therapy team to intervene and deal with an issue almost before it has happened, preventing admissions to hospitals and most importantly, keeping people healthier and more independent in their homes. Often, someone about to be discharged from hospital just needs a little support to stay independent. Instead of needing a care home bed they can go straight home to the comfort and familiarity with the Lilli monitoring arrangements.

Dorset Council is currently recruiting 100 people for a three month trial

Staff will identify people suitable and participants will have a choice of taking part. You don’t need to be able to
use the internet or even have a computer to have the Lilli technology in your home. Piers is clearly an enthusiast.
“The technology enables us to design reablement (temporary care to help a convalescent get back to normal and stay independent) care around the person. It makes a meaningful difference to someone’s life.” With the ability to improve quality of life by keeping people safe in their own homes and improving health, the new technology makes it an exciting time for reablement in the county.

By: Rachael Rowe

Last weekend Stalbridge teenager Ruby Else-White competed in the England Boxing National Schools Championships, and once again was crowned champion. Twice-national champion Ruby was also selected as Female Boxer of the Tournament by the England Talent coaches.

Earlier this year we reported that 14 year old Ruby Else-White from Stalbridge has earned recognition as one of Europe’s top boxing prospects. As she boarded the flight to Newcastle Ruby admitted that she felt confident for Saturday’s semi- final, with a game plan that she stuck to. But the Sunday final saw her nerves jumping. “I didn’t know my opponent; she’d come from nowhere so I hadn’t had the prep I usually do. I was proper nervous. We knew nothing about her – I just managed to watch her semi-final after my own.

Winning the title

Did she feel like she’d won? Ruby grinned again. “I thought so. I keep a count in my head of the punches they land, and the ones I do. Plus Shaun tells me at the end of each round how I’m doing” I wondered if her coach Shaun Weeks would really tell her mid-fight if she was losing? “Yes he does! It’s ‘fight harder, do more, be smarter, you’re not working hard enough!’ So if he says I’ve got it, I know I’m doing okay. But nothing’s ever guaranteed.”

The Team GB pathway

The England Boxing National Schools Championships has now been running for a century and gives young boxers their first taste of competitive action on the national stage. More than 200 boxers took part this weekend – and though Ruby was thrilled to win her class (female 48kg), it was being selected as ‘Female Boxer of the Tournament’ – from all classes – by the England Talent coaches that really made her grin as we chatted. “it means I’ve been noticed!” Those who won Classes A and B titles are now invited to train with the England Talent coaches later this month. In March next year Ruby plans to make it ‘Three Times National Champion’: “If I make the final of the National Junior Championships, I’ll compete for England in the Tri Nations European Championship. If I win that then I’m put forward to represent GB in the Junior European Championships next summer. Next stop Olympics 2028!”

Shaun cautions that Ruby would need to continue winning National Titles over the next four years in progressive age classes, to be in a very strong position to be selected by the Olympic committee: “there is a lot of hard work, commitment, dedication and sacrifices to be made to get there.”

She’s a girl with a very clear plan; it’s easy to think that the drive and determination might be all-consuming. And yet hearing her complain about the ‘huge bruise’ on her cheek (“I never get hit!”), and seeing her checking her hair in the gym mirrors before posing with her golden gloves, blithely ignoring the older male boxers waiting for her to be done, it’s easy to see she’s actually just a 14 year old girl who loves to box.

By: Laura Hitchcock

Like every general practice surgery in the NHS, Gillingham Medical Practice is under pressure. But despite the workload, the priority is always making sure the patients get the right care from the right person in a timely way.

There has been a lot of publicity in the mainstream media recently about GPs not offering face to face appointments and increasingly long waiting lists. There has been significantly less reported on what clinical
staff have done about working ‘smarter’ in order to protect vulnerable people. A lot of this work goes on behind the scenes and is generally invisible to the public – but is, in fact, making a big difference. Dr Chris Pearce explains some of the issues and why Gillingham Medical Practice had to change some of the ways it assesses patients by adopting a new solution. “Prior to the new system, Gillingham Surgery received 14,500 phone calls a month. Only 53 per cent of those calls got answered; there simply weren’t enough people to pick up the phone. It’s impossible to deal with that volume.” Just think about that number for a moment. That’s just one practice in Dorset. Others have the same issues. And it’s not sustainable. The team, like so many other practices across the county, have turned to technology to help them, and implemented a new system called Total Triage and eConsult. Of course there’s still an option to simply phone the practice and make an appointment, but patients can now use an online system to describe exactly what they would like help, along with any symptoms. eConsult is based on evidence-based algorithms – it is will cut in and tell them to call an ambulance. The system also flags people who need to be assessed quickly by the local surgery. Every patient’s data is very secure under the NHS system and the system also links to your GP record. But it’s what happens next that is beginning to make the system more efficient.

What happens to your form?

A team of clinicians at Gillingham Medical Practice look at each online requests; they make assessments and aim to get the patient seen by the most appropriate person. People are usually contacted within a day for more serious issues. Minor issues are dealt with in three working days – sometimes faster. Chris told me they have two meetings a day to review the online submissions and agree who will speak to the patient; it doesn’t always have to be a GP. For example, someone with a chronic arthritis flare up may benefit most from seeing a physiotherapist to help with exercise. Someone with a complex medication issue could be better off seeing the pharmacist. And if a GP has been handling a particular case, the triage system means they can continue seeing them instead of the patient being allocated to a clinician unfamiliar with the history. In Gillingham, the team is managing 300-400 people a week in this way and they are working far more efficiently as a result. Dr Pearce was enthusiastic about being able to maintain continuity by using this system of triage: “General practice cannot function without continuity of care.”

What about those phone calls to the surgery?

As a result of implementing the new service, the number of phone calls has decreased to 8000 a month. 74 per cent are being answered which is a significant improvement. But for those using eConsult, the new system means they are triaged and assessed more efficiently.

We’re always open

Practice manager Karen Rhys is also keen to emphasise that though the Barn Surgery is temporarily closed for safety reasons, the practice has always been open. ”We have never been shut, and by doing things differently we can ensure vulnerable people are protected.” It is clear that a lot of healthcare needs to be delivered differently in future and all of us will need to adapt to new ways of doing things. What hasn’t gone away is the dedication, the care and compassion from our local GPs and primary care staff who are doing their utmost to ensure that people get the best possible care in North Dorset.