:00:00. > :00:00.Whatever happened to high-tech health care in the home?
:00:00. > :00:00.It's a disaster for that family and the patient.
:00:07. > :00:09.Someone now needs to step up and take ownership of this and say,
:00:10. > :00:12."I'm really sorry it has gone wrong, it was a trial, but
:00:13. > :00:18.The veteran airmen on a mission for the Guinea Pig Club.
:00:19. > :00:24.I hit the ground rather violently and this was an inferno.
:00:25. > :00:29.And how to navigate your way through the winter months.
:00:30. > :00:31.Winter is actually quite a fun time to do it.
:00:32. > :00:34.We've got fewer leaves on the trees so we can look at some things
:00:35. > :00:40.I'm Natalie Graham with untold stories closer to home,
:00:41. > :00:58.from all around the south-east, this is Inside Out.
:00:59. > :01:01.Hello and welcome to the programme, which this week comes
:01:02. > :01:05.to you from a rather wet New Haven in East Sussex.
:01:06. > :01:08.Now, no one likes staying in hospital if it can possibly be
:01:09. > :01:11.avoided and a few years ago, the government backed
:01:12. > :01:14.a new scheme called telehealth, designed to help people
:01:15. > :01:19.Kent was at the forefront of that experiment,
:01:20. > :01:33.Can you come and have a look a minute, please?
:01:34. > :01:41.He's a former Lord Mayor of Canterbury.
:01:42. > :01:43.When he was younger he ran marathons.
:01:44. > :01:47.He was also a rugby player and boxer.
:01:48. > :01:50.But these days he suffers multiple health problems.
:01:51. > :01:54.He's covered in cuts and bruises from regular blackouts and falls.
:01:55. > :01:58.He doesn't often move far from his armchair.
:01:59. > :02:04.I got kicked in the head playing rugby and had two blood clots
:02:05. > :02:08.on the brain and developed epilepsy from the heart.
:02:09. > :02:11.I then had a couple of heart attacks and that followed
:02:12. > :02:20.He fell unconscious while you are interviewing him and his wife.
:02:21. > :02:39.I asked Betty how often that happens.
:02:40. > :02:48.There are thousands of people like Pat in the south east -
:02:49. > :02:51.in and out of hospital - with long-term conditions that put
:02:52. > :02:57.But Kent was one of the first local authorities to
:02:58. > :03:01.experiment with a high-tech solution - telehealth.
:03:02. > :03:05.Telehealth is a system, first developed in America,
:03:06. > :03:07.where patients use high-tech equipment at home to take
:03:08. > :03:12.their own health readings, which can be monitored remotely.
:03:13. > :03:15.What it allowed us to do was monitor patients on a daily basis
:03:16. > :03:18.from our office or from where ever we were without having
:03:19. > :03:24.The government was so enthusiaistic about telehealth that it launched
:03:25. > :03:27.the Three Million Lives campaign, which aimed to get three
:03:28. > :03:31.million people signed up to telehealth within five years.
:03:32. > :03:34.And it apppinted Kent as a pathfinder authority,
:03:35. > :03:40.because Kent had been operating a telehealth system since 2005.
:03:41. > :03:43.So we are going to find out what happened to telehealth.
:03:44. > :03:53.There were certainly high hopes back on.
:03:54. > :03:55.We know that this saves money and improves lives.
:03:56. > :03:58.We know it has fantastic potential benefits, reducing the number
:03:59. > :04:00.of crisis admissions in hospital when everything goes
:04:01. > :04:03.wrong, which happens to often at the moment.
:04:04. > :04:06.But in the same year the NHS was reformed,
:04:07. > :04:09.devolving power from large primary care trusts to smaller clinical
:04:10. > :04:16.At the time, Roy Lilley, a former NHS trust chairman, sounded
:04:17. > :04:22.He said it would only work on a large sale.
:04:23. > :04:29.Because if you work as it is now, with a few local bits of kit that
:04:30. > :05:03.get plugged in in some way or other to the local GP's surgery,
:05:04. > :05:05.They were told to take Pat's vital readings every day,
:05:06. > :05:07.to include blood pressure, blood sugars and oxygen levels.
:05:08. > :05:11.These were relayed to a nursing team that monitored them remotely.
:05:12. > :05:14.The whole system gave him a lot of confidence that
:05:15. > :05:18.if he didn't feel well, put him on the machine
:05:19. > :05:23.and he would know roughly what was wrong with him,
:05:24. > :05:27.you know, whether it was the heart, the head or what.
:05:28. > :05:29.Rather than being in hospital maybe three times a month,
:05:30. > :05:35.it stretched it out to maybe once every three months and it made
:05:36. > :05:39.To start with, Pat and Betty were very happy
:05:40. > :05:44.It meant that despite Pat's severe health problems,
:05:45. > :05:50.they felt they had the security that someone was watching.
:05:51. > :05:52.But after a while, Pat and Betty noticed a change
:05:53. > :05:55.in the telehalth service - to them it seemed the
:05:56. > :06:03.If the readings that were going through to the listening station
:06:04. > :06:08.were above or below his parameters, then somebody would
:06:09. > :06:16.Or they'd ring me and say, 999, and then gradually this has gone
:06:17. > :06:22.The visits have come down to the fact that
:06:23. > :06:27.Betty became so concerned about the service that she started
:06:28. > :06:38.Every month I took, I started taking a picture.
:06:39. > :06:41.And were there are things that concerned you about his readings?
:06:42. > :06:43.That you felt you should have got a phone call?
:06:44. > :06:46.These are down in the threes, blood sugar.
:06:47. > :06:52.Was Betty right to be concerned that she didn't get phone calls
:06:53. > :06:57.from nurses when she thought perhaps she should have done?
:06:58. > :07:00.We are not experts so we don't know, so I have taken some of those
:07:01. > :07:03.readings and I am going to show them to somebody who might
:07:04. > :07:13.Dr Lawrence is a GP and a reader in medicine at Warwick University.
:07:14. > :07:18.He agreed to take a look at Betty's photographs.
:07:19. > :07:20.We can see certainly as far as the BP is concerned
:07:21. > :07:23.that there are times when it has been quite high and out
:07:24. > :07:26.of a certain range, or quite low and I would expect
:07:27. > :07:28.that there would be some kind of communication
:07:29. > :07:35.What I'll do is I will ring Betty now and see if she did
:07:36. > :07:47.I'm just looking at the BP readings from March of 2016.
:07:48. > :07:55.Your husband's BP was around 105, 110 systolic.
:07:56. > :08:01.If it is quite low, then it can reduce the flow of blood
:08:02. > :08:04.to the brain and physiologically one will therefore feel dizzy
:08:05. > :08:10.I would expect that you may have received a call at this time.
:08:11. > :08:15.No, I haven't had any calls this year.
:08:16. > :08:22.Dr Lawrence, what do you think about the fact that they didn't
:08:23. > :08:31.So what has been happening with the Burke's telehealth service?
:08:32. > :08:35.In 2013, the NHS was totally reformed.
:08:36. > :08:37.Responsibility for telehealth switched from the Department
:08:38. > :08:43.Kent County Council is no longer involved.
:08:44. > :08:46.So with responsibility for telehealth now passed
:08:47. > :08:49.on to the NHS, we contacted the Clinical Commissioning Group
:08:50. > :08:55.We asked why Pat Burke didn't get calls from
:08:56. > :09:01.the service in March last year and if the service has deteriorated.
:09:02. > :09:04.The reply came from Kent community health NHS
:09:05. > :09:07.Foundation Trust who run the service for South Kent coast CCG.
:09:08. > :09:36.The Burkes told us that that's not the case and they hadn't
:09:37. > :09:43.agreed that Pat should come off telehealth.
:09:44. > :09:51.They also did not know about him being discharged. Betty said the
:09:52. > :09:55.reason a nurse came out to see him in March is because she called the
:09:56. > :09:59.service concerned about a bad cough he had at the time. We wanted to
:10:00. > :10:05.know what had happened to tele- health. All be Kent CCG 's gave us a
:10:06. > :10:36.joint statement. The Kent CCGs told us the telehealth
:10:37. > :10:40.system has gone. They sent out letters to telehealth users but the
:10:41. > :10:47.Burkes say they did not get the letter. Nothing has come to us. As
:10:48. > :10:51.we heard earlier, Roy Lilley was sceptical four years ago about the
:10:52. > :11:00.likely success of tele- health unless it's run on a big scale. He's
:11:01. > :11:05.critical of way the bags have been treated. It's a disaster for the
:11:06. > :11:09.reputation of tele- medicine and it's a disaster for the CCG and the
:11:10. > :11:14.practice because they have to take over looking after these patients in
:11:15. > :11:19.some other way. There is no failure regime when these things go wrong,
:11:20. > :11:24.it was put in under the terms of being a trial. The trial has failed
:11:25. > :11:29.now someone needs to step up and take ownership and say, I am sorry
:11:30. > :11:33.it has gone wrong, but we will sort it out. I asked if there was any
:11:34. > :11:37.prospect of the CCGs being able to prospect of the CCGs being able to
:11:38. > :11:43.organise a telehealth system that organise a telehealth system that
:11:44. > :11:47.works in the future. There are 212 telehealth CCGs in England. There
:11:48. > :11:52.are far too many and they are far too small and they are occupied with
:11:53. > :11:59.being avalanche with demand. Wherever tele- medicine was on the
:12:00. > :12:03.list to do, it's hip to the bottom. It makes a life that I had vanished.
:12:04. > :12:14.A way of life. It should not be taken away. It would be taken away.
:12:15. > :12:17.I think that is wrong. While we were filming with Pat, he had an
:12:18. > :12:21.epileptic fit which left him lying on the floor. In spite of his
:12:22. > :12:26.long-term health problems, the Burkes want to stay in their own
:12:27. > :12:31.home. They thought telehealth would be the answer, but at the moment, no
:12:32. > :12:45.telehealth scheme is in place in Kent. Coming up: We bring you tips
:12:46. > :12:51.on how to navigate your way through a winter wonderland. It's finding a
:12:52. > :12:58.way using nature, the sun, the moon, the stars, even buildings.
:12:59. > :13:04.Everything is a clue. He may be 95 years old but one that trend pilot
:13:05. > :13:07.is on a final mission, to build a memorial to the airmen who are
:13:08. > :13:09.seriously burned in the Second World War and to ensure we never forget
:13:10. > :13:29.the members of the Guinea Pig Club. The 22nd of September was a very
:13:30. > :13:34.important day of my life. By the end of the day, my life had changed. I
:13:35. > :13:42.hit the ground violently and this was an inferno. I undid the straps,
:13:43. > :13:47.the buckle, climbed over the starboard side of the aircraft and
:13:48. > :13:55.fell to the ground and then I was unconscious again, woke up in
:13:56. > :14:00.hospital. It was... Just a horrible feeling, like terror. You feel as if
:14:01. > :14:13.you are going to die now. Where are you? I am up there. You
:14:14. > :14:19.can tell from my hat. A trainee glider pilot
:14:20. > :14:22.on a navigation exercise in Warwickshire when the plane's
:14:23. > :14:36.engine stalled and it crashed. I was covered with aviation fuel and
:14:37. > :14:39.I was on fire. I got horrid burns of my entire legs and my hands and my
:14:40. > :14:41.face. He suffered 40% burns and in 1947,
:14:42. > :14:59.was sent to a pioneering plastic I was referred to Archibald McIndoe.
:15:00. > :15:03.He said I needed a further 14 operations, which gave me the face I
:15:04. > :15:05.have now. McIndoe had been appointed
:15:06. > :15:08.by the RAF to treat The Battle of Britain led to rising
:15:09. > :15:13.numbers of young pilots By the end of the war, the majority
:15:14. > :15:23.were from Bomber Command. McIndoe's patients became
:15:24. > :15:26.known as his Guinea pigs because of the experimental plastic
:15:27. > :15:29.surgery they had. He encouraged them to form
:15:30. > :15:32.the so-called Guinea Pig By the end of the war,
:15:33. > :15:50.it had 649 members. 75 years after the GPC was formed,
:15:51. > :15:55.Sandy feels it's time the severely burned airmen should be given
:15:56. > :15:58.a permanent tribute. With his wife Maggie,
:15:59. > :16:01.they've come to see it taking shape at Graeme Mitcheson's
:16:02. > :16:17.workshop in Leicestershire. You've got the drama. Yeah, quite
:16:18. > :16:23.sharp flames here, thinning out to smoke at the top. It's catching that
:16:24. > :16:35.drama of how the injuries were obtained. I commissioned this
:16:36. > :16:43.memorial because if I hadn't done so, nobody else would. At East
:16:44. > :16:50.Grinstead, Sir Archibald McIndoe needs 37 members of the day big
:16:51. > :16:52.clubs. His hands have given new hands and faces to burned their men.
:16:53. > :16:56.the Queen Victoria Hospital in East Grinstead.
:16:57. > :17:03.It's still a leading centre for the treatment of burns injuries.
:17:04. > :17:15.Welcome, gentlemen. Like Sandy, Roger Chaplin has also been treated
:17:16. > :17:20.at East Grinstead. After crashing his private plane, he has had 70
:17:21. > :17:26.operation so far. The guinea pig story gives him hope. It is quite an
:17:27. > :17:33.inspiration. When you have a serious burn, you deal with the aftermath.
:17:34. > :17:36.It is easy to get into a very low situation psychologically. To see
:17:37. > :17:42.that they can come through that particular low and come out on the
:17:43. > :17:51.other side and go out to have a decent and fulfilling life, it is
:17:52. > :17:56.very uplifting. Sandy's mission to have a memorial is nearing
:17:57. > :18:00.completion. He has managed to raise ?20,000 to pay for it. The edge
:18:01. > :18:08.traces the profile of Archibald McIndoe's face. He is his face. His
:18:09. > :18:09.hands touched me and now I am touching him. It doesn't half bring
:18:10. > :18:20.back memories. The day of the back memories. The day of the
:18:21. > :18:25.unveiling at the National Memorial Arboretum in Staffordshire. The Duke
:18:26. > :18:30.of Edinburgh became president of the Guinea Pig Club after McIndoe's
:18:31. > :18:38.death. He is here to pay his respects alongside some of the loss
:18:39. > :18:45.of bribing members of the club. It's very appropriate, I think. The
:18:46. > :18:52.bottom bit and aircraft going down in flames. I am only a lightly
:18:53. > :18:59.toasted one. It's overwhelming. Absolutely overwhelming. I think
:19:00. > :19:04.he'd be slightly up at the extent to which 75 years after it was founded
:19:05. > :19:10.and 56 years after his death that something of this nature can attract
:19:11. > :19:16.such interest from around the world and nationally for something that
:19:17. > :19:24.started in a little cottage hospital in Sussex all those years ago. I'm
:19:25. > :19:32.very grateful to be able to live to see it on failed. I am glad I took
:19:33. > :19:38.the initiative. Archibald McIndoe inspired Sandy to train as a doctor
:19:39. > :19:43.after the war. He practised as a GP for 40 years. Now in his 90s, Sandy
:19:44. > :19:55.has terminal cancer, but he has one more chance to fly in a Tiger Moth.
:19:56. > :20:11.It just brings it all back. Yes. I wish I were young again.
:20:12. > :20:19.Sandy has tracked the Himalayas, sailed the Atlantic and skied until
:20:20. > :20:25.he was 82. He has led the full and active life that Archibald McIndoe
:20:26. > :20:30.wanted his guinea pigs to lead. Now his final mission is complete. There
:20:31. > :20:43.is a place where the injured their men will always be remembered.
:20:44. > :20:50.It can't have escaped your notice that we are in the depths of winter,
:20:51. > :20:52.but it's a good time to enjoy the great outdoors. As long as you know
:20:53. > :20:56.how to find your way about. From its headlands to its beaches
:20:57. > :20:59.and waterways, the South East of England is surely one of most
:21:00. > :21:04.beautiful corners of the country. Perfect for a walk in
:21:05. > :21:09.the crisp fresh air. But this is the time of year
:21:10. > :21:12.where you probably want nothing more than to snuggle up indoors and see
:21:13. > :21:16.out the cold weather and the long dark nights with a warm
:21:17. > :21:19.drink and a good boxset. After all, in the dead of winter
:21:20. > :21:23.you might think, quite reasonably, that there's nothing
:21:24. > :21:27.of interest to see. The Natural Navigator,
:21:28. > :21:36.AKA Tristan Gooley, is going to show me -
:21:37. > :21:39.and my dog Boris - how to find our way around
:21:40. > :21:42.the South East at this time of year, and why it's not so much bleak
:21:43. > :22:01.mid-winter, it's more You are the natural navigator. Tell
:22:02. > :22:07.me what that means. It's finding a week using nature. Using the sun,
:22:08. > :22:12.moon, stars. We are going to go on a small adventure but first we need to
:22:13. > :22:13.check the weather and see if there are clues to tell us what the
:22:14. > :22:16.weather is going to be like today. Tristan has got me gazing up
:22:17. > :22:22.to the skies to try to forecast the weather
:22:23. > :22:33.by just using the clouds. It's a day of blue skies but not
:22:34. > :22:44.perfect blue skies. Can you see these wispy, very high clouds? There
:22:45. > :22:47.is a vertical ones, striped? Yes, they are tailing away and that can
:22:48. > :23:01.be a sign that the weather is going to change. It is not a caste guy
:23:02. > :23:05.cast-iron guarantee. -- cast-iron guarantee. It's a sign that says
:23:06. > :23:13.don't assume is good weather will last forever. Let's make the most of
:23:14. > :23:17.it. The one thing I lead in the guide is if you are lost in the
:23:18. > :23:22.woods, look for the moss growing on the side of the tree and that will
:23:23. > :23:27.take you which way is North. That is what everybody thinks, but Moss is
:23:28. > :23:32.one of the most unreliable indicators. All it tells us is that
:23:33. > :23:37.there is moisture. There is something here which makes a
:23:38. > :23:43.fantastic compass. This gold colour here. It's a beautiful light can,
:23:44. > :23:48.one of my favourites and it loves light. When it gets lots of
:23:49. > :23:54.sunlight, it turns gold and we get most of our light from the South so
:23:55. > :24:02.the more cold it gets, that tells us which way self is. -- old. One of
:24:03. > :24:08.these birches, it's a good sign if you think you are lost because they
:24:09. > :24:12.tend to grow at the outer edges of a woodland. It did not take me long to
:24:13. > :24:20.notice some of the other clues for myself. Look, that is a colour
:24:21. > :24:25.compass. Yes! Can you see just here we have got what looks like hair
:24:26. > :24:31.lichen again and it loves fresh air lichen again and it loves fresh air
:24:32. > :24:37.so it is telling us we are in our own little patch of wilderness.
:24:38. > :24:41.Telling us the countryside is clean. It's fascinating getting to decipher
:24:42. > :24:46.some of the secrets the natural world has to offer. Can you see the
:24:47. > :24:53.lines in the sky there. Are they from planes? Yes, we didn't see any
:24:54. > :24:58.of that earlier and suddenly we are seeing these lines spreading out and
:24:59. > :25:03.staying out in the sky. It's not a good sign. It means the air is
:25:04. > :25:08.getting moister which means they weather is probably turning. It's
:25:09. > :25:13.the end of day one of our mini adventure and Boris and I have
:25:14. > :25:18.enjoyed a woodland walk. Let's hope the weather holds for the next leg.
:25:19. > :25:23.The following day the winter sun had been replaced by wind and rain.
:25:24. > :25:28.Boris decided to take a rain check and stay in his basket by the fire
:25:29. > :25:31.at home while Tristan and I hit Camber Sands. It's pretty cold and
:25:32. > :25:35.windy today. At least we have the windy today. At least we have the
:25:36. > :25:44.beach to ourselves. Yes, in amongst these doings, can you see how they
:25:45. > :25:46.have been swept over by the wind and our prevailing wind comes from the
:25:47. > :25:50.south-west so the south-west must be south-west so the south-west must be
:25:51. > :25:56.out there somewhere. Let's see what the water is like. We have some
:25:57. > :26:00.ripples here but they have flat tops and that's a sign the water has
:26:01. > :26:05.flowed quickly one way and then quickly back the other way. But
:26:06. > :26:09.actually the wonderful thing is this is a work of art and nobody will
:26:10. > :26:16.ever see anything exactly the same as this ever again. It is lovely.
:26:17. > :26:22.Shall we get an ice cream? We left the seaside and travelled to ride
:26:23. > :26:27.but can you try your hand at natural navigation in a town? And if you
:26:28. > :26:33.thought Tristan's use of lichen is a makeshift compass was inventive, you
:26:34. > :26:39.nice compass up here I would like to nice compass up here I would like to
:26:40. > :26:48.show you. This is it, your giant compass. Churches can be brilliant
:26:49. > :26:53.compasses. The alignment, churches are online from west to east with
:26:54. > :26:58.the altar at the eastern end. The auto traditionally would be in the
:26:59. > :27:02.direction of the holy land. Tradition means the church would be
:27:03. > :27:08.a line towards sunrise on the feast Day of the Saint that the churches
:27:09. > :27:12.Church and I believe the day in Church and I believe the day in
:27:13. > :27:18.question is August 15 and the sun rises north of East in August, so we
:27:19. > :27:23.north of East. The graves face a north of East. The graves face a
:27:24. > :27:28.certain direction because of the beliefs of those who are buried in
:27:29. > :27:32.them. Gravestones will be at the Western end and the feet of the
:27:33. > :27:38.person buried will be at the eastern end. On the day of judgment when the
:27:39. > :27:42.dead shall rise, they should be facing the holy land. If you are
:27:43. > :27:48.ever struggling to find your way in the centre of a town, find a church.
:27:49. > :27:58.They will give you a good sense of direction. If you can pull yourself
:27:59. > :28:02.away from your scented candles and socks, there is much to see at this
:28:03. > :28:04.time of year. Let's not forget about using the church as a giant compass.
:28:05. > :28:17.Surely this proves that we really do live in a winter wonderland.
:28:18. > :28:25.For more information about the programme, you can go to our pages
:28:26. > :28:31.on the BBC News website. You can watch the programme again on BBC
:28:32. > :28:36.iPlayer. Next week: The fisher men who are abusing drugs in the English
:28:37. > :28:42.Channel. That's what we have to live with, you have gone from being a
:28:43. > :28:47.good fisherman, strong, great man to a druggie. An organ donors who have
:28:48. > :28:51.their final wishes overruled. If someone has taken the time and
:28:52. > :28:55.effort to express their wishes by carrying a donor card, no one should
:28:56. > :29:02.have the right to overwrite that wish. That's all from us tonight.
:29:03. > :29:05.Hello, I'm Riz Lateef with your 90-second update.
:29:06. > :29:08.Overcrowded - the number of patients on wards in England have been
:29:09. > :29:12.at unsafe levels in nine out of ten hospitals this winter.