IfG.CC -
Institute for eGovernment

How do you improve service efficiency and create quality care for residents? This was the challenge we faced when I joined Hillingdon council in 2010. Our target was to deliver efficiency savings of £8.5M in adult social care by 2012/13.

The government claims it can save £1.2 billion over five years through the wider use of telecare technology.

In a speech to a telecare conference this week health minister Paul Burstow said telecare can help people to live more independent lives and stay in control of their care. It also means, he said, patients no longer have to wait at home for the doctor or district nurse to call to check vital signs, and they spend less time in NHS waiting rooms.

Speaking at an Age UK conference, he set out his vision for improving the lives of people with long-term conditions through the roll-out of telehealth.

It will enable them to use electronic information and technology to manage their health independently and have more control over their own care.

Telehealth uses technology to help people with health problems live more independently at home. For example, blood pressure or blood glucose levels can be measured at home and electronically transmitted to a health professional, reducing the need for hospital visits.

The debate around remote care frequently stalls on the matter of expensive or complicated equipment, but often people have all the technology they need sitting in their pockets. While some healthcare providers use text alerts to remind patients about appointments or about submitting data, little use is made of responsive telehealth – the sending and receiving of linked information.

Developed by the NHS as a simple telehealth application, Florence (or Flo for short) allows clinicians to engage patients with their own healthcare. This achieves faster health outcomes, better adherence to medication or other treatments, and increased productivity compared with normal care. Harnessing this SMS technology has yielded much better engagement between clinician and patient, too.

The situation that Barbara's family found themselves in was not unusual. She was in her 80s and living alone with moderate dementia, her family were constantly concerned about her welfare. Barbara had a habit of leaving the house during the middle of the night, going for a walk and getting lost. Her family originally thought there may be no other option than residential care in a home before they tried telecare.

The NHS is facing a £30bn hole in its budget by 2020 and Clare Gerada, chair of the Council of the Royal College of GPs has said that we are currently short of 8,000 GPs, and by 2021 we shall need an additional 16,000.

It's obvious that the current way of delivering healthcare within the NHS is not sustainable.

The introduction of high speed broadband across the UK in recent years means that 80% of the adult population now has easy access to the internet either at home or at work. But so far, this has made surprisingly little difference to the way in which healthcare services are provided by clinicians and nursing staff.

Despite a lot of talk at healthcare conferences, the reality is that you need to look hard to find examples of where telemedicine – as internet-enabled healthcare is known as within the NHS – is starting to make a difference.

The deployment of remote medical devices to three million Britons is part of the government's Life Science Strategy, nicknamed 3Million Lives.

The deployment of high-tech medical equipment into people's homes could radically improve healthcare in the UK, said Jon Lindberg, healthcare programme manager at IT trade group Intellect.

Guy's and St Thomas' hospitals will become the first in Europe to use the system within the next 12 months when they install the Philips eICU Program to enable patients to be monitored by specialists using clinical software, high definition video cameras and two-way audio communication.

According to Philips the technology has cut death rates by 27% and reduced the length of hospital stays by 23% in the USA, where it is used in around 300 hospitals.

Telecare has long been tipped as the future of social care. Yet little has really been known about who uses it, or who could in future. This gap in evidence is important: for all telecare's apparent potential, policymakers will struggle to realise the benefits across the care system without knowing more about who uses it.

Paul Burstow, minister of state for care services, used a keynote speech at the second international congress on telehealth and telecare yesterday to lambast the "confused, disjointed, fragmented mess" of today's health and social care system.

"Up until now, each part has organised itself around its own needs. Hospitals around what a hospital needs. GP practices around what GPs need. Social care providers around what they need," he told the conference at the King's Fund in London.

The Whole System Demonstrators showed that, "if used correctly", telehealth reduced death rates by 45%, NHS resource usage by 15-20% and tariff costs by 8%. With these striking results and the launch of the industry/NHS funded 3 Million Lives campaign, telehealth is steaming out of its backwater into the clinical mainstream.

With the help of this new technology, people will be able to keep a check on their health, at their own homes, and this would definitely make life simpler for them. They wouldn’t have to wait to go to the hospital each time for minor checkups.

Dr Susan Copstick, Clinical Lead for Neuropsychology, from NHS Greater Glasgow and Clyde’s Institute of Neuroscience, delivered the first tele-neuropsychology clinic to Stornoway last month, supported by the Scottish Centre for Telehealth.

Dr Copstick commented: “We are delighted to develop services which support improved access to services for patients and that will contribute to improve clinical outcomes.

Speaking at the NHS Confederation annual conference, Lansley said innovation had always been "at the heart of the NHS".

The controversial 111 non emergency service, which is set to replace NHS Direct, wasn't about a system that could identify a caller's location and link them to the right call handler, said Lansley.

Timeline

Last November, health secretary Jeremy Hunt pledged to meet the 100k patient target through contracts with telhealth providers as part of the 3millionlives initiative– which aims to have three million people managed with telehealth by 2017. By March, doubts over the cost effectiveness of telehealth services began to emerge after a DH-funded trail of the technology concluded that telehealth may not be a cost effective use of the NHS funds at current prices.

To provide patients and clinicians with more convenience, and reduce the need for in-person visits, the NHS has commissioned the deployment of a secure, made-for-purpose video conferencing solution that connects clinicians to patients at home in scheduled online appointments.

The survey of 200 patients currently using telehealth in North Yorkshire and York showed that 96 per cent of them would recommend the technology to others, with 98 per cent being either satisfied or highly satisfied with how it was helping them manage their long term health condition.

Kerry Wheeler, assistant director of strategy at NHS North Yorkshire and York, said: “The results of the survey speak for themselves and are further evidence of the huge positive impact telehealth is having on local patients’ lives.”