Glocs GPs paid £70 a telehealth patient

A £5m telehealth project in Gloucestershire has deployed less than a quarter of its 2,000 devices in its first ten months.

In June last year, Tunstall Healthcare and NHS Gloucestershire launched a project to provide telehealth to 2,000 patients with chronic obstructive pulmonary disease, chronic heart failure, chronic heart disease and diabetes.

The stated aim was to roll out the telehealth devices over 12 months, starting in the summer.

However, NHS Gloucestershire has confirmed that only 454 patients are currently being supported this way.

A spokesperson for the trust told eHealth Insider a roll-out plan has been designed to bring the number of patients in the county being supported by Telehealth to 2,200.

“GP training has been largely completed and the programme established within practices,” a statement said.

“With growing buy-in from GPs, and steadily increasing referral rates, we are on course to achieve real quality improvement and to have at least covered our costs by March 2013.”

The PCT is giving GPs £70 for every referral made, which it describes as a “referral compensation” in recognition of the extra time required to set up each patient.

The service has also been extended to “patients with other conditions where the GP’s clinical opinion is that telehealth could enhance their quality of life and reduce avoidable hospital admissions,” a March press release said.

A trust spokesperson said the payment was designed to free up initial clinical time to focus on appropriate referrals, and was supported by both clinicians and local commissioners.

She added that Gloucestershire’s telehealth scheme is the “most successful and largest GP referring programme in the UK, with 88% of GP practices (74 out of 85 so far) actively referring patients.”

The apparent issues in getting patients on to the Gloucestershire scheme mirror reported problems at another large telehealth project.

NHS North Yorkshire and York introduced a pilot telehealth scheme in 2009 and extended it in early 2010 with a £3.2m contract for 2,000 devices.

However, the roll-out of the devices has been significantly delayed. Initial plans for the contract with Tunstall were to have 1,500 units in use by the end of the 2010-11 financial year. But in June 2011, only 350 of the 2,000 units had been deployed.

The North Yorkshire PCT was also paying GPs to make use of the devices, giving practices a one-off payment of £200 and additional £50 per installation.

In March, Linda Prosser, project lead for NHS Gloucestershire, said the service was receiving between five and ten referrals a day and the technology was helping reduce referrals to hospital.

However, these figures do not fit with the overall number of patients on telehealth in the region which would suggest a referral rate of less than two people a day.

The PCT also provided a number of supporting statements from local GPs in a press release about the project.

Dr Will Haynes, GP and long term conditions lead for NHS Gloucestershire, said: “Being able to monitor vulnerable patients means that we notice changes or deterioration earlier, which enables us to change the outcome of that particular deterioration.

“The impact of being able to do this is leading to a reduction in consultations and emergency call-outs.”

The telehealth units monitor patients’ vital signs such as weight, blood pressure and oxygen levels with results viewed and triaged on a daily basis by a monitoring team.

Last updated: 12 April 2012 16:35

Totally blips of the heart

Geepsi211 weeks ago

Early identification and treatment of deteriorations sounds a good way to improve care, reduce admissions etc.

But there is a problem, distinguishing day to day variations and 'blips' from a genuine early deterioration. For example a patient has a sudden drop in their oxygen level. Is this a worsening of their COPD or had they been exerting themselves just before the reading?

This then results in false alarms and even admissions and is one of the reasons that other schemes based on closer patient monitoring (e.g. community matrons) did not have the expected impact. It can also lead to a loss of confidence in schemes by clinicians.

I am a keen supporter of telehealth but we need to separate the reality from the hype.





Trend Management as opposed to reactive decision making

Mike@SOS210 weeks ago

'Totally blips of the heart' makes a common misconception that people who are not embedded in Telehealth could make when not in possession of all the facts.

Telehealth works on trend management - so your data over time (a week, a month etc) shows whether you are doing OK or whether you need intervention. One result means nothing - my dog could have sat on my weighing scales - it doesn't mean an Emergency Responder arrives due to my 10 stone weight loss since yesterday.

The other huge area that is missed is the fact there are also interviews on the system. So when a clinician or other is asssessing the vital signs data (blood pressure, pulse, oxygen levels, weight etc) they also have the answers to the interview questions that the patient has answered - thus giving them a broader view of the person. Questions such as 'do you have chest pain?', 'are you more short of greath than normal?', 'do you get short of breath after an activity or at rest?' help the assessment enormously.

Try before you buy; talk to others that are using systems. When I say others I mean nurses (both community and monitoring), patients and others working alongside them within Local Authority social care and housing services. There are a few pockets and projects that are doing tremendously well even without having to bung a GP a few quid to do it.

I believe GPs see this as a lot of extra work - but it isn't if you go down the managed service route.

I assess people and I spend most of my working day with real people that use these systems. High levels of satisfaction but low levels of quantifiable cost benefits which is why it is seen as not a good investment. Does the outlay work against the return - unfortunately the outlay is in one place but the return is across too many sectors and will only truly be shown in 30 years time.





 Newsletter sign-up

Digital Health News
Digital Health Digest