DH telecare demonstrator trials to start work

Small scale trials for the Department of Health’s Whole System Long Term Conditions Demonstrator Programme are to begin in the New Year, ahead of the full implementation in the spring.

The two year programme will officially start in April 2008 but the three selected areas, Newham, Cornwall and Kent, will begin testing the concepts involved early next year.

The current plan is for more than 7000 telecare and telehealth devices to be installed in users’ homes, making the study the largest trial of telecare and telehealth ever undertaken in England.

All three sites will recruit approximately 1000 patients for telehealth and 1500 patients for telecare, although the sites are still awaiting final confirmation of the numbers for the evaluation to ensure there are sufficient numbers for the evaluation to be robust.

Andrew Forrest, programme director for the Whole System LTC demonstrator in Cornwall, told EHI Primary Care that it was important that the numbers were statistically significant to test the national business case for telecare and telehealth.

In Cornwall the project team also aims to recruit a further 7500 patients for ‘light touch’ telehealth. Trained telephonists will make regular scripted calls to patients identified as low risk on the community matrons’ caseload to support self management.

Call scripts will include robust exception protocols and community matrons will supervise telephonists. ‘Light touch’ is not part of the national study and will be evaluated locally.

Forrest said the pilot for the programme would begin at the end of January 2008 in one GP practice in order to try out the equipment and iron out any problems before the start of the trial in April.

Cornwall is hoping to recruit as many practices as possible to take part in the trial and Forrest said response fell into three groups at the moment.

He added: “There is a small group of practices who are ringing us up and want to take part, there is the majority which are those who want to find out more and are thinking about it and then a small group who don’t want to take part because of workload or other commitments.”

The evaluation consortia will look at impact on emergency admission rates, patient/carer experience and quality of life and the impact on primary care. Targeted patients will be adults with severe chronic obstructive pulmonary disease, diabetes, heart failure or co-morbidity, and adults with social care or health and social care needs at risk of hospital admission.

The telehealth part of the programme will provide patients with simple biometric equipment which will prompt them to take readings for vital signs such as blood pressure, pulse oximetry and blood glucose levels and transmit the results automatically to a central computer. In Cornwall the patient’s community matron or specialist nurse will remotely monitor the results to detect deterioration and avoid acute episodes. The information will also be shared with out-of-hours services.

The telecare programme will provide patients with a range of active and passive sensors and devices to monitor such activities as bed occupancy, falls and medication reminders.

Fiona Barr