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Technology Supported Health Service at Scale
About this good practice
Published on 18 June 2018
United Kingdom
Bedfordshire and Hertfordshire
This is the good practice's implementation level. It can be national, regional or local.
To respond to the challenge of increasing demand for health services (within static resources), NHS Liverpool Clinical Commissioning Group redesigned a community COPD service. Under-pining redesign is technology to improve education and information to enable patients to self-care and manage their condition with remote monitoring.
Partnering with NHS services, third sector organisations and industry, NHS Liverpool CCG has scaled this service to support over 10,000 patients. At any one time c1000 patients are supported by the service.
Utilising clinical patient telemetry to deliver ‘intelligence led healthcare’ has resulted in reductions in emergency admissions and secondary care costs of between 22% and 32%. And this model uses scarce clinical resources more efficiently 1 nurse supporting 200 patients (compared to 1 nurse supporting 35 patients in the existing service model)
NHS LCCG and a new supplier of the technology element of this service are planning to extend the range of conditions supported (to include e.g. patients with heart failure, asthma, cancer), to patients with a higher level of need (to speed hospital discharge) and to increase the number of citizens activated.
Key stakeholders include:
• Mersey Care NHS Trust (Clinical Hub provider)
• Primary care practitioners inc. general practitioners (GPs)
• Citizens/patients
• Technology providers (Docobo and Florence)
• Civil society partners inc. PSS
Partnering with NHS services, third sector organisations and industry, NHS Liverpool CCG has scaled this service to support over 10,000 patients. At any one time c1000 patients are supported by the service.
Utilising clinical patient telemetry to deliver ‘intelligence led healthcare’ has resulted in reductions in emergency admissions and secondary care costs of between 22% and 32%. And this model uses scarce clinical resources more efficiently 1 nurse supporting 200 patients (compared to 1 nurse supporting 35 patients in the existing service model)
NHS LCCG and a new supplier of the technology element of this service are planning to extend the range of conditions supported (to include e.g. patients with heart failure, asthma, cancer), to patients with a higher level of need (to speed hospital discharge) and to increase the number of citizens activated.
Key stakeholders include:
• Mersey Care NHS Trust (Clinical Hub provider)
• Primary care practitioners inc. general practitioners (GPs)
• Citizens/patients
• Technology providers (Docobo and Florence)
• Civil society partners inc. PSS
Expert opinion
In the European Union healthcare sector, one of the main challenges is to reduce wasteful spending, which occurs when patients receive unnecessary tests or treatments or when care could have been provided with fewer and less costly resources. The good practice offers a path to reduce wasteful spending using digital technologies. It offers patients with chronic obstructive pulmonary disease (COPD) to self-care and manage their condition with remote telemetry monitoring. The good practice has resulted in a reduction in emergency admissions and secondary care costs by up to 32%. The telemetry monitoring approach has allowed to increase the productivity of healthcare employees with 1 nurse supporting 200 patients instead of 1 nurse supporting 35 patients.
Some insights from the good practice:
-Digital technologies have the capacity to (1) reduce wasteful spending in the healthcare sector, and (2) improve the patient well-being and health outcomes.
-The good practice can serve to inspire other healthcare systems in the European Union in creating their telecare systems using telemetry monitoring and digital technologies.
Some insights from the good practice:
-Digital technologies have the capacity to (1) reduce wasteful spending in the healthcare sector, and (2) improve the patient well-being and health outcomes.
-The good practice can serve to inspire other healthcare systems in the European Union in creating their telecare systems using telemetry monitoring and digital technologies.
Resources needed
Oct 2012-Sept 2015 Redesign & Scaling Phase = £2.05m capital and revenue from NHS Liverpool CCG + Innovate UK. Project team consisted of Programme Director, 2 Senior Programme Managers, Administration Manager, 2 service designers + staff from 7 sub-contrators
Oct 2015 Operational Phase = £2m pa
Oct 2015 Operational Phase = £2m pa
Evidence of success
c10,000 patients have been supported to date and c1,000 patients are supported at any one time.
90% of patients feel more in control, have gained confidence &/or feel better able to cope with their condition
52% of patients report improved lifestyle & 79% improved health or better health management
Reduction in emergency admissions & secondary care costs in comparison with a control group ranging from 22-32%
Nursing/patient ratio reduced from 1:35 to 1:200
90% of patients feel more in control, have gained confidence &/or feel better able to cope with their condition
52% of patients report improved lifestyle & 79% improved health or better health management
Reduction in emergency admissions & secondary care costs in comparison with a control group ranging from 22-32%
Nursing/patient ratio reduced from 1:35 to 1:200
Potential for learning or transfer
One of the largest, mainstreamed technology supported services in Europe for a single health economy. This Good Practice has:
1. patient scaled self-care, enhanced current service offer and integrated technology rather than focusing solely upon scaling technology through service design.
2. secured clinical engagement across health partners and through governance and operational levels, creating innovative solutions to evidence gathering
3. engaged smartly with citizens through the things they like and need to do (as “health” is a really difficult sell)
The reader should note that:
a) this GP may be system specific and require tailoring for export/import
b) although positive impact (reported above) adds much needed service capacity it rarely results in savings. High service demand means that for every person moved in to the new service model, there are many more to take their place in the old service model.
1. patient scaled self-care, enhanced current service offer and integrated technology rather than focusing solely upon scaling technology through service design.
2. secured clinical engagement across health partners and through governance and operational levels, creating innovative solutions to evidence gathering
3. engaged smartly with citizens through the things they like and need to do (as “health” is a really difficult sell)
The reader should note that:
a) this GP may be system specific and require tailoring for export/import
b) although positive impact (reported above) adds much needed service capacity it rarely results in savings. High service demand means that for every person moved in to the new service model, there are many more to take their place in the old service model.
Further information
Website
Good practice owner
You can contact the good practice owner below for more detailed information.
Organisation
Liverpool City Region LEP
United Kingdom
Merseyside
Contact
Programme Manager