Service brings reduction in emergency hospital admissions and GP visits for patients
Southern Health NHS Foundation Trust has secured its full quota of Commissioning for Quality and Innovation (CQUIN) payments following the success of its 2011-12 telehealth pilot.
The funding will enable the continued delivery of telehealthcare services to patients living with long-term conditions in the South of England.
Southern Health serves a population of around 1.3 million people. Long-term conditions such as chronic obstructive pulmonary disease (COPD), congestive heart failure and diabetes accounted for 17% of emergency admission episodes in 2011-12, costing a total of £3.4m, with COPD noted as the most costly.
Adopting telehealth as part of our operational model has delivered real benefits, improving the quality of care and resulting in a significant reduction in emergency admissions and the use of unscheduled care
In recognition of this, along with national initiatives to alleviate associated pressures placed on NHS resources, Southern Health introduced its telehealth programme in partnership with Tunstall Healthcare to improve efficiency and maintain quality of service within the delivery of care for patients living with long-term conditions.
Central to the initiative, which focused on supporting patients living with COPD, heart failure and other long-term conditions, was Southern Health’s investment in 300 telehealth systems from Tunstall. In addition to this, Tunstall also provided clinical support to help identify the right cohort of patients, along with staff and patient training, and installation. The technology enables clinicians to remotely monitor patients’ vital signs including blood pressure, pulse rate, and blood oxygen levels on a daily basis which allows them to triage patients effectively, supporting early intervention and prioritisation of care.
Southern Health reported positive results from the first 144 individuals to use the service. Telehealth brought a significant reduction in the number of unplanned emergency hospital admissions, with a 66% reduction in non-ambulatory and 78% in ambulatory cases. Telehealth also reduced the number of GP visits, allowing them to take on more cases and removing unnecessary travel for patients, and the number of home visits made by local community nurses, enabling them to prioritise patients according to their level of care.
Patrick Carroll, lead allied health professional at Southern Health NHS Foundation Trust, said: “Adopting telehealth as part of our operational model has delivered real benefits, improving the quality of care and resulting in a significant reduction in emergency admissions and the use of unscheduled care. Patient engagement and satisfaction has been high.”
Many patients involved in the pilot said they felt more empowered in managing their condition, as telehealth provided them with reassurance and greater independence. Even after telehealth was removed, due to improvement in the stability of patients’ conditions through understanding and education, patients sustained a 60% reduction in the use of rapid response units and out-of-hours services. Patients became more confident knowing when an intervention was required, and as a result did not depend on contact with their GP.
The scheme is an excellent example of how telehealth can be hugely beneficial in helping the NHS to manage long-term conditions more cost-effectively
David Cockayne, managed services director for Tunstall, said: “Southern Health’s telehealth programme has delivered notable efficiency gains by reducing unplanned admissions to emergency and secondary care and supporting patients in the home environment. The scheme is an excellent example of how telehealth can be hugely beneficial in helping the NHS to manage long-term conditions more cost-effectively.”
Following the receipt of the full quota of CQUIN funding, Southern Health plans to continue and further expand its use of telehealth and is considering the benefits of rolling out wider adoption using a managed service approach. It is also exploring the possibility of working with the acute sector on an integrated strategy for supported and early discharge, using telehealth systems to facilitate more effective and stable transfers of patients back into their own homes.
In addition, the trust is examining the value of applying telehealth to mental health services, and the feasibility of using it to support people with learning disabilities and anxious patients who are regular users of health services.
The CQUIN payment framework enables commissioners to reward excellence, by linking a proportion of English healthcare providers' income to the achievement of local quality improvement goals.