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“2020health is an important and thoughtful contributor to the health debate”

Dr Sarah Wollaston MP, Chairman, Health Select Committee


Press Release Telehealth does produce savings

  • 15.02.2013
  • John Cruickshank & Jon Paxman

Results of telehealth hub pilot in Yorkshire show that telehealth can reduce hospital admissions, provide care at home and improve patient outcomes.

This evaluation by 2020health looks at the outcome of the Yorkshire and Humber telehealth Hub. Set up in 2010, this scheme aimed to demonstrate the benefits from delivering telehealth at scale to patients with chronic conditions. Outcomes from the patient point of view have, so far, been overwhelmingly positive, with decreased hospital admissions, care delivered at home and greater patient satisfaction ratings. However, in retrospect the time frame for the pilot scheme was overly ambitious, as important obstacles prevented the services reaching as many patients as the Hub had envisaged.

During this pilot scheme, services were provided from three sites: NHS Airedale Foundation Trust, South West Yorkshire Partnership Foundation Trust (SWYPFT) and Hull and East Yorkshire NHS Trust/ University of Hull. A different telehealth service was provided by each sight.

Airedale Foundation Trust piloted ‘telemedicine’ services, that is, delivering healthcare remotely through video conferencing technology. The Airedale ‘lessons learnt’ report notes that:“The telemedicine technology and new way of working has brought about a significant and real culture change in the way clinicians and physicians believe medical consultations can be delivered”.

SWYPFT aimed to encourage patients with chronic conditions to take greater control of their health and well-being. They have set up a ‘telecare call centre’, a telephone-based health coaching service delivered by nurse care navigators. They support patients through self-care and improve their condition management over the phone. The Hub project initiation documents states that “It is well documented that factors associated with health status are largely behavioural. Therefore helping people understand how lifestyle choices impact on health and well-being is critical in promoting positive health.”

The SWYPFT tele-coaching service is almost unique in the NHS, enabling the intelligent dispatch of services to help people to connect into the appropriate pathway of care. Results showed an increased number of people living independently, improved patient satisfaction, 20% fewer hospital admissions and a 30% reduction in LOS. This led to an overall 32% cost reduction.

The objective of the Hull element of the Telehealth Service was to scale up and provide the existing Hull-based clinical triage capability to other tele-monitoring projects around the east of the region.

They noted that for every 100 patients being tele-monitored, 10 all-cause admissions are averted each month. Up to £2 000 can be saved per averted admission this represents a Return on Investment (RoI) of 48%.

However, these pilot schemes did highlight obstacles which will need to be overcome. First, current uncertainties within the NHS mean that the future of funding is unknown for these sites. The new Department of Health (DH) Year of Care Tariff may help, but meanwhile this is slowing down their development.

Second, structural changes also meant that staff who were important supporters of the project were moved to different roles during the trial.

Third, there is need for a redefining of the GP/ patient relationship if telehealth is going to flourish. The Yorkshire and the Humber Telehealth Hub found that it was difficult to get GPs to sign up to telehealth as they expressed a feeling of apprehension towards the use of technology in health in general. GPs were also worried that they were being asked to take on more work. However, evidence suggests that telehealth in fact allows GPs to see more patients with a decreased workload.

These obstacles meant that the pilot scheme didn’t achieve as much as it had set out to do in the allocated time frame. Notably, not as many patients as they hoped signed up to participate in the scheme and it was therefore difficult to measure potential saving costs. Hull noted, however, that as the scale of their scheme increased from 2010 to 2012 RoI increased from 39% to 48%, which suggests that there is a strong chance that telehealth could make more savings if rolled out at a national level.

These obstacles are not however, impossible to overcome. More support, financial and spoken, from DH, professionals and organisations is crucial. Our evaluation suggests that professionals need to evaluate and pursue opportunities to benefit from these technologies and to support a shift to care closer to home, whilst DH need to rigorously assess why the uptake of telehealth has been so slow, even in cases without up-front capital costs such as the Hub.

Note to Editors
1. For interviews, comment or further information please contact John Cruickshank or Julia Manning on 020 3170 7702

2. is an independent, grass-roots, Think Tank passionate about creating a healthy society. We identify issues and bring informed people together to create these solutions. 

3. The full report will be released [25.01.2013]. The report was sponsored by an unrestricted educational grant from Yorkshire & the Humber SHA. The University of Hull completed a quantitative analysis of the Yorkshrie Telehealth Hub which is attached to this report. The views expressed in this evaluation are those of the authors.

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