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

Dr Sarah Wollaston MP, Chairman, Health Select Committee

 
 

2020health Report Healthcare without Walls: Delivering telehealth at scale

An independent report designed to inform the future NHS strategy for telehealth.

Summary

Our earlier “Fixing NHS IT report” concluded, “While evident that telemedicine can offer a great potential, it does create challenges, especially in terms of its funding and impact on current reimbursement schemes…without a clear national direction, the risk is that a fragmented, point-to-point approach is adopted without taking advantage of common national infrastructure.” This led NHS IT team at 2020health, led by the author of “Fixing NHS IT” John Cruickshank, is keen to contribute to the debate and has published an independent, authoritative report on the future NHS strategy for telehealth, recommending both national and local actions. Several leading companies including Accenture, BT, Medtronic, TPP, Tunstall, iSOFT, Pfizer and Vodafone have collaberated with us on the study.

Background

Following on from 2020health’s widely acclaimed recent publication Fixing NHS IT – a plan of action for the new government, our major new research study on telehealth is now underway.

The White Paper, Equity and Excellence – Liberating the NHS charts out a course to transform the NHS with patients at the heart of the NHS. 2020health sees telehealth – the provision of care remotely, for example by extending the reach of clinicians into the domestic care setting through assistive and mobile technology – as a key enabler of the White Paper’s aspirations. We believe that it can lead to the delivery of services more focused around the patient, with a more efficient and effective use of scarce clinical resources, and much lower levels of admissions for patients with chronic conditions.

Our earlier Fixing NHS IT report concluded, “While evident that telemedicine can offer a great potential, it does create challenges, especially in terms of its funding and impact on current reimbursement schemes…without a clear national direction, the risk is that a fragmented, point-to-point approach is adopted without taking advantage of common national infrastructure.” The NHS IT team at 2020health, led by the author of Fixing NHS IT, John Cruickshank, are keen to contribute to the debate. 'Healthcare without walls' makes recommendations on the future NHS strategy for telehealth, recommending both national and local actions.

To date, most NHS telehealth initiatives are no more than one-off, small-scale projects – often just pilots - that are not well integrated into healthcare systems. The market is quite fragmented around specific point solutions. Large scale system integrators are now interested in the market to deliver end to end solutions at scale. Open, industry standards are emerging through the Continua Alliance. Other countries have developed a much more strategic approach to telehealth, leading to significantly greater levels of adoption. They have followed more radical approaches with telehealth being part of a full service redesign or used to support preventive healthcare and self-care. In England, the Department of Health has established and funded three large Whole System Demonstrators, with a national evaluation due to be published in 2011. A wider network of interested NHS bodies is forming to share experience and learn lessons, although commissioning authorities still lack clarity over the business case.

“The greatest challenge facing the NHS is not how to change its management, but how to make 4% compound efficiency savings over the next four years. I welcome this report because it describes a significant way in which some of those efficiency savings can be made and at the same time improving quality of care through much smarter use of telehealth technology. It's not an option that we can afford to ignore.”

Rt. Hon Stephen Dorrell MP, Chairman, Health Select Committee

Outcomes

The aim of this work is to set out an independent view on how best the NHS should exploit the potential of telemedicine, based on best practice in the UK and elsewhere, and what action the new government should take. In particular, it will address:

  • a review of key projects and evidence to identify those areas with most potential for early exploitation;
  • the potential savings at national and local levels, through embracing telehealth;
  • how the NHS can move telehealth on from ‘pilot-itis’ to an integral role in mainstream care provision;
  • investment, funding and reimbursement options and preferred recommendations
  • organisational change best practice, including patient adoption and stakeholder engagement
  • implications for national and local infrastructure (both public and NHS), and standards
  • integration with core patient record systems, at a national and local level
  • how the market could be developed and encouraged, for both point solution and service providers
  • legal and ethical considerations
  • an action plan for national and local implementation, including policy recommendations

 

Impact:

• Support and responses from Joanne Harding, Programme Lead, Long Term Conditions, NHS West Midlands, Dr Shahid Ali, GP and Clinical Lead Primary Care, NHS Yorkshire and the Humber, George MacGinnis, Director, PA Consulting and User Group Chair, Continua Health Alliance, Iain Hunter, General Manager, Scottish Centre for Telehealth and Christine Hancock, Director, C3 Collaborating for Health and Former RCN General Secretary.

“This report recognises the significant impact assistive technology such as telehealth can have on care. We are investing £31 million in the world's largest trial of telehealth and telecare, which has involved over 6,000 people. Promising results are already emerging. We will give careful consideration to the recommendations made and welcome the clear direction.”

Rt Hon Andrew Lansley MP, Secretary of State for Health

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Press Release NHS could save up to £1 billion by embracing high-tech monitoring of chronic sick, says new report

• Remote capture of health information from the home can save NHS millions and improve quality of life for people with long-term chronic conditions, says new report “Healthcare without walls – a framework for delivering telehealth at scale.”
• Urgent government action needed to put in place a national strategy.
read on NHS could save up to £1 billion by embracing high-tech monitoring of chronic sick, says new report

2020health Report Related Research

Related Research

The report, 'Fixing NHS IT' puts forward a detailed rescue plan for the £12 billion National Programme for Information Technology (NPfIT). Recommendations are made for how to save £1bn and get IT working better for patients. read on Related Research