The seven ‘pathfinder’ sites (Worcestershire, Merseyside, North Yorkshire, South Yorkshire, Cornwall, Kent, Camden) are named in an unbranded press release (PDF) on the 3millionlives (3ML) site. All have been ‘pathfinding’ – some with more success than others – for the past few years, so it makes sense to help them build on their experience by giving them an extra focus and a ‘target’ to get the 3ML ball rolling, of 100,000 new users. The target does not come with any new funding but there will be a new (framework agreement?) contract which they can commission through. The new Secretary of State for Health Jeremy Hunt has apparently picked up his predecessors’ interest in telehealth, mentioning it in the launch of the NHS Mandate (Independent item – read the comments) on Tuesday, 13th Nov 2012 . “With our industry partners, we will make England a world leader on telehealth. Getting another 100,000 people to benefit from this technology is a very important step and I congratulate all involved on their hard work. I hope it will be the first of many steps towards our overall goal of getting three million people to benefit in the years to come.” Other UK media takes on the announcement: 100,000 to get ‘doctor by broadband’ in 2013 (The Telegraph) GPs might remain unconvinced but telehealth is a no-brainer (‘Dick Vinegar, Patient from Hell’ in The Guardian). We note ‘telecare’ getting squeezed out of the coverage, as if 3ML is all about ‘telehealth’.
Of particular interest is the DH statement:
“…Leading technology companies will be supplying the NHS with the technologies and services at no upfront cost”.
Some people have been concerned about the cost of telehealth particularly after some references to a very high QALY from the WSD results back in March 2012 (paper not yet published).
Obviously, the WSD trial had set up and other costs which may not necessarily be the case in mainstream services.
Thinking around technology and services has moved on quickly since the 2008-2010 trial.
3 Million Lives has been looking at different business models to see if they could be used in telehealth and there are some references in the ‘Requirements Document’ on their website as to how this could all take shape in future.
This could mean that GPs and other clinicians in the pathfinders do not have to worry about inventory, data handling etc and can work with their patients and community on helping people who would most benefit from telehealth/telecare services.
With around £70bn of the NHS (England) budget (Total £104bn) spent on long term conditions annually, these new business models could help clinicians and patients in terms of better outcomes at lower costs.
I don’t think that telecare is being squeezed out as it is in the NHS Mandate, but I can understand the emphasis on scaling telehealth home monitoring at this time from its low base.