As part of this strategy, there is a commitment to increase and speed up the use of telehealth technologies – such as home-based equipment that can send the vital statistics of at-risk patients direct to clinicians. The delivery of this technology will be done in partnership with industry and will aim 'to improve the lives of three million people over the next five years'. This could help to position the UK at the forefront of global health care in this field.
At the same time, the Department of Health published its headline findings from the Whole System Demonstrator (WSD) programme – the largest trial of telehealth and telecare ever conducted, with almost 6,000 participants. We already knew these results would be positive, but the findings show that – if 'delivered properly' – telehealth could achieve an impressive 20 per cent reduction in emergency hospital admissions; a 14 per cent reduction in elective admissions; another 14 per cent reduction in bed days; and an 8 per cent reduction in tariff costs. Most strikingly, the evaluation demonstrated a 45 per cent reduction in mortality rates.
These impressive results will surpass the expectations of many in the private sector who have found the UK telehealth market (particularly in England) a tough nut to crack. Talking to the chief executive of a major telehealth service provider at a conference last week, we both agreed that the difficulties in mainstreaming telehealth services in England were probably insurmountable unless there was a directive 'from the top'. Moreover, while we felt that remote technologies would be used routinely in caring for people with chronic illnesses within three to five years, we could not predict when it would take off and whether the long-delayed results of the Whole System Demonstrator trial might act as a catalyst.
The government's plans to involve industry in its Three Million Lives campaign (a statement of intent rather than a target) indicates that they are serious about providing national leadership, strategic direction, and advice to NHS and social care organisations to help create a market and to deliver change. So it is tempting to conclude that the government has reached the watershed moment when the deployment of new technologies will increase exponentially.
However, it is clear in the Department's short report that the best results will happen only where telehealth is delivered properly, and that this requires a more integrated health and social care service. As I discussed last month, if we are to make telehealth a reality, we need a clearer understanding of the operational processes that are required at an organisational, clinical and service level to ensure that users and patients feel the benefits of these new technologies. For this to happen, the Department of Health and policy-makers will need to accept and prepare for the consequences of such a change. Significant investment is needed to improve skills and enable primary care providers to deliver and co-ordinate care in the home.
It is inevitable that this agenda will require some 'double-running' costs in the short term and the subsequent down-sizing of activity undertaken in acute hospitals in the medium term – neither of these are particularly palatable concepts politically or economically. The government's strategy is to use a large chunk of private sector capital to inject the necessary impetus into the system. However, the NHS market is volatile, bureaucratic and cash-strapped, making any significant investment risky. To encourage companies to invest in new technologies, we will need to reassure them that they will not lose their shirt in the process. Nevertheless, now that telehealth has a stronger evidence base and the support of the Department of Health, we have created the most receptive environment for it yet, which could fundamentally change the way service users and patients experience care.