Service brings reduction in emergency hospital admissions and GP visits for patients; enables Trust to meet quality improvement targets and secure financial support for continued delivery of telehealthcare across the South of England.
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, delivered in partnership with Tunstall Healthcare. This funding will enable the continued delivery of telehealthcare for patients living with long-term conditions in the South of England.
Southern Health serves a population of around 1.3m people. Long-term conditions such as COPD, CHF 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.
In recognition of this, along with national initiatives to alleviate associated pressures placed on NHS resources, Southern Health introduced its telehealth programme to improve efficiency and maintain quality of service within the delivery of care for patients living with long-term conditions.
Central to the telehealth initiative, which focused on supporting patients living with COPD, HF or 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 Southern Health 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. 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, and Tunstall has lived up to its reputation as an established provider, supporting us throughout the project.
Many patients involved in the pilot 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 intervention was required, and as a result did not depend on contact with their GP.
David Cockayne, Managed Services Director for Tunstall added:
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.
The Trust is also 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 Commissioning for Quality and Innovation (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.