As the new government prepares its 10-year plan to radically reform the NHS, product director Jamie Innes discusses how remote monitoring technology can prevent illness, create capacity in hospitals and help patients access treatment earlier.
You have helped to design and develop some of the UK’s largest digital health services, tell us how Labour can build a health service that is fit for the future.
The government should do what a number of others have done across the globe and concentrate on how technology can support healthcare professionals to make their lives easier. It can help them avoid some of the manual activities they are currently undertaking. It can alleviate some of the stresses and strains they have on a day-to-day basis and increase staff retention at a time of historic recruitment challenges.
As a long-term theme, we help systems interoperate more appropriately with each other so organisations can share data without manual activity and present information to healthcare professionals when they need it. Technology can make the health service more robust for patients so they get access to care when they need it and do not end up waiting for 12 hours in accident and emer-gency departments. Digital pathways can make data more readily available to support informed decision making.
Based on your experience, how can the NHS shift its focus towards preventive care to reduce long-term pressure on the health service?
The NHS is generally very good at treating patients when they turn up for an appointment. It is not so good at unplanned care. We can understand the reasons why. When people can’t get a GP appointment, it has a knock-on effect in other parts of the health service, perhaps in a few years’ time. I would be looking at commissioning the NHS to focus much more on prevention by making interventions at a younger age that have knock-on impacts later down the line.
Can you tell us about the Connect Me initiative in Scotland and how it’s benefiting both patients and the NHS?
In Scotland, Connect Me, powered by Inhealthcare, has empowered patients to take control of their blood pressure, reducing the risk of heart attacks and strokes while easing the burden on the NHS. More than 100,000 people have used the pioneering remote monitoring initiative, saving an estimated 400,000 GP appointments.
This has been a hugely successful service, in part down to the collaboration between the Scottish government and the territorial health boards. They have taken a top-down, whole-system approach to manage patients with hypertension. They have standardised across Scotland so that everybody, regardless of where they live, has access to the same level of digital care, which I think is a fantastic model.
It as been so easy and accessible to all patients in Scotland – that’s why we have seen 100,000 patients go through it. I would advocate that England adopt this model, standardise the best practice, and roll it out at scale. We take the approach that no citizen should be disadvantaged and everybody has ubiquitous access to the same care. For it to succeed in England, it would require the integrated care systems to have that top-down system approach to managing hypertension in their particular region and ensuring alignment across primary, community and secondary care organisations.
How are virtual wards helping to manage hospital capacity and improve patient care before and after procedures?
We have been working with a number of organisations on virtual wards to support the earlier dis-charge of patients. One of these trusts has been focusing on freeing up bed capacity before patients have a surgical procedure. Rather than focusing on how they can discharge patients quicker after a procedure, they understand these patients are in hospital beforehand and taking up bed days. We are supporting those patients at home instead.
This not only saves beds but also means clinicians have early visibility of whether a patient is going to be suitable to have the procedure. If not, they can make adjustments to planning and ensure operating theatres are working at 100 per cent. When hospitals have the challenges of high occupancy rates and a big backlog of procedures, this type of approach addresses both issues and is a win-win situation.
How can remote monitoring and the ‘hospitals without walls’ approach support long-term condition management beyond virtual wards?
I’m a big believer in the ‘hospitals without walls’ approach to patient care. Virtual wards are a pillar of this approach. But patients only stay on virtual wards for 10-14 days. Some have their conditions for life and need to be treated appropriately. This is why the government is right to focus more re-sources on prevention.
Long-term remote monitoring can support patients after discharge from virtual wards. It helps the NHS to take a proactive approach to managing patients in the community and prevent them from falling ill and going back to hospital. We are advocating that some of our NHS partners extend their virtual ward provision into long-term condition management for patients to continue the care cycle and put in place the areas of prevention.
This comes back to what the NHS is really good at – managing patients when they are visible to them. What they need to do is extend this to patients when they are not entirely visible and are at home dealing with long-term conditions on a daily basis, and support them with prevention activities such as lifestyle guidance that will ultimately add to efficiency gains and interventions that will prevent them turning up at hospital.
Could you explain Inhealthcare’s work on developing end-to-end holistic pathways, including rheumatology care?
It’s a really exciting time for Inhealthcare. We’re developing end-to-end holistic pathways so we can treat patients throughout the continuity of their disease rather than focus on short-term intervention. You can start to see the different parts of the journey that patients come from and how they end up in the healthcare system and where maybe resources are stretched and where they are allocated. You can start to see the knock-on impact so you can make improvements in one area and these filter downstream into other areas of the health service.
It’s really interesting to map out those journeys and see the full system of care that patients receive across primary, community and acute care. We have been working with a hospital trust to develop a pathway for rheumatology patients which has gone live with 8,000 patients already. It should have an immediate impact on the efficiency of consultants and how they manage their patient caseloads, referrals and deteriorations.
Benefits include managing patients in a more proactive way. When they suffer flareups and need support on medication, they have immediate access to the consultants and consultants can see how they are managing their condition and medication. It gives them visibility of how the patient has been progressing with the disease. Ultimately they are looking at earlier access to treatment for patients.
The caseloads for rheumatology are quite large and can result in lengthy times when it comes to treatment. Having a digital tool gives clinicians earlier visibility of what’s working and what’s not. It also provides patients with early access to therapies to support them and has a massive impact on their livelihood and supports a debilitating condition.
Finally, how can the government and NHS better collaborate with digital health providers like Inhealthcare to improve patient care?
It would be great for our industry to be part of the process and work hand in glove with the NHS to identify where there are existing technology solutions and proven models that can be rolled out at scale and used by the NHS. We would like to share our learning from other areas and demonstrate how we can improve patient care and support healthcare professionals.
You can also listen to Jamie’s latest podcast here.