An influential audience of financial directors, commissioners, NHS directors and GPs gathered at The King’s Fund on 8th February 2012 to hear senior figures call for more integrated care pathways and integrated financial and managerial incentives to boost healthcare productivity made possible by today’s integrated healthcare technologies.
Erik Sande, Senior Director of Home Healthcare for Philips described how Philips is poised to bring innovative solutions to over-stretched hospitals. “The technology is out there now and we should employ it quickly,” urged Sande. “We need a more coordinated collaborative approach patient care across the healthcare sector – including the involvement of volunteer and private organizations such as Philips to make it work because nobody can do it on their own.”
This supports the UK government’s recent call for greater collaboration with telehealth companies to bring home healthcare to 3 million people in the UK by 2017. One of the boldest endorsements by any western government to shift healthcare from the hospital to the home, this follows the Department of Health’s Whole System Demonstrator trial (WSD), the largest global clinical study of home healthcare technologies to date involving over 6000 patients.
Sande commented that solutions1 are already available to target the right groups of people and that a proper home health care system with Telehealth could alleviate the current financial burden facing the healthcare sector. This has been clearly demonstrated by the early headline findings of the trial, which showed a 15% reduction in A & E visits and a 20% reduction in emergency admissions, whilst maintaining the quality of patient care.
Sande’s call for a new era of integrated patient care was echoed by speaker Dr Linda Patterson, Clinical Vice President of the Royal College of Physicians. “We really need a whole system approach, with proper pathways,” she explained. Citing her work with older people as evidence, Dr Patterson suggested that developing integrated, whole system solutions and services specifically for older people could produce better quality and in return reduce demand overall.
Having the ‘hospital at home’ could be clinically effective, according to Dr Patterson, with patients themselves also preferring services closer to home. “If you get it right for older people you will get it right for others,” she added.
This inherent problem of failing to manage demand and supply, according to Sue Jacques, Deputy Chief Executive, Chief Operating Officer and Director of Finance at Co. Durham and Darlington NHS Foundation Trust, is partly due to the fact that the individual ‘customer’ has no financial responsibility. The government’s move towards a more whole system, integrated approach to incentives would be a key system driver, she claimed.
“With modern technology” she said, “people Google illness symptoms and find things that may be wrong with them. They are better informed but more likely to seek intervention which puts more pressure on the system. We are grappling and struggling with finances from the inside and need help from GPs and others to address the problem.”
Erik Sande went on to inform delegates that the provision of medical technology which could aid such integration was the fastest growing segment of home healthcare.
“We know we are an ageing society with increases in heart disease and disability,” he said. “Around 21 per cent of healthcare spending is on just one per cent of the population. Research shows that a quarter of health care cases in the UK involve people approaching the end of their lives,” said Sande. “There needs to be home monitoring and observation of the elderly, with phone calls checking whether they have taken their medication or if they have picked it up.” As well as reducing urgent admissions, he claimed, “it could also increase compliance. “If they can be at home, having a cup of tea or be in the garden, there is going to be less stress all round,” he explained.
The workshop concluded with a question and answer session, in which both speakers and the audience supported the idea of aligning technology and secondary care with appropriate need. When asked about reforms in the health service Dr Patterson summed by saying, “something has to be done because the old model is just not working. Hospitals need to be designed for the changing world.
Notes to Editors