NHS – the National Home Service

Out-of-hospital initiatives are at the forefront of UK government plans to modernise the way the NHS delivers care.

THE NHS often gets a bad press for being slow to adopt new medical technologies or practices. But when it comes to out-of-hospital initiatives, the health service is no slouch.

Earlier this year, NHS England chief Simon Stevens announced that the government was working closely with innovators like Verily (formerly Google Life Sciences) and Philips Healthcare to deploy the latest technology in a bid to overhaul the way care is delivered. At the heart of the shift is the firm belief that modern methods of gathering information and remotely monitoring vital health signs can be paired to improve the management of chronic conditions. In short, the aim is to allow more patients to be managed in their own homes rather than hospital. The NHS Test Beds will try out a variety of new systems for improving health care delivery through technology. The ambitious programme requires extensive co-operation between government departments, NHS hospitals, clinical commissioning groups and community care providers. But if it works, it could change the face of NHS care for good.

So what exactly are these pilot projects, where are they taking place and how will they benefit patients?

North-east London
An ambitious project to promote healthy ageing across a million-strong population, this pilot scheme aims to help patients manage their own conditions and remain as independent as possible. For example, it will include an online tool for those with dementia, a social network app which offers peer-to-peer support safely online with guidance from credible organisations and institutions, and a device which assesses falls risk and mobility.

Greater Manchester
In the Greater Manchester areas of Heywood, Middleton and Rochdale, the latest technology will be deployed to try and predict which patients are most at risk of long-term conditions. Verily, along with drug firm MSD, local GPs and academics, will analyse trends in areas such as heart failure and lung diseases like Chronic Obstructive Pulmonary Disease, to identify patients most likely to benefit from tele-health, tele-care and tele-medicine technology. Doctors hope to use predictive techniques to pre-empt serious illness.

Lancashire and Cumbria
Here, Philips is involved with numerous agencies to try and find ways to support the frail elderly and people with long term conditions to remain out of hospital. The idea is to use new technological approaches to spot those likely to benefit from additional support and help them self-care at home through improved education and telehealth technologies.

This pilot targets serious chronic illnesses such as diabetes, mental health problems, respiratory disorders and high blood pressure, all of which can lead to unnecessary hospital admissions. A local ‘intelligence centre’ is being set up – with the help of tech giants like IBM and GE Finnamore – to identify and target those most at risk of relapse in a bid to keep them well, independent and out of hospital by securing the clinical support they need when they really need it.

Birmingham and Solihull
A mental health project here aims to team medical expertise with the strategic , marketing and digital skills of Accenture. The aim is to provide more proactive support for those with psychiatric issues through online back-up, regular risk assessments and crisis intervention plans. Predictive analytics will be used to try and identify those most likely those heading for a mental health episode, allowing mobile crisis team members to intervene in time to prevent admissions.

Announcing the plans earlier this year, Life Sciences Minister George Freeman MP said: ‘We are determined to ensure the NHS can remain a pioneer of new treatments and models of care, so that UK patients will be amongst the first in the world to benefit from these hugely exciting medical advances, made possible by the life sciences industry in partnership with the NHS. ‘Not only does it demonstrate the NHS’s attractiveness as a place to test and develop revolutionary new products, it is also another important step towards creating a truly twenty-first century NHS.’

Alongside these initiatives, there are also 15 Academic Health Service Networks across the UK. These are groups that aim to turn innovation into mainstream clinical practice – as quickly as possible. They are made up of NHS providers, commissioning groups, universities, research bodies and social care providers. These groups are charged with exploring ways to use technology to get the very best value out of the NHS budget – primarily by keeping patients out of hospital.

In Hounslow in London, for example, an extra £190m a year is being spent on out of hospital services, including integrated care and more access to general practice. GPs in the area are already starting to identify patients at highest risk of unscheduled admission to hospital. Practice nurses then co-develop a care plan with the patient and carer (where appropriate), ensuring that all the services the patient needs are working together to prevent them attending hospital when they don’t need to. A care navigator then works with the GP, the community matron and the social worker to support the highest risk patients. Diabetes is the number one target but the plan is to roll it out to respiratory illness too.
It all makes clinical sense. But does it make financial sense? Definitely.

It’s estimated that one in four people in hospital in the UK could be looked after in their own homes or the community. And some estimates suggest for every £1 spent in hospitals, alternative community care can be provided for 70p.

By Pat Hagan

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