17th March 2014 – A busy day out in Manchester Central
In early March the NHS Expo headed North to Manchester for a two day event that focused on the theme of the “House of Care”. This is a subject that underpins much of what we have been working on for several years now. One of the key features of our teleconsultation work is the use of technology to deliver an immediacy of response to a person when they have a concern about their health – by doing so, we feel we can decrease, not increase the flow of patients around the health system.
The NHS’ traditional view has been that unless there is a gatekeeper in place, work will continue to grow apace and eventually overwhelm the system’s ability to cope. Well – guess what – we have had gatekeepers (GPs and their colleagues in primary care), who do a great job and are working flat out – but work continues to hit our hospitals in ever increasing volume, particularly via Emergency Departments. There are many complex reasons for this, but we have long felt that one is that patients who have a problem want the answer to that problem right away – and do not respond well to being put into a “pathway”. This is often the agreed “optimal system response” but is usually not the optimal response from their perspective, leading to them voting with their feet and turning up unannounced in a local Emergency Department.
Our ability to use video links to those most likely to need care support on a regular basis (the frail elderly in residential care and those with long term conditions) means there is now a practical means of offering near immediate access to a clinical decision maker, 24 hours a day. Does this make a different? – It’s still early days, but our first and second year experience is suggesting that it has a substantial impact on the need for hospital admission (down by 35%), the need for Emergency Department attendance (down by 53%) and the total number of bed days needed for the cohort being supported in this way (down 59%). Patient and Carer feedback is excellent and we are scaling up rapidly – currently offering the service to 100 care homes and a population of over 3000 people. Given that a small proportion of the general population drives the majority of the unplanned work in hospital care, there does seem to be a real opportunity to make a material difference to patient flow and health service utilisation, providing these new service delivery tools are deployed at scale to those who are the high service users within a community.
What has this got to do with Manchester? Well, the House of Care is in our eyes rapidly becoming “Your House of Care” and we were delighted to not only have the chance to speak about our work in the seminars and to the BBC at the Expo – but also to say hello to so many people who visiting the Future Care Zone and had the chance to use our teleconsultation equipment to speak with Airedale’s 24 hour Hub from the exhibition floor. We had a great couple of days – hope you did too!
– Richard Pope, Consultant