‘Let me die at home’. The human and financial cost of ending telehealth (Cornwall UK)-update

See below for ITV coverage. Jill Diggett, a resident of Bodmin in Cornwall, is one of undoubtedly many local people losing their telehealth monitoring next week. A business decision was made to abandon telehealth monitoring provided by NHS Kernow, whose statement is extensively cited by this article in Cornwall Live. NHS Kernow, which is £54 million in the red, cites “the service did not have significantly robust clinical evidence for effectiveness and did not demonstrate the desired outcomes that we would expect to see.” The Cornwall Partnership NHS Foundation Trust, which provides the service, will hand it off in advance to the telehealth user’s GP, and will provide community services or getting a helper to manage their condition.  

From this article, Mrs. Diggett is 1) an exception to their findings and 2) the handoff appears to have been dropped. Mrs. Diggett has five serious chronic conditions. She is on oxygen. Last December, she was in hospital for three weeks. Post-discharge, she was given telecare and telehealth monitoring of her vital signs (weight, blood oxygen, blood pressure), performed by her husband and sent to a care coordinator (a ‘medical expert’ in the article). There’s medical intervention if things trend poorly. However, she has stayed out of hospital since and is presented here as medically stable, though not doing handsprings. In the article, Mrs. Diggett expresses despair and real fear that she will be taken from her home and wind up back in hospital where she assumes she will die, an understandably emotional reaction. Worse, her husband gives no indication that his wife’s care has been transitioned. 

Readers of Cornwall Live are also pointed to the closure of a Bodmin treatment centre in March. So the Diggetts will be traveling much farther to receive care if they were using it.

Mr. Diggett was told that the average cost of a hospital bed is £1,000 a night. For 21 nights, that is £21,000. Let’s assume that the fully allocated cost (devices and monitoring) of the telehealth service is £100/month. That is 210 months–17.5 years–of monitoring for the cost of one hospital stay. If it is £250/month, that is 84 months or 7 years.

What is not cost-calculable but has consequences? Mrs. Diggett’s state of mind and her husband’s quality of life. Her predicament is shared by patients and caregivers who had telehealth or telecare withdrawn after a pilot or the ending of an at-home program. There is a feeling of abandonment, that they don’t have this help or support, no one is listening, the safety net’s been taken away, and they are all alone again. Anyone who has worked for telehealth and telecare companies, such as this Editor, knows this is an unavoidable consequence of service withdrawal unless that person is much better or is transitioned properly, which almost never happens. Readers on both sides of the Atlantic will surely be able to supply their own examples where the books don’t balance. Hat tip to Susanne Woodman, our Eye on Tenders.

Update: ITV last night (11 July) reported on this here, interviewing the Diggetts. Bravo!

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