A report on the HSJ website headlined “Key telehealth group axed” appears to confirm what many have suspected: the ending of the 3millionlives programme. However reading down the article it transpires that actually all that is happening is a widening of the stakeholder grouping because of a perception that 3ML was too much about industry box-shifting and too little about improving patient outcomes, which should be welcomed greatly by many and should strengthen the programme. As a result, industry will probably sell more too, so everyone should win.
NHS England Director for Long Term Conditions (Domain 2), Dr Martin McShane, is quoted as saying that the new group, the Integrated Care for 3millionlives Stakeholder Forum, comprising clinical leaders, providers, the third sector and local government, as well as a “significant” industry presence would replace the original steering group. The revised 3ML will embrace a wider range of technologies; it will be delivered using “a matrix approach of clinical advocacy, service improvement and technology strategy, making it a true partnership within NHS England”.
Closing the article, HSJ are sadly unable to resist further putting the boot in about telehealth, referring both to the historic, and wholly-unrepresentative-of-telehealth cost effectiveness comparisons for the Whole System Demonstrator, which adds further weight to our campaign to say farewell to the WSD, as well as O2’s withdrawal from the telehealth market, which again need not reflect poorly on the technology. Thankfully the Guardian continues on a more optimistic note!
3millionlives was originally conceived as a 5 year programme to deliver what was a relatively modest target (although of course it never really was a target). So a programme of work was set out and embarked upon, including all the stakeholder consultation now being championed (apart maybe from not enough attention to the role of providers). Given the enormous distraction of the transition to NHS England (for 3millionlives and commissioners and everyone else) it was bound to suffer a stall. The production of the 3millionlives Way of commissioning, focussing specifically on the need for commissioning outcomes with technology being no more than an enabler was welcomed by most if not all stakeholders who saw it. So I don’t know where successors thought the programme was too much about ‘box-shifting’. But never mind. Good luck to Martin McShane – at least it’s in the right place now (Domain 2), which I advocated, and not loitering in ‘Innovation’. The only innovative thing about 3millionlives was the way in which it suggested a new model for introducing technology into healthcare – the 3millionives Way of commissioning.
In principle this has to be the right way to go. Assistive care for patients in their homes needs to be clinically led. Suppliers can advise, cajole, encourage, share experiences, but are not able to commission.
For the sake of all the parties, there need to be some clear targets and short term objectives, or this initiative will go down the same plughole as all the previous efforts. the past is full of good intentions but no ability to achieve what is a significant change in the pattern for providing long term care for the patients with long term conditions. The nettle needs to be grasped in a way that carries along all the interested parties. The care benefit to patients and the economic benefit to the providers is so great that it would be shameful not to be successful.
If DH can afford £500m to prop up the existing A&E problems with short term patching, with all the benefit totally gone at the end of two years, then surely they can afford the same amount for a long term solution.