Can the NHS be in crisis when they want to waste money like this?

January 16, 2015 | by

The Guardian had a headline yesterday: “GPs to be offered £1bn in new funds if they improve access and elderly care” Upon reading further it transpires that £250m pa is to be offered for the next four years. A clue to the rationale and preferred direction of the monies is:

“NHS England believes using the £1bn to transform existing GP surgeries and build some new premises will help reduce the pressure on hospitals buckling under the strain of unprecedented demand.”

Telehealth & Telecare Aware believes that this is totally the wrong approach. Given the huge increases in the popularity of remote consultation as we covered in our review of our 2014 predictions, surely the right focus for additional funding is to provide substantial incentives to get GPs using existing technology to consult with patients remotely? This should be allied with an advertising campaign to point out the benefits to patients of not having to visit a surgery or exchange germs with others in the waiting room plus offer reassurance that face to face appointments will always be available if the doctor thinks one is necessary.

One way to start might be for the NHS to do deals with organisations like GP Access to offer technology like their askmygp to all GP surgeries for free and give large financial incentives to GPs conducting remote consultations with more than an agreed percentage of the patients on their books by year end…then raise that percentage every year for the next four years. That has got to be far cheaper than building works that will anyway become redundant soon because attitudes are changing and people will be preferring remote consultation shortly anyway! It would be much quicker to implement too.

In mitigation, the article also mentions that surgeries, apparently also “will also be expected to make much better use of technology to monitor patients’ health as a way of reducing their need to seek direct care from a doctor.” However that sounds more like a tepid endorsement of telehealth than encouragement to be radical.

Hat tip to Mike Clark

When will we learn how to evaluate complex healthcare interventions?

August 12, 2014 | by | 1 Comment

This editor’s piece last week entitled “Is this the last time the flat earth society will be celebrating” was very widely read – thank you readers – and prompted both further thoughts and an especially thoughtful pointer from Mike Clark.

As readers of that post will be aware, the paper referred to in the post focused heavily on the high cost/QALY supposedly shown by the Whole System Demonstrator RCT. Mike drew my attention to a paper, published both here and here, by Trine Bergmo on the different ways in which the concept of a QALY is calculated for remote patient monitoring. The thrust of the paper is that different methods give significantly different results for interventions like telehealth. To this editor there was another equally important message though, that (more…)