Telehealth Solutions and Wiltshire Medical Services: Moonray makes the marriage (UK)

The Surrey-based investment company Moonray Healthcare which bought Telehealth Solutions Limited (THSL) in early 2011 [TA item] has now acquired Wiltshire Medical Services (WMS) with the intention of bringing the two together. Press release: WMS and THSL come together to create new breed of telehealthcare provider.

Telehealth Solutions was founded in 2006 and, after a couple of years finding its feet, has since been making strong progress in the UK telehealth market. It is one of the few companies (other than Tunstall) that has benefited from the Government Procurement Service’s Framework Agreement. Wiltshire Medical Services’ core business has been to provide out-of-hours services to GPs but a while ago it extended its call centre operations into telecare monitoring. Moonray, which says it is into investment in this field to add long term value looks like it has made a smart move in arranging their marriage. Although the press release says “As part of the deal WMS will acquire Telehealth Solutions…” it is not yet clear which company will take the other’s name or whether a new brand will emerge, but a name containing something as local as ‘Wiltshire’ does not sound like a good bet.

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  1. Steve Hards, Editor

    It’s interesting that the press release headline refers to ‘telehealthcare’, whereas, as far as I can recall, this has never been used by THSL and is not referenced anywhere else on its website.

    Perhaps it betrays a preoccupation about Tunstall (which has commandeered that term in the UK) being its biggest competitor. However, they should take care. Its use could have the effect of validating Tunstall’s claim that it is the largest telehealthcare provider.

  2. Jo

    I’d prefer to think that use of telehealthcare is the next step towards returning to using telecare to mean all remote monitoring in the home irrespective of whether the focus is on safety or on physiological parameters, and whether it results in a local alarm or a remote analysis of trend. The term telehealth seems to have been created by companies trying to sell remote vital signs collection data at inflated prices (compared with telecare). Since the WSD
    reports have shown that silly prices were a factor which significantly reduced the cost-effectiveness of services, devices have suddenly become a lot more affordable. The potential of continuous monitoring of activities as well as heart and breathing functions inside and outside the house using smart phones and cloud computing is also destroying the business case of those companies that still promote a narrow telehealth agenda. Maybe we will end up with telecare in the home and mCare elsewhere – and this will be recognised before 3ML approves specifications for the pathfinder projects.
    I look forward to the day when it’s all care and nobody worries where it’s delivered and how much technology and communications are involved.


    What the company is called is not a problem. What the company will do might be though.

    Moonray is an investment company. THSL and WMS provide a monitoring centre and kit. I will be interested to see the much needed, mythical and magical pathway redesign offering that comes out of the merger of these acquisitions. A bigger picture organisation is what is needed from Moonray; as well as the sector expertise.

  4. Steve Hards, Editor

    I beg to differ. The company’s branding problem can have a knock-on effect if they cannot get it right. Simply, their success may be less than it could be, weakening whatever potential they have for delivering a bigger picture which, in turn, would not be good for the market or people who could benefit.


    Wiltshire Farm Foods would disagree; maybe even Tunstall (East Yorks) or TyneTec might disagree.
    The marketing magic can work on any name.

  6. The combining of Telehealth Solutions and Wiltshire Medical Services will enable us to give patients integrated care; telehealth and telecare from a single supplier and triage centre.

    Telehealth is about proactively working with a patient to give them the confidence to remain stable at home for as long as possible. The information a patient provides, allows specialist telehealth nurses to work with the patient to decide on the best course of action for them. This supports and educates the patient, enabling them to take an active part in their health, a win; and enables the NHS to save money from reducing the number of unplanned visits made to GP practices and Hospitals, another win. Unlike the WSD, which does not show the scaled up costs and savings of telehealth due to a number of factors, including the equipment now being less costly than four years ago, the failure to concentrate on telehealth as a service with defined outcomes and the patients not being selected on the grounds of already being significant users of health resources, a meaningful ongoing cost of the service was never calculated. Calculations from our experience show that Telehealth should cost £100 per patient per month for an end to end service including the clinical triage, and should enable savings of at least £150 per patient per month from reduced unplanned hospital admissions and GP visits.


    Great sales pitch there Rebecca – and thanks for clearing up what Telehealth is about – there are so many terms thrown about nowadays that it is hard to keep up.

    The meaningful costs and savings you have included – are they purely costs to the services or do they include costs to the individual such as taxi, bus and fuel costs as well as costs to the person that sits in for half a day waiting for a nurse to pop along to ‘do some obs’? Community nursing (Long Term Condition Teams) costs and benefits seem to not be included in your calculations.

    The above could dramatically impact on your experienced calculated costs and savings.

  8. Thanks! The costs are just relating to the use of service as opposed to those other expenditures you mention – do you know of any studies that use this information?

    I think it would be very interesting to look at it from the patients perspective! Thanks for the suggestions

  9. Cathy

    [quote]Telehealth is about proactively working with a patient to give them the confidence to remain stable at home for as long as possible.[/quote]
    [quote]I think it would be very interesting to look at it from the patients perspective! Thanks for the suggestions [/quote]
    So glad to hear you think it would be interesting to find out about it from the patients perspective Rebecca … not sure how you could achieve what you said in your first reply without doing so!

    @UNATTR then there would be the cost to be considered of the person staying at home and heating it while they do their telehealth readings instead of getting a warm at the clinic and then perhaps treating themselves to a coffee and bun on the way home … I get your drift but if we accounted for every possible cost and saving we wouldn’t be able to make ‘apples’ compare to the ‘oranges’ would we? :-*

  10. Sorry Cathy – I meant cost wise. We are currently conducting a study in Portsmouth with Imperial College London, which includes the patient experience and how their quality of life is affected.

    However it would also be interesting to see if telehealth is more cost-effective for them as well as the NHS!

  11. Mike Clark

    Some of the patient costs have been looked at in Scotland primarily for their telemedicine activities.

    Also in the United States, quite often patient travel costs have to be reimbursed through Medicare/Medicaid so remote monitoring and video consults are often an effective alternative.

    There are some standard costings available for Healthcare visits etc in England that were used in the yet to be published WSD paper from LSE.


  12. Cathy

    Rebecca – if a patient is worried about finances it is going to have a negative impact on the efficacy of the intervention and reduce the impact on their quality of life.

    Say a person with COPD cannot afford to adequately heat their home? They would prefer to go to a clinic perhaps where they are warmer and their health is better.

    If they are sitting at home miserable, cold and worrying about the heating they will soon be having an exacerbation of their condition and heading for hospital.

    So if you do not consider the cost from the patient perspective how the heck are you ever going to proactively work with them to give them the confidence to remain stable at home?

    We simply cannot separate out the cost wise consideration for the patient and the quality of life consideration any more than we can separate out telehealth from the other care and supports that they need.

  13. Kevin Doughty

    Lots of good discussion points – and all suggesting that a package of tele-whatever should be offered only after a full assessment where the patient/service user profile has to be fully explored. It’s obvious that this isn’t being done well enough at the moment. Hopefully, the lessons that the UK has learned from the WSD and all the pilot projects is that it’s win win win when the prescribed solution matches the holistic needs of the end user. This does means offering real choices to people and from these choices we will see a range of benefits – so the evaluations will be necessarily more complex because there can be no standard packages because people are different. But personalised care packages will be both popular and cost-effective.

  14. UNATTR

    The clinic is warm and inviting when I go for my Botox and when my fillers are due. The clinic is warm when I go for IVF treatment down that there Harley Street. The clinic is very warm when my GP who doubles up as a surgeon of vasectomies fits me in for a fee. The clinic is never warm at the GPs. It is never warm in the heart failure clinic. They are also full of ill people that spread their germs (Clinic Acquired Infections).

    The bus to these clinics is cold. There is no bus stop anymore so there is just a post with a sign on so no protection from the wind and rain that we occassionally get. The pavements are full of broken slabs and litter so walking with my dodgy hip is actually an extreme sport. And don’t get me started on the Rottweiler/Pitbull cross that manages the reception at the clinic.

    Give me a machine that I interact with. That has personality, that has an interest in me – not just my condition. Give me a machine that alternates its questions and greetings based on my previous observations and interview responses. give me a machine that looks nice and is not to big, that fits in my magazine rack or sits on my pouffe. Give me a machine that when people ask what it is I tell them it is my electronic friend/advocate/nurse/carer/big video phone. Give me a machine that loves the whole me, not just the ill me.

    Then the benefits come flooding.

  15. Cathy – just the other week one of our Specialist Nurses (Lawrence) was concerned about a patient’s decline in health. He called them up and discovered that they had no heating as they couldn’t afford it. Lawrence followed up this up with the patients local social care service so that they could help him.

    The advantage of telehealth over visiting clinicians is that clear patterns can emerge, when you are recording vital signs on a daily basis, which can identify causes of exacerbations. This allows the patient to alter their behaviour to help stay healthier longer.

    Our patients frequently tell us how they are more confident with their condition since joining the system. It is as much as them learning more about their disease and being able to manage it themselves as feeling secure that a clinician is reviewing their data every day.

  16. Cathy

    UNATTR you do tell a good tale … [quote]The bus to these clinics is cold. There is no bus stop anymore so there is just a post with a sign on so no protection from the wind and rain that we occassionally get. The pavements are full of broken slabs and litter so walking with my dodgy hip is actually an extreme sport. Read more:
    … our buses are lovely and cosy, the drivers wait for folk with dodgy hips to sit down as well and even my tiny hamlet has working bus shelters!

    The cracked pavement I’ll give you that – but you forgot the ice to add the slip hazard and dog poo to add an antisocial touch.

    By the way if you can afford all that healthcare you can pay for your telehealth so you can choose your electronic friend … :P

    You only get wind and rain occasionally? – we are still getting rid of 60cm of snow in the real north and the buses kept running and Evelyn still went out with her shiny new rollator! Of course if we totally wrap someone in cotton wool so they sit at home with their electronic friend and don’t risk the bus and the pavement then we kinda missed the point of the exercise?

    @Rebecca – yes I understand all that – but you did not put it across that way in your sales spiel; which could come across so much better if you did. Your company is not selling an electronic friend as UNATTR calls it – your company is selling the outcomes of owning an electronic friend to people and what you have just described there are benefits they won’t have even considered. It matters not whether they are paying directly or it is being paid for by their care provider – what the patients – the end customer – want to know is “what will that do for me?” and yes they do need to know “will I be able to use it?; what happens to the personal information? etc”

  17. UNATTR

    Telephysio, Telecoaching, Telezumba all help in building those muscles and strengthening those joints for the half a year you can go out safely. Necessary journeys are always, well, necessary but if we can cut out unnecessary journeys we can assist in enabling people to take control and manage their lives more effectively.
    I would love to live in a hamlet but as it is I am surrounded by urban monoliths and areas of relatively high deprivation with strokes, heart attacks and smoking all very real facts of lives for high percentages of the population.

    My Botox and bum plumpers aside, I am living in a world we are terrible at looking after ourselves and always live on the bright side ‘oh it will never happen to me’ and ‘well I take my pills so I will be fine’. It is an attitude that needs to change first not the technology. We could have had 3D TVs years ago but the companies keep us waiting and still sell us the same old same old. Once our demands change the technology will follow. If we don’t demand we get what we deserve.

  18. Cathy

    UNATTR you say on another thread that you are not the brightest star in the sky – I beg to differ – you are certainly one of the brightest stars in the TA firmament and if laughter was a core NHS service you could be responsible for much wellbeing. 8)

    People do still get ill, have strokes or need hip replacements in our wee hamlet (couldn’t comment on the demand for botox) – the difference is we also still have a small enough community. So when the Council refuses to grit an unadopted road even though one of their council tenants lives on that road and is dependent on a mobility scooter [b]we demand[/b] and get a grit bin installed and neighbours help out with gritting the paths so she can still get about on suitable days. She never goes far but how liberating to be able to pop 100 yards to the post box and drop her mail in it. Of course we also benefit in a small community that the Postie would take it from her at the door, as he/she would any of us if we asked but then she would only have a blether with the postie and not with the several folk she encounters on her travels.

    The downside for our wee hamlet is that we are still very dependent on fixed landline telephony; the mobile signal is variable and we have decent but not fast broadband.

    You are so right about the consumer needing to demand progress especially in our technology supports.

  19. UNATTR

    Cheers Cathy, two more compliments like that and we will have to virtually get married (Telemarriage?).

    Demanding grit bins is so 1990s. Under road heating utilising the old copper from the telephone lines is the future.

    Demand fibre.