The ongoing cost of the NYY telehealth project exposed (UK)

At the end of this month NHS North Yorkshire and York (NYY) – a Primary Care Trust (PCT) – and the Yorkshire and the Humber Strategic Health Authority (YHSHA) that oversees it, will be no more. They will be replaced by four Care Commissioning Groups (CCGs).

NYY and YHSHA together spent £3.2million capital money on Tunstall telehealth equipment in 2010, with the PCT paying ongoing support fees and depreciation costs. The procurement was intended to provide 2,000 devices for a project to deliver telehealth to people in the area. It was a pre-cursor of the 3millionlives (3ML) campaign but the local GPs had to be persuaded to participate without the benefit of knowing the Whole System Demonstrator (WSD) results.

The NYY project has had the aspect of a slow motion car crash for everyone apart from Tunstall (PDF) which, using it as an example of ‘telehealth at scale’, has since generated several similar large projects, or for one person which Tunstall recruited from NYY (PDF, bottom of the page). A maximum of 674 units were in use at any one time, and 120 of those were purchased previously for a pilot project.

With the approaching demise of NYY, the four CCGs that cover the area have to decide what to do about the telehealth project and the continuing costs. The local paper ran a story in January that discontinuing it was a serious option. Telehealth revolution in tatters after snub by doctors.

Last Thursday (28 February 2013), a paper setting out the project background and current options was presented to one of the four inheriting CCGs, the Hambleton, Richmondshire and Whitby Clinical Commissioning Group Shadow Governing Body.

The paper reveals just how much the project has cost that part of the NHS this year: fixed (‘service desk’) costs of £358,752, plus variable (‘communication fees’) of £238,645, giving a total of £597,397 and it could have risen to £665,680 if all units were deployed.

Other running costs (apart from staff-related costs, which are not part of the calculations) include capital depreciation charges of £575,000 per annum on the cost of the original 2,000 units. It appears that one of the last acts of the PCT will be to ‘impair‘ the equipment, writing down its value so that the CCGs do not have to continue paying capital depreciation charges. The paper states that this accounting manoeuvre, together with reduced charges by Tunstall, will bring down the ongoing cost of each unit deployed from £172 per patient per month to £48 per month for each unit used.

TTA readers will find their own other interesting insights in the paper which can be downloaded from the CCG’s website (Item 7) or from here (PDF) if the web page is taken down. Please share them with us by means of a comment.

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  1. Steve Hards

    [Posted by Ed. Steve for someone who wishes to remain anonymous]
    I was fascinated to see that Ernst & Young seem to have been airbrushed out of the story completely. This time last year they were doing the rounds with PCTs saying what a great job that they were doing working with Tunstall promoting telehealth take-up in Gloucestershire & North Yorkshire. Intriguingly if you go on the E&Y UK site there is no mention I could find of E&Y’s work in either of these places now, and indeed their last items on telehealth are dated March 2012 (there are later ones on their worldwide site).


    So the project will be extended in order to facilitate a managed exit. The End.
    And I lost count on how many times Tunstall was mentioned.
    In this report it is the ‘Tunstall Telehealth Project’ – NYY appear to be distancing themselves already. So you need to stop calling it the NYY Telehealth Project immediately!

    I can see how the shadow CCG and others mix names up. It is very easy to get confused with the titles and who is running it and who is funding it. Take this press release from 4th June 2010 that can be found on the NYY Telehealth (not called the Tunstall Telehealth Project website) website for example:

    David Cockayne, Director of Strategy for NHS North Yorkshire and York, said: “We are delighted to announce this significant investment in Telehealth which we, and local clinicians, believe will continue to make a huge difference for patients living with a long term health condition.

    “As outlined in our recently published five-year strategy, we are committed to providing care closer to home and improving the quality of life for patients living with a long term health condition. We recognise Telehealth as being a key enabler to us achieving our aspirations.”

    And to add to all the confusion shortly after the award of the £3.2 million contract to Tunstall Mr Cockayne started work for Tunstall. So you can see where the confusion and the names and the funding all get a little blurred.

    Not helpful for Telehealth at all. No matter what results come out of it as it could be seen as being tainted.