NHS White Paper: Innovating the NHS

Dr Ewa Truchanowicz, managing director of Dignio in the UK, analyses the latest proposed reorganisation of the NHS published in the government’s White Paper. 

More reforms of the NHS are on the way. The government’s latest health White Paper will reverse many of the changes pushed through by the then prime minister, David Cameron in 2012. The latest reforms will mean more innovation and collaboration across the healthcare sector, something that’s already happening in some parts of country.

The White Paper is full of phrases that clearly mean more integration and innovation going forward. There’s also references to greater collaboration between different parts of the healthcare system, including local councils, who play a crucial role in the commissioning of care for the frail elderly. The document, published last month, talks about enabling the NHS and local authorities to arrange healthcare services to meet current and future challenges “by ensuring that public and taxpayer value, and joined up care, are first and foremost.” In many parts of the country collaboration on that scale has already happened as part of separate pilot schemes with encouraging results.

In Greater Manchester a collaboration between healthcare specialist Mastercall Healthcare and Dignio, the Norwegian healthtech company, has been transforming care home treatment with digital remote care. In a scheme funded by the local authority, they’ve been embracing digital care and it’s bringing huge benefits for both healthcare providers and patients. Mastercall, an out-of-hospital healthcare provider based in Stockport, has overseen the implementation of a new digital approach to patient care called ‘Technology Enhanced Living’ (TEL). It’s just the sort of innovation that government ministers are now looking for. The idea of TEL is to monitor and follow up on patients remotely, while reducing the need for labour intensive and costly face-to-face GP check-ups, admissions to hospital and use of emergency services, as well as improving health and social care outcomes. 

This system involves individuals or their carers using Bluetooth devices, linked to a smartphone app, to monitor their health, which is sent in real-time data back to a digital platform. The technology solution is delivered by Dignio, while Mastercall provides the TEL service. The system involves extensive use of video consultation where possible, and the establishment of a Hospital@Home team that can respond to patient deterioration, avoiding admission to hospital, where clinically safe and appropriate. The system allows clinicians to monitor appropriate data, which is risk stratified by the platform so they can accurately detect and respond to changes in patients’ conditions, whilst simultaneously reducing the strain on NHS services.

Reducing the strain on the NHS seems to be one of the key drivers of the latest round of reforms. The involvement of the local authority ticks even more boxes! 

Dr Michaela Buck, chief executive of Mastercall Healthcare says: “Our collaboration came about after we started having regular meetings with the chief executive officer at Stockport Council. They are very savvy and visionary when it comes to the use of digital technology to help support residents in social care. We now have around 20 care homes on the Dignio platform and early results suggest that admissions to hospital amongst the frail elderly and others with acute comorbidities have reduced significantly.”

The pilot in Stockport began before the arrival of COVID-19 and was designed to manage patients with long-term conditions. After COVID was declared a pandemic, it was realised that the same system could be easily adapted to monitor deterioration in coronavirus patients and again help to reduce demand for hospital beds. The platform was quickly identified as an enhanced version of the Oximetry@Home service being rolled out by the government. 

The Dudley NHS Clinical Commissioning Group was one of the first to realise the significance of what was being offered. 

Lead clinician, Dr Jonathan Darby says: “We’ve been using the platform as a pilot in monitoring Category-2 COVID patients at home. We have found the software easy to use as well as enormously reassuring for patients. It’s helping to keep hospital admissions to a minimum, meaning that there’s more capacity for COVID patients who are in a more serious condition.” 

And following the success in Dudley there are now plans to introduce the platform in care homes around the area too. 

Feedback from both Dudley and Stockport has so far been incredibly positive with patients stating that they felt more empowered and less isolated during the pandemic, knowing that there was a clinical team monitoring them remotely.

Linked up healthcare is nothing new in Norway, where Dignio developed the technology before setting up in the UK. Since 2014, the company has been working in close collaboration all over the country, including in the capital Oslo. Through a series of projects set up by the Norwegian directorate of health, effective technology and methodology have been developed to improve the lives of patients with conditions like, COPD, diabetes and cardiovascular diseases. More recently Oslo has included patients with mental illnesses and preventive care in their services. Independent research demonstrated significant improved patient outcomes and higher care service efficiency. 

The latest NHS reforms highlight the need for much more joined up thinking within healthcare and clearly more innovation. Ultimately, that will lead to better patient outcomes and savings, which could be ploughed back into funding more innovation. The platform Dignio is providing is already a tried and tested technology solution in Norway and the company is working hard to ensure the same benefits can be delivered here. 

The White Paper suggests that instead of working independently every part of the NHS, public health and social care system should continue to “seek out ways to connect, communicate and collaborate” so that the health and care needs of people are met. With change on the way again within the NHS, the results of the pilot schemes in Manchester and Dudley will clearly provide a valuable insight into the way forward.