Who will take responsibility for rolling out ‘telecare’?

Despite the government’s enthusiasm for telecare, many GPs will be too busy trying to commission to learn how to do it

 

Telecare: the future of the NHS? Photograph: Christopher Thomond for the Guardian

Last week, I expressed my disappointment with the King’s Fund’s International Telehealth and Telecare Conference. I am so upset that I am returning to the subject again.

For starters, I was amazed that there were only three GPs present. I found this strange, as telecare is likely to change the way GPs treat patients for ever. Or do GPs consider telehealth as just another irritating technology, like electronic patient records and email, which will go away if you ignore them long enough?

One speaker involved in the project said that GPs were divided between those who were interested, those who were not sure and those who didn’t want to know. One GP claimed that telecare increased patient anxiety and workload for GPs.

On the other hand, community matrons and nurses already involved in telecare monitoring were generally very positive. They found that telecare made it easier to manage their own time. They even claimed that telecare would reduce the GPs’ workload! This figures in my experience; nurses tend to welcome new ways of treating patients, but doctors hang back, particularly if what is proposed will radically change their way of life.

One of the GPs who did turn up asked the minister, Paul Burstow, a very intelligent question: “We GPs are up to our eyes in learning how to commission. How are going to find time to get our heads round telehealth?”

The minister had been emphasizing that 3millionlives was not a top-down initiative, like Tony Blair’s nasty centralised National Programme for IT. It is going to be rolled out by lovely localised commissioning consortia. Paul Burstow had no answer for that GP, who was going to be too busy for telecare.

All he had to offer were “how to do it” guides and awareness campaigns. The trouble is that too many clinicians do not seem to want to know. It will take more than awareness campaigns to persuade them, and then educate them, which could be a long and arduous process, with all the other demands on their time.

Burstow’s sidekick in the Department of Health called for the NHS, social services and industry to work together. He asked for leaders to come forward, including financial leaders, to share the vision and drive 3millionlives forward. He is right. But I have heard these calls before, and they haven’t been answered.

I can’t see where the charismatic champions will come from. Instead, I have a nasty feeling that 3millionlives will come to be regarded by clinicians as just another part of the hated Lansley reforms, and will be rejected by the profession.

There was, however, one bit of good news to come out of the conference. Apparently, Cornwall was not waiting for the peer-reviewed report. It had decided to start extending telecare to 30,000 patients. They had seen the evidence with their own eyes, and have people fired up to give more patients the benefits of telecare. So, why hang about?

http://www.guardian.co.uk/healthcare-network/

 

1 Comment

  1. Philippa Russell says:

    I was particularly interested in the comments on telecare/telehealth as we (as a family with an adult son with a learning disability) have now used telecare for about five years. My son has significant support needs. He has support workers, day care and a lot of family support but there are times – as he tries to live more independently – when he is on his own.

    We were offered the opportunity to be part of an EU funded programme to see how telecare could improve the lives of people with learning disabilities and promote greater independence. I have to say that we have fiound telecare a huge resource and it has avoided several potentially very nasty doemstic disasters.

    Telecare is not the same as Teklehealth (thought both are very similar in many respects, not least the technology) and I think there is a lot of confusion. Telecare is much more geared towards living safely. It can provide alarm systems, sensors (eg to tell you when someone gets out of bed, whether they draw their curtains, whether they get downstairs safely in the morning). It can monitor for intruders as well as for doors left open and unlocked and it will also pick up leaks, fires and all the domestic disasters we all fear. It can also be linked to SKYPE/CCTV monitoring if that is what is wanted. In effect it could be a very useful part of a personal budget.

    Of course people matter. The call centre that responds to alarms is a conduit to the people,family, support workers. who need to know. But it can bring peace of mind and added scurity. And yes, we did have a fire. It might have gone out on its own but Telecare had everyone round at Simon’s house so quickly that there never was any real risk.

    However, I agree that both Telecare and Telehealth are not ‘stand alone’. They are part of a range of options and commissioners and professionals need support in understanding and using their potential. Apologies for a long message – but I am something of an evangalist for a technological development that really can make a difference. I just wish I had had access to it when my mother had dementia. We could have kept her at home so much longer.

    Best wishes

    Philippa

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