A new telehealth scheme has been launched by the DH to help an initial 100,000 patients with long-term conditions gain control over their own care.

Patients will get access to the use of electronic information and technology to help manage their health independently reducing the need to visit primary or secondary care facilities.

The scheme complements the NHS Mandate, which aims to provide telehealth access to three million people by 2017.

Health Secretary Jeremy Hunt said it was “logical” that the NHS should use technology to help patients “manage their condition at home, free up a lot of time and save the NHS money.”

The initial roll out of the project will see seven NHS ‘pathfinders’ across the country agreeing contracts with telehealth suppliers. The project is like no other witnessed in the UK before and is the largest outside the US.

The DH aims to make England the world leader in telehealth in coming years.

“In a world where technology increasingly helps us manage our social and professional lives, it seems logical that it should also help people manage their health,” said Jeremy Hunt. “With our industry partners, we will make England a world leader on telehealth.

“Getting another 100,000 people to benefit from this technology is a very important step and I congratulate all involved on their hard work. I hope it will be the first of many steps towards our overall goal of getting three million people to benefit in the years to come.”

David Nicholson, Chief Executive of the NHS Commissioning Board, said the introduction of the scheme had the potential to transform the lives of people with long-term conditions. “Telehealth not only saves lives, it transforms them, so that people with a long-term condition can feel in control of their life,” he said.

“The seven pathfinders that are offering this new technology to patients will give the NHS Commissioning Board important insight into how best to extend this option to any patient managing prolonged ill health or a chronic condition. 

“Working closely with the local commissioners involved and informed by their experience, we plan to promote vigorously the use of telehealth across England from next April.”

Is QIPP really about ‘doing more with less’?

The NHS Quality, Innovation, Productivity and Prevention (QIPP) Challenge was launched in March 2010 as a strategy to facilitate major cost savings within the NHS, in response to the impact of the global recession. The principle of QIPP was that given the need for austerity budgeting, serious planning and rethinking were needed to ensure ‘smart’ cost-cutting that did not harm patient outcomes. The QIPP agenda was about identifying solutions that held together the four key principles, reducing overall costs by making interventions more timely, efficient and effective.

The new Government’s NHS reforms promised to facilitate QIPP by empowering local providers and commissioners to develop the best solutions for their communities. However, the economic pressures on CCGs and Foundation Trusts within the new system, combined with the ‘Nicholson challenge’ of cutting £5 billion out of the NHS budget in each of four successive years, have meant that the dominant theme of QIPP at a local level is cost reduction.

The first full year of QIPP (2011–12) delivered savings of £5.8 billion against a target of $5 billion. However, reports of NHS rationing and ‘postcode prescribing’ have proliferated. QIPP was devised as a strategy to combine two goals: the shift towards community-based healthcare and the urgent drive towards NHS cost-cutting. Is that still the agenda, or have the pressures of NHS reform reduced its four principles to one: reducing expenditure? Is QIPP really about “doing more with less”, as Andrew Lansley claimed, or is it just about doing with less?

A new healthcare paradigm
The DH booklet introducing the QIPP challenge in March 2010 set the context: “The NHS needs to identify £15–20 billion of efficiency savings by the end of 2013/14 that can be reinvested in the service to continue to deliver year on year quality improvements.” The booklet placed emphasis on improving quality while reducing overall costs through strategies such as early intervention, improved infection control and home-based care. Its authors included Jim Easton, then National Director for Improvement and Efficiency. The DH described a series of QIPP ‘workstreams’ it was setting up to help clinical teams and NHS organisations “improve quality and productivity across care pathways”. The first of these related to care of long-term conditions, urgent care and end-of-life care. Further workstreams would examine safety challenges, such as pressure ulcers (bedsores), and ‘right care’ issues such as referral management and identifying “low-value treatments” (later to become controversial issues).

The authors called for “a collective response at local, regional and national level” to address the QIPP priorities. These included early diagnosis, primary and secondary prevention and patient self-management. The need for “better partnerships between primary, community and secondary care to support people with long-term conditions” was emphasised. QIPP extended from the “daily clinical practice” of individual HCPs to “the wider care pathway”, the booklet said. Each SHA had its own QIPP lead and innovation lead, and was establishing an online regional ‘quality observatory’ and Innovation Fund to help clinical teams improve quality and productivity.

These ideas were illustrated by case studies where local NHS organisations had developed better and more affordable healthcare solutions. These included the use of an electronic system to ‘re-engineer’ blood transfusion, reducing waste and improving safety; and systematic guidance on antibiotic prescribing to reduce rates of C. difficile infection. These solutions all involved using teamwork and sharing information to make the best use of available resources.

The booklet ended on a warning note: “If we do not respond to this challenge there is a real risk that the need to cut costs will overtake our best intentions to improve care for our patients.” More than two years later, the crucial question is: has QIPP averted that outcome or brought it closer?

Innovation is ‘core activity’
In June 2012, Nicholson’s annual report claimed 2011/12 had been “a remarkable year” for the NHS. He highlighted the contribution of local initiatives to maintaining service quality while cutting costs. Austerity would dominate the NHS “for the foreseeable future”, he said. However, the innovation agenda promoted by the previous Government’s Office for Life Science and revived by the current Government in December 2011 would engage dynamically with that challenge: “Innovation has to... become the core activity of the NHS.”

His report went through the elements of QIPP, noting achievements in each area. Quality achievements highlighted included: in cancer care, the achievement of key treatment standards across all eight performance measures, as well as improved early detection figures; and in stroke care, better access to specialist stroke units and faster treatment of people with transient ischaemic attacks. Community-based asthma services in South East Essex were used as an example of a successful local initiative.

The brief section on innovation focused largely on the use of technologies in the community, including telehealth and home dialysis. The preventative care section emphasised the growing role of health visitors, and drew attention to the success of a national screening campaign for risk of venous thromboembolism (VTE) with prophylactic drug treatment given where needed.

In the productivity section, Nicholson noted QIPP savings of £5.8bn and praised the “modest reduction in activity levels” across the NHS – placing these in the context of the QIPP Long-term Condition Workstream, which aims to reduce unscheduled hospital admissions by 20%, reduce hospital stay length by 25%, and maximise the role of “supported care planning” in helping people to manage their own health. However, no reference was made to the rationing of procedures or the cuts in hospital nurse staffing.

Milestones or millstones?
A recent Health Service Journal report on the DH’s QIPP tracker indicates that the PCTs (soon to be abolished) plan savings worth £13bn nationwide between now and 2015, with £4.5bn of this to be achieved through the 53 local QIPP plans. The planned savings are front-loaded: £3.8bn this year and £3.6bn, £2.9bn and £2.6bn in the next three years. However, only £2bn of the planned QIPP savings are currently being achieved on schedule, and only six local QIPP plans are on track with all of their workstreams.

According to the tracker, productivity gains are the main objective of most local initiatives. Common features include the redesign of care pathways for long-term conditions, including diabetes and COPD, and the development of integrated care teams for dementia patients. However, many local plans have the single goal of reducing the cost of services – for example, South of Tyne and Wear PCT notes as an objective: “reduce price paid for Gateshead Health Foundation Trust older people’s mental health service”.

John Appleby, chief economist of the King’s Fund, commented that this emphasis on savings denied the original point of QIPP: “to improve value to patients”. He also said there was no evidence of the money saved being reinvested in future services, which was a key principle of the original QIPP agenda. The Audit Commission has since reported that the NHS has £4bn in “uncommitted finances”: cash reserves created by aggressive cost-cutting. Mike Farrar, Chief Executive of the NHS Confederation, has argued that this money needs to be invested in community and primary care.

Jim Easton, the NHS Commissioning Board’s Director of Improvement and Transformation, warned in July that too many NHS organisations were relying on spending cuts without any element of service redesign. The “deeper change” of shifting healthcare to the community was not being undertaken, he said, and
QIPP was becoming a “label” for “cost improvement plans”. As a result, the QIPP savings of the past year would be very difficult to repeat. Instead of building a new healthcare model, the NHS was just cutting
parts of the old one.

Easton has since announced that the Board will fund a new innovation body to deliver a “system-wide” response to the QIPP challenge. From April 2013, the new organisation will replace all existing NHS innovation and technology adoption bodies. He anticipates that it will “provide hands-on support for great models of care” developed within and beyond the healthcare sector. However, his resignation has cast a shadow over these plans.

According to the King’s Fund, 27 of 42 NHS finance directors it surveyed believe there is a high risk that the NHS will fail to meet the ‘Nicholson challenge’. A key question for industry, and for patients, is whether QIPP can help the NHS deliver on the more important challenge of transforming healthcare to meet the
changing needs of the population.

GP commissioners will start their new roles free of “legacy debts” and positioned to develop innovative care solutions, Andrew Lansley has said.

The Health Secretary reassured an audience of GPs at the Commissioning Show that CCGs would not need to “provide for deficits in the local health economy”: that would be the task of Monitor, he said.

Lansley’s speech placed strong emphasis on the need for NHS service innovation to deal with the coming “demographic tsunami”.

The NHS Outcomes Framework will “focus our minds” and “enable clinicians to lead, not be micro-managed from on high,” he said.

Addressing the fears of many GPs, he said the NHS Commissioning Board would not “top-slice” CCGs’ budgets or require them to be re-authorised once in action.

He intended to ensure that CCGs started with “no legacy debts”, though that would not be true of providers.

Echoing Malcolm Grant’s speech to the NHS Confederation last week, he said that “we do not want to tell you how to achieve” – though he did not mention the recently announced NHS CB guidelines on commissioning processes.

Lansley also cited the fall in GP referral rates as a positive achievement, without mentioning the National Audit Office’s recent statement that falling referral rates were harming diabetes care.

He highlighted the potential of GP-led commissioning to develop innovative care solutions such as telehealth, and to improve dialogue between GPs and local government.

A blueprint for integrated and patient-centred care in Kent has been hailed by health secretary Andrew Lansley as a “bold move”.

The report from Kent Health Commission proposes a new community-based service delivery model, combining health and social care budgets.

Kent Health Commission said it aimed to empower patients and GPs, creating a new market in health provision, while saving £5m per district.

The report’s recommendations include the development of community hospital facilities and services available to people in local areas.

This approach would increase the availability of district nurses and other mobile health workers to deliver intermediary and home-based care, including telehealth systems.

The Commission aims to accelerate joint commissioning between health and social care to provide new services.

Lansley commented that he welcomed “the work underway to make sure the new health reforms provide the very best health and social care services,” and hoped it could provide “a model for other areas to follow”.

Focusing on Dover and Shipway, the report claims it can both improve patient outcomes and save £59m – an average of £5m per district.

Local GP Dr Joe Chaudhuri commented: “Strong, trusting relationships among different agencies are key and the fact that we have a shared vision gives me real confidence that we can achieve our collective ambitions.”

The new UK life science strategy and NHS innovation review, launched by the Government this month, has been praised by the UK medical technologies sector for its promotion of innovative research and the rapid uptake of high-value technologies.

The NHS Chief Executive’s review Innovation, Health and Wealth: accelerating adoption and diffusion in the NHS outlines a number of measures the NHS will take to work in partnership with industry in order to implement effective new medical technologies throughout the NHS.

The document draws in attention, in particular, to the potential of telehealth systems to improve the management of long-term conditions, reducing hospital admissions and GP visits and so reducing the overall cost of care while improving patient outcomes, as demonstrated by the recent Whole Systems Demonstrator project.

Other areas of medical technology highlighted by the innovation document include the use of fluid monitoring in acute care and the use of assistive technologies, including wheelchairs, to improve the access of disabled people to working and other everyday environments.

Peter Ellingworth, Chief Executive of the Association of British Healthcare Industries (ABHI), the leading UK medtech trade association, said: “I welcome the Government’s focus on the life science industry. As highlighted by the Prime Minister our sector is part of ‘the virtuous circle of health, wealth and well-being’ – a real growth area for the Government as well as having the potential to make a difference to patients through the innovation we bring.

“Measures such as reform to the tariff system, enforcement of NICE guidance and the development of a procurement strategy, if done properly, could make a real difference to the medical technology sector.

“ABHI will work with the Government to make sure that the measures outlined in the Innovation Review are translated into firm actions. The measures could make a real difference to the SMEs in our sector and it is crucial that we are able to take advantage of them and continue to grow.”

Doris-Ann Williams MBE, Chief Executive of the British in Vitro Diagnostics Association (BIVDA) and a member of the Innovation Review’s External Advisory Group, commented that the Government’s announcements “represent a crucial opportunity for the life sciences sector” – and that the life science strategy and the innovation review in combination “will reinforce a genuine partnership between industry, the NHS and government.”

“To accelerate the use of innovative technologies to benefit patients and the NHS, tangible and realistic proposals were needed,” she added. “The NICE Implementation Collaborative, an innovation scorecard and a commitment to examine reimbursement mechanisms for diagnostics will all help the IVD industry to do what it needs to do to turn the vision into reality.”

Tony Davis, Chair of health technology business support organisation Medilink UK, noted that the new life science strategy “sets the stage for telehealth and telecare technologies to be made available to every person with a long-term condition or in need of care in the UK, helping them manage their health while maintaining their independence.”

“Medilink UK has been working with industry, other trade associations and the Department of Health to accelerate the roll-out of telehealth and telecare services in the NHS and social care, which will enhance the lives of three million people over the next five years,” he concluded.

The idea that ‘any qualified provider’ can deliver NHS services may be contentious, but it has roots in existing policy. Thoreya Swage examines the opportunities for industry in the changing health provider landscape.

Successive governments have tried in recent years to shake up the healthcare system in the UK, with England probably being subject to the greatest number of changes. A key element of these shake-ups has been various attempts to expand the healthcare market in order to include the private or independent sector.

This widening of the doorway started in earnest with the deployment of the waiting list initiative in the 1990s, using the spare capacity of independent hospitals to reduce the queues for elective procedures that had built up in the NHS.

The baton was then taken up by the independent sector treatment programme under the last administration: the range of work done by private providers expanded to diagnostic procedures and screening programmes, as well as the construction of bespoke independent hospitals to take on hip, knee and cataract operations from the NHS.

It was at this stage that the concept of patients choosing which healthcare institution to go to for treatment or diagnostic procedures started to take off, with some of those options being in the independent sector. The idea of an ‘any willing provider’ began to take shape, with NHS care being delivered by any appropriate healthcare body as long as it had reached identified quality and safety standards.

However, before the recent change of government this initiative began to cool under external political pressure and at one time even seemed likely to fade away.

What AQP means

Despite opposition, the coalition Government has renewed the ‘any willing provider’ policy, calling it this time ‘any qualified provider’. In July of this year the Department of Health in England issued ‘operational guidance’ to the NHS providing further details to PCT clusters and the emerging Clinical Commissioning Groups (CCGs) – the renamed, modified GP consortia.

This policy has come under the guise of improving the quality of care by widening patient choice for specific services.

The intention is to permit the patient to choose from a list of qualified providers when they require a referral for a specific community or mental health service. To meet the ‘any qualified provider’ (AQP) requirement, a healthcare organisation needs to fulfil the quality, price and contractual obligations for NHS services. This process, as we have seen, is already in place for elective care.

The guidance states that the implementation of AQP will be conducted in phases from April next year. However, some work needs to be done before that. PCT clusters and their associated CCGs need to have decided which community or mental health services they wish to identify for the implementation of AQP locally by October, so that their patients can begin to have access to that care between April and September next year. Three or more services from the following list, drawn up by the DH in conjunction with patient groups, should be identified:

• musculo-skeletal services (neck and back pain)
• audiology services in the community (adults)
• continence care (adults and children)
• diagnostic services (e.g. imaging and heart and lung investigations)
• wheelchair services (children)
• podiatry services
• wound healing and management of leg ulcers
• primary care psychological therapies (adults).

The guidance also says that PCT clusters and CCGs can choose alternative services for AQP in different priority areas if these are supported by local patients – for example, as identified through the shadow health and wellbeing boards (the new joint health and social care joint commissioning boards) – and effective gains in quality and access can be made by doing so.

Getting involved

How can independent provider organisations participate in this process? The principles of the AQP approach are as follows:

• Organisations can qualify and register to provide NHS services as long as they meet NHS assurance requirements.
• Referral pathways and protocols set by CCGs must be accepted by the providers wishing to be on the AQP list.
• Patients are offered a choice of services from the list of qualified providers.
• There will be a fixed price based on a national or local tariff, to ensure that the provider is chosen by quality.

A national qualification process for all AQP providers is currently being developed by the DH in order to minimise bureaucracy and reduce transaction costs. The proposed principles for qualification are that providers:

• must be registered with the Care Quality Commission to demonstrate that they meet the essential standards for quality and safety (or equivalent assurance requirements if providing services not covered by CQC registration)
• are licensed by Monitor (from 2013) so that they are authorised to deliver NHS care
• can meet the terms and conditions of the NHS Standard Contract, including having regard for the NHS Constitution, appropriate guidance and legal obligations
• deliver care at NHS prices
• can meet the service specifications developed by commissioners and comply with referral protocols
• agree with the commissioners on any supporting schedules to the NHS Standard Contract, e.g. on activity levels.

More details of the qualification process will be published this autumn.

The providers that have successfully achieved the national qualification process will be listed in a directory available to GPs later this year.

By November 2011, lead PCT clusters will have produced detailed implementation packs for each service on the AQP list that will include service specifications, contract currencies, tariffs and information models.

It is anticipated that AQP for the services identified above will begin to be implemented from April 2012, with all CCGs having this in place for their patients by September 2012.

What happens next?

AQP will continue to expand: for 2013/14 a further list of services has been identified by the DH for discussion with commissioners, patient groups and providers. The list is not finalised, but will probably include:

• maternity care, e.g. antenatal education and support for breastfeeding
• speech and language therapy
• supporting patients to self-manage long-term conditions
• chemotherapy in the community setting and at home
• primary care psychological therapies for children and adolescents
• wheelchair services (adults).

Opportunities for medtech

The most obvious opportunity for medtech in relation to AQP is in the sphere of direct access diagnostic services, where many investigations such as non-obstetric ultrasound, echocardiography, cardiac physiology, MRI, X-ray, endoscopy and phlebotomy can be provided in the community setting, as indeed some already are (e.g. via Inhealth). These direct referrals can enable GPs to obtain rapid investigations and help to manage their patients in primary care, without having to refer to a hospital consultant.

Another key area is adult hearing services, including audiology and hearing aid fitting. Telehealth and telecare also have a part to play in supporting some of these services by monitoring people with long-term conditions at home. The services identified for the initial phase of AQP have traditionally had poor information systems. Better data collection on activity and health outcomes will be vital for the success of the providers delivering services under this initiative.

The key challenge for medtech companies is to get onto the recognised list of AQP that the DH is drawing up, or to work with partners who will be applying to go onto the list. Rather than regarding independent providers simply as customers, medtech suppliers can work with them to achieve AQP success.

Potential providers need to get up to speed on a number of areas, such as ensuring that they are registered with the CQC, have a good understanding of the standard NHS contract, offer services in keeping with the CCGs’ requirements and can manage within NHS financial envelopes.

The aim should be to identify the lead commissioner(s) within the local PCT cluster and associated CCGs and find out which community services they are planning to include on their local AQP. Alternatively, contacting the local shadow health and wellbeing board (if it is sufficiently developed) may indicate other priority areas for AQP. This is an opportunity for marketing medtech services that can be shown to improve patient care and are aligned with the local health economy’s priorities.

Medtech providers should also be clear about whether they can meet (or help their partner organisations meet) the qualification requirements for AQP. They should look closely at the details of these when they are published by the DH later this year.

Companies should also start doing their homework now on pricing and the care outcomes that can be achieved through their services, bearing in mind that the NHS commissioners will be looking at how the five high-level domains of the NHS Outcomes Framework will be achieved.

Another key milestone to look out for is the implementation packs due in November on service specifications, contract currencies, tariffs and information models. These will require close examination by potential providers seeking to ensure that they are fully prepared for AQP.

Although this initiative seems small in scale it looks set to grow in the future, and further opportunities will present themselves for 2013 and beyond as AQP continues to expand. For more information, visit the Department of Health website.

Dr Thoreya Swage was formerly an NHS clinician and a senior manager in various NHS organisations covering acute and primary care. She has expertise in commissioning health services and is currently working for a number of NHS organisations, including DH agencies, to develop a more commercial approach to the commissioning of healthcare.

UK-based telehealth and telecare leader Tunstall Healthcare Group is to acquire remote health monitoring and 24/7 communication provider American Medical Alert Corp (AMAC).

Jack Rhian, President and CEO of AMAC, said: “Tunstall’s longstanding culture of engineering excellence, technological innovation and commitment to providing seniors with the tools to live independently is perfectly aligned with AMAC's mission.”

New York-based AMAC has two business divisions. Health and Safety Monitoring Systems (HSMS) includes a portfolio of remote patient monitoring devices and services including personal emergency response systems (PERS), mobile PERS, medication management and telehealth.

The company’s second division is Telephony Based Communication Services (TBCS), AMAC’s contact centre services group, which provides quality communication services to all types of healthcare departments, including physicians, hospitals, homecare and the pharmaceutical industry.

Gil Baldwin, CEO of Tunstall, said: “AMAC will support our ambitious growth plans in the United States.”

AMAC is “one of the largest providers of PERS in the US with 75,000 subscribers nationwide and a strong reach within hospital systems, home healthcare, government agencies and senior living facilities,” Baldwin noted, adding: “I believe there will be far reaching benefits for all of our customers, partners and employees of the Group.”

Tunstall will obtain all of the outstanding common shares of AMAC for $8.55 cash per share.

The deal is expected to close at the end of the fourth quarter of 2011.

Based in North Yorkshire, Tunstall Healthcare is a leading global supplier of telehealth and telecare systems.

The global market for telehealth services will pass $1 billion by 2016, a new business report has claimed.

In the 2011 edition of its report The World Market for Telehealth, medical electronics market research group InMedica forecasts that the telehealth market could reach $6 billion by 2020.

The report highlights the growing use of home monitoring systems to monitor vital signs, improving the control of long-term conditions such as diabetes, heart failure and COPD.

The leading market for telehealth systems is the US, the report notes, but there have been some large-scale trials in Europe – most notably in the UK, where more than 2,000 patients have received telehealth services.

“Many public healthcare systems now have targets to reduce both the number of hospital visits and the length of stay in hospital,” said Diane Wilkinson, Research Manager at InMedica. “This has led to a growing trend for healthcare to be managed outside the traditional hospital environment, and as a result, there is a growing trend for patients to be monitored in their home environment using telehealth technologies.

“What is apparent is the convergence of many different industries in this space, including telehealth companies, device manufacturers, healthcare agencies, service providers and telecommunication companies.”

The World Market for Telehealth – a Quantitative Market Assessment, 2011 Edition” provides an overview of the global telehealth market, analysing the sector’s business models, technologies, peripheral devices, major suppliers and market drivers/inhibitors.

InMedica is the medical research group of IMS Research, a leading supplier of market research and consultancy to the electronics industry.

A model of integrated care developed by NHS Kirklees for people with long-term conditions, deploying telehealth monitors and electronic patient records, has been praised by Health Secretary Andrew Lansley.

The NHS Kirklees system, developed through joint working between health and social care teams, involves using an online ‘emergency care plan’ for each patient to prevent and manage acute episodes.

This initiative has reduced ambulance trips by 16% and saved NHS Kirklees £1.09 million in a year.

Lansley commented: “The NHS can work more efficiently to improve care for their local communities, as they have shown in West Yorkshire. People with long-term conditions have some of the most complex health needs in the country and we need to personalise services to suit their needs, not fit them around how the NHS is organised.”

Strategies used by NHS Kirklees include: telehealth monitors to help patients keep track of their own health; ‘generic workers’ to support health and social care needs in the home; a single point of access to services; electronic patient records; and an emergency care plan developed by each patient with paramedics, hospital staff and community matrons.

Dr Jeremy Till, Consultant in the Emergency Department at Dewsbury and District Hospital, explained the emergency care plans: “The plan clearly highlights symptoms which are the ‘norm’ for that patient and can be managed by a health professional in the comfort of the patient’s own home or in the community. It also highlights at what point a hospital admission may be required.”

Robert Flack, MD of Kirklees Community Healthcare Services, added: “We are rolling out a new way of working with each long-term condition patient and their family at the centre of a Community Care Team. This team comprises the staff needed for that particular patient and includes their GP, community matron, district nurse and generic worker, therapist etc as appropriate. They work closely together with the aim of supporting the patient to stay at home wherever possible rather than being admitted to hospital.”

A Department of Health statement declared that NHS Kirklees was “leading the way” in joint working between paramedics, hospital clinicians, GPs and community nurses to support people with long-term conditions – an integrated healthcare model that could help over 15 million people in the UK to manage their health and avoid hospital admissions.

A home-based pay-as-you-use telehealth service will shortly become available for people living with long-term conditions in the UK.

New telehealth provider Appello’s offices in Lymington were opened in July, and its service is set to go live later this year.

Appello offers a solution without initial capital outlay to health providers and service users: it will provide a personalised, nurse-led monitoring, advice and support service, at a low monthly ‘pay-as-you-use’ cost.

Patients with conditions such as diabetes, asthma, heart disease and COPD will be provided with a telehealth monitor and connected to a central hub of nurse advisors, and will also have access to a web-based assistive personal health record.

The Appello service brings together elements from four established companies: telecare monitoring from CarelineUK, health records from CentriHealth, contact centre infrastructure from Volt Delta, and telehealth home hubs and remote monitoring from Numera Health.

Carl Atkey, Head of CarelineUK, said: “We have developed a service which has no capital outlay for the end customer, is easy to use and where a low-cost monthly subscription will allow the service to be adopted at scale by local authorities and other care organisations charged with delivering long-term care in the community.

“Individuals with long-term conditions are intensive users of healthcare, accounting for 52% of all GP appointments. Self-management by users and direct nursing advice reduces unplanned hospital admissions, visits to the GP and visits from welfare staff.”

 
Launch of Appello: Jackie England, Deputy Mayor of Lymington, with Carl Atkey and Gill Bennett from Careline UK