A look back on telecare and telehealth progress during 2008

Mike Clark 

2008 was a year of considerable progress in the field of telecare and telehealth as local authorities, primary care trusts and their partners used government funding from the Preventative Technology Grant and other sources to move ahead with advanced forms of telecare, lifestyle and telehealth vital signs monitoring.

At the start of the year, the focus was on the recently published Putting People First concordat and the Transforming Social Care circular, which set out the policy for personalisation of social care services. By the end of the year, talk was around the possibility of personal budgets for health care and we saw the publication of one of the largest telehealth case reports from the Veterans Health Administration in America.

So what were some of the milestone events of the year and how has the evidence base developed?

The Prime Minister, Gordon Brown, announced:
'...over the next few years we will give 100,000 people with long-term conditions the opportunity to manage their care in this way as "expert patients". And during 2008 we will bring forward a patients' prospectus that sets out how we will extend to all 15 million patients with a chronic or long-term condition access to a choice of "active patient" or "care at home" options.'

The Department of Health (DH) published a long-term conditions compendium of information, providing useful background information for commissioners and service providers.

Five CSIP Networks events across the country drew an audience of more than 440 people to hear how telecare and telehealth were being implemented in England. The events covered a wide range of telecare progress, outcomes and achievements with more than 50 presentations from 30 speakers.

New telecare and telehealth product announcements were coming out on a weekly basis, for example:

  • Birmingham PCT to extend its telephone-based care management programme from 2000 to 27,000 patients 
  • Southampton City to use cardiac telemedicine
  • Walsall & Hull use telehealth for COPD and congestive heart failure

Services were becoming more innovative in their approaches to supporting people in their own homes using telecare and other standalone assistive technologies.

The DH's Whole System Demonstrator programme started across the three pilot sites in Cornwall, Kent and Newham. The importance of building commitment through stakeholder engagement, workforce training and ensuring that systems were in place were vital from the outset of this complex trial.

The National Dementia Strategy website was launched, followed later by a consultation on the strategy. The publication of the strategy itself is due in early 2009.

Health Secretary Alan Johnson MP launched an intense six-month debate about the future shape of care and support services, also formally announcing the start of the WSD Programme.

The Department of Health published the Carers Strategy. Carers are an important beneficiary of telecare and telehealth services and the strategy identified that 600 carers would be interviewed in the WSD evaluation.

Lord Darzi presented his final report of the NHS Next Stage Review on 30 June, setting out plans to raise the quality of health care. By putting patients' wishes first and giving doctors and nurses the freedom to respond to those wishes and offer the safest and most effective treatments, his proposals aim to transform the quality of care that patients receive.

Social Care Minister Ivan Lewis MP launched the Whole System Demonstrator Action Network (WSDAN) at The King’s Fund.

The DH published Delivering Care Closer to Home: Meeting the Challenge. It referenced the Darzi review and also the White Paper from 2006, and looks at a number of programmes, including the Whole System Demonstrators, to make care closer to home a reality.

The Technology Strategy Board announced the first round of projects under the Assisted Living Innovation Platform (ALIP). These collaborative projects will result in research and development in telecare and telehealth areas. Explaining the background to the initiative, the Technology Strategy Board’s Chief Executive, Iain Gray, said:

'The impact of living longer, the quality and potentially increasing cost of care for those with chronic long term conditions, and preventing health problems like obesity, are major societal and economic challenges.  However, such challenges also give us the incentive to develop innovative solutions.'

The Integrated Care Pilot Programme prospectus was launched.

CSIP published a range of telecare summary reports and performance profiles from 150 social care authorities. The summary reports also recorded progress towards the 160,000 additional users identified in Building Telecare in England (DH, 2005).

As we reached the end of the year, we heard that the Continua Alliance will begin to certify their first round of interoperable telehealth products.

Looking ahead to 2009
It is unclear yet what the impact of the financial situation will be nationally and locally on services as we move forward. Indeed, this tougher economic climate presents real opportunities for commissioners and service providers to radically review their services rather than to retrench.

All in all, the progress made last year looks to continue into 2009 as organisations that have good local evidence move forward with their telecare and telehealth programmes for the benefit of users, patients, carers and their families.

We must not forget, either, the many individual local champions in organisations who have had the courage to innovate and search for new solutions using technology as part of an integrated care approach.

Mike Clark is co-project lead for WSDAN