Investing for Health – telehealthcare in the West Midlands

Joanne Harding is the programme lead for long-term conditions and telehealthcare in the West Midlands ()

Tony Bruce, Chief Executive Officer at North Staffordshire PCT, is the executive lead for telehealthcare across the West Midlands region

The increasing number of older people, many of whom have long-term conditions, provides a considerable challenge to health and social care organisations in the West Midlands.

To meet this challenge, health trusts, local authorities (LAs) and partner organisations are adopting an innovative approach as part of ‘Investing for Health’ that includes the use of telehealthcare. This integrated approach across health and social care utilises the best of a wide range of assistive technologies now available from a range of vendors.

Seventeen primary care trusts (PCTs) and 14 social care authorities are working together in this pioneering regional programme to incorporate telehealthcare technologies into day-to-day service provision. The programme builds on the existing telecare programmes and early telehealth pilots in the region and is led by the Regional Telehealthcare Network, which all 17 PCTs and 14 LAs participate in.

In January 2010, the health authority appointed eight project managers for a year to work with local organisations to ensure that services are available to those who could most benefit. The team, working with PCT and LA colleagues, aims to raise the profile of telehealthcare, promote investment and demonstrate real benefits by using appropriate technology to promote independence, self-management and moving care closer to home for thousands of people with long-term conditions.

Aims of the programme

·         To enable the widespread, systematic application of telehealthcare where there are reasonable grounds to indicate effectiveness.

·         To promote innovation and new ways of working to enable the shift from secondary to primary care and to reduce unnecessary admissions and utilisation of services.

·         To put service users and their carers in control (moving towards consumer-directed care) and to promote self-management of long-term conditions.

·         To increase satisfaction among consumers and commissioners.

·         To identify measurable benefits in terms of health outcomes and successful change management methodology.

·         To promote partnership working and cultural development to support mainstream integration of telehealthcare throughout the health and social care workforce.

As part of the programme, we will be looking at the best approaches taken in the UK and around the world to adopt technology-supported services. Fortunately, the strategic health authority (SHA) is partnered with the Veterans Health Administration in the United States, and is able to learn from their extensive programme and their published outcomes.

Implementing our plan in 2010

Part of our plan is to build a directory of the technologies and services available to health and social care professionals. This will include modest self-care devices as well as more sophisticated systems for managing complex long-term conditions. We recognise that the market is now moving very quickly, with the possibility of more interoperable and mobile devices becoming available. We also need to ensure that we get the best from our existing equipment and services, particularly the deployment of the more expensive vital signs units for people with long-term conditions to carry out monitoring in the home.

Our early audits across the region have provided us with valuable information about take-up and the most effective use of this technology. As telehealthcare is made available in a co-ordinated way across the region, local evaluation will provide more details about people who are more likely to benefit, as well as the impact on health outcomes and service utilisation. In addition, there are opportunities to link in studies in particular areas – for instance, the use of medication reminders and the use of risk stratification and predictive modelling in each PCT area.

There are opportunities for health and social care practitioners to network together through meetings, events and learning sets in conjunction with our partner organisations, which include Medilink (West Midlands), Tribal, and the Health Services Management Centre at the University of Birmingham. This enables practitioners and service champions to overcome implementation barriers and challenges by sharing knowledge and expertise. Collaborative working also enables us to provide a more person-centred approach as well as to engage users, carers and patients in the development of services and reviews of the actual equipment used in their homes.

We recognise that our workforce needs to be supported through the programme. A set of workforce competencies for health and social care, including some for patients and carers, is being developed in relation to telehealthcare. We are making a range of training programmes available to meet staff requirements. Staff will be trained in the appropriate competencies to effectively deliver and use assistive technologies. Best practice will be collected and shared across the region.

To improve capability and capacity within PCTs, there are project management and implementation plans to roll out telehealthcare services. This roll-out will be coupled with evaluation approaches to strengthen the local evidence base and build more robust business cases. We are examining ways in which we can benchmark services across the region and with other sites around the country. Governance arrangements are in place through local steering groups and the programme is recognised at board level. Telehealthcare is linked to the QIPP priorities (Quality, Innovation, Productivity and Prevention).

A commissioning and evaluation toolkit is also being developed. This will be launched later in 2010 after being tested with stakeholders.

In conclusion, our West Midlands telehealthcare programme, together with outcomes from the Whole System Demonstrator (WSD) programme and other evaluations in the UK and around the world, will provide valuable feedback on the benefits of using technology-supported services in the community that are not only beneficial for users, patients and carers, but also have the potential to improve overall service quality and productivity.


For more information, visit:

Investing for Health

Telehealthcare newsletter (Feb 2010):

Long-Term Conditions: Investing in the Future - An integrated approach for the West Midlands, 24 November 2009 (presentations)