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Exclusive: Test bed CCG explains how technology will cut A&E admissions


18 February 2016

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Fylde and Wyre clinical commissioning group (CCG) was announced as a test bed last month, and in his first interview since the announcement their chief clinical officer, Dr Tony Naughton, explains how they are using technology to reduce A&E admissions for frail older people.

Fylde and Wyre clinical commissioning group (CCG) was announced as a test bed last month, and in his first interview since the announcement their chief clinical officer, Dr Tony Naughton, explains how they are using technology to reduce A&E admissions for frail older people.

The pilot is part of the CCG's complete system overhaul, 2030 Vision for Health and Care, which aims to create coordinated, integrated care, with a focus on self-care, seven-day access, community services and informed patient choices.

The £3.5 million two-year test bed is entirely Department of Health (DH) funded, Naughton explained, and Philips is providing the equipment for free in order to improve the company's learning, so the main cost would be funding engineers to install it.

“Smaller things have been done but this will be the first really big, real-world test of the technology, that asks ‘will this work on a much less selected group of people?’” Naughton said.

The test bed, involving three CCGs in total, is expected to create £10 million savings over two years, by reducing unnecessary A&E and hospital admissions by 20%.

The partners involved already knew each other from previous collaborations, and included Lancashire Care Foundation Trust, councils and the organisations involved in the Fylde Coast and Morecambe Bay vanguards. The partners created a written submission on what they would do/achieve, and they were then called to the Department of Health to do a presentation. The whole process – from submitting the application to having it confirmed – took about four months.

The new technologies are advanced. Philips will create a hub in people’s homes linked to their TV and broadband, then elderly people can weigh themselves or check their blood pressure and this information will be transferred to a central hub, managed by a team of clinical and non-clinical staff.

Rather than exacerbating staff shortages, this should free up GP time. The test bed looks at the 2-3% of people who use 50% of resources in their local area, and can often end up in intensive care unnecessarily. Instead, the technology can alert practices in good time if a patient needs an appointment, and avoid people booking appointments unnecessarily.

For example, patients with heart failure – whose hearts are not pumping properly – can retain access fluid, which is heavy. They can measure their weight everyday on easy-to-use scales, and this will automatically get inputted to the system. The CCG chief explained: “We can say to patients ‘if you’ve put on more than 3kg a week increase your medication by this much’, and we can take action before they become ill or are aware of any symptoms.”

Moreover, what happens at the central hub can be automated. So if the system sees rapid weight gain there can be algorithms in place to recognise this, and automatically alert the staff. The test bed has identified 16,000 people who could benefit from the technology, so the idea is to minimise the care required by clinical staff.

What about elderly frail people who aren’t technologically-minded? “Initially, we need to be using people who are enthusiastic and willing. Then we will be exploring how to engage people who aren’t technologically literate,” the doctor said.

This is one of seven test beds launched by Simon Stevens, chief executive of NHS England, in January, that will see the NHS partner with technology companies like International Business Machines Corporation (IBM), Philips, and Verily (formerly known as Google Life Sciences) in order to keep patients with long-term conditions healthy at home.

The first wave of test beds includes five health and care test beds and two ‘Internet of Things’ test beds. The sites are spread across different areas of England, including the West of England, Surrey, Sheffield and Birmingham.

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