Evaluating the London remote monitoring scale up programme – lessons learnt

Across the five London Integrated Care Systems (ICS), several interventions aiming to support the remote monitoring of patients with Long Term Conditions (LTCs) have been scaled up over the last two years, across a number of clinical pathways. Each of these have been set up differently, influenced by local factors and the digital solution chosen to support the remote monitoring of patients in each ICS.

In order to understand how implementation and delivery have progressed at a local and pan London level, the London Digital team at NHS England commissioned a series of evaluations looking at the use of remote monitoring in supporting the management of LTCs across different clinical pathways.

This report summarises the insights generated through the five ICS-level evaluations, and articulates the lessons learnt and implications across them.

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Overview of recommendations

 Condition: -	Establish clear exclusion and inclusion criteria -	Clearly define digital pathways, including multi-conditions pathways Technology: -	Consider interoperability at the procurement stage -	Consider solutions with automated feedback mechanisms for both clinicians and patients -	Infrastructure for the collection of operational data and mechanism for reporting should be in place from the onset  Value proposition: Put strategy in place to ensure ongoing engagement including: -	Engaging existing clinical reference groups and recruiting local clinical champions -	Creating communities of practice and mechanisms to share learnings  -	Setting up a cross organisational steering group Establish whether the supplier has the technical and operational capabilities to support multiple pathways and comorbidities Establish capabilities early on and agree on a collaboration approach between the provider and supplier   Adopters: -	Patients: Consider accessibility and usability beyond the procurement phase -	Provide patient support (through digital navigators, staff providing support etc) -	Full equalities impact assessments should be undertaken -	Collect feedback from non-users -	Communications with patients should be a considered at every stage of their remote monitoring journey -	Healthcare professionals: encourage ongoing clinician engagement -	Include guidance around how to communicate effectively and empathetically with patients in clinician training  -	Include practical details on what is entailed in working with a RM solution in job descriptions -	Put in place appropriate communication strategies to increase awareness of RM solutions among staff   HealthCare Organisation: -	Delivery teams need to work on the ground with clinicians  -	Ensure there is some protected time for staff to engage, support and deliver RM Services -	Adequately resource with administrative and project management support from the onset -	Consider using evidence-based project management tools specifically developed to support the effective and efficient implementation of technology in health such as NASSS-CAT tools -	Prioritise data monitoring needs, with some standardised data fields in place -	Agree on SOPs for each pathway with clinical and operational stakeholders in all boroughs where they will operate -	Establish IG requirements and clearly communicate them to suppliers at the earliest possible  Wider System: -	Alignment of objectives and priorities can be facilitated through regional clinical reference groups, local, clinical champions and significant ongoing public engagement and dialogue Embedding and adaption over time: -	Evaluations should be repeated to determine if/ how the benefits of RM implementation and delivery change overtime