Remote monitoring and the potential benefits for patients with long term conditions

Dr Annette Pautz has been a GP at Holmwood Corner Surgery in South West London for 16 years. She is Deputy Chair for the Borough Committee in Kingston, Chair of the Council of Members for Kingston (a group representing Kingston GPs) and is also the clinical lead for community, care homes and respiratory in Kingston for SWL CCG. She believes introducing remote monitoring systems into care homes can have huge benefits both for primary care clinicians and care home residents. More than that, she believes it could be a first step to unlocking better care for larger portions of the population too.

Remote monitoring provides a way for us to effectively and actively monitor our patients in care homes, identify early deteriorating patients and get a much better idea of who needs a home visit urgently. This is particularly important when care homes are understandably trying to reduce the amount of people visiting because of the pandemic. It should also give GPs more certainty around their decision making – it can be difficult for a non-clinical person to describe why they are concerned over someone’s health, whereas the data provided by remote monitoring is in the ‘same language’ the GP uses.

In addition, if general practice has all this data, we can potentially link up with hospital consultants more easily and quickly to discuss a patient’s care. This will provide better and more responsive clinical care for care home patients without them having to wait for GPs or Community Healthcare Staff to do a home visit and then come back and prescribe. I think sometimes the system is a little slow for care home residents and this will provide a much more interactive, responsive service for them which will be better for patients and the care home staff who worry about them. That has to be a real selling point.

Listen to Dr Pautz talking about the benefits for primary care

I know primary care colleagues have concerns about whether these systems will integrate with their existing clinical systems or increase their workloads. That’s why we’ve made sure in South West London that the software which we have chosen will integrate with EMIS, the system which the majority of our GPs use. And rather than roll this out to all GPs at once, we will pilot it with a couple of our GP care home leads first. We’ve had good engagement from them through their PCNs and our hope will be that through the pilot we can identify a good process for monitoring and using the data.

Excitingly, if we can make a success of this in care homes then it opens up the possibilities for how we can look after people who are still in their own homes and move more care out of hospitals and into the community. It would definitely be useful for people with long-term conditions – patients will be able to learn more about their condition and take more control, reducing the need to go to a doctor’s surgery or hospital. It could also help with discharging patients earlier if they can be monitored at home.

Listen to Dr Pautz talking about the benefits for primary care

We have an opportunity now with the pandemic to see if we can roll this out and find a way to share this way of working with colleagues in secondary care. We’re already having virtual MDT meetings and there’s the possibility that the vital signs that are recorded on devices could be expanded to include spirometry, ECGs and ultrasounds. With these it will be vital to have the view of secondary care consultants and allied health professionals like radiographers where we can all see the same data in real time to give advice.

It is clear what we are looking to do with care home is the first step on what has exciting possibilities for how we care for large numbers of people in the near future.

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If you’re interested in finding out more you can contact the London Innovation Collaborative programme lead Fay Sibley.

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Support for the deployment of GP online consultation systems in south London

Support for the deployment of GP online consultation systems in south London

Since its inception, Health Innovation Network’s Technology team has been interested in how new communications technologies offer the opportunity to enhance healthcare interactions. Such interactions could include clinical consultations between a GP or specialist and a patient in general practice or hospital outpatients’ department. They could also include discussions between professionals, for instance:

  • A multi-disciplinary team (MDT) meeting in a hospital/community setting
  • A GP seeking the input of an expert specialist.

In July 2016,we undertook a review of the Hurley Group’s ‘eConsult’ (formerly ‘WebGP’) platform, in which we sought to understand the nature and extent of this particular opportunity to transform access to general practice. More recently, we have undertaken work to promote the spread and adoption, specifically, of video-based remote consultation in hospitals—often generically referred to as ‘Skype clinics’.

Given the announcement in October 2017 of NHS England’s GP Online Consultation Systems Fund, Health Innovation Network’s Technology team is now exploring how it could be of support to CCGs and GPs in south London as they progress plans to introduce or further develop provision for GP online consultation.

We are well-aware that CCGs across south London are by no means lacking in ambition where digital transformation is concerned, and many are already forging ahead with enhancements to primary care provision with online consultation solutions of one form or another at their heart. We watch these developments with great interest and excitement.

We would be interested to hear from colleagues across south London to understand your plans for offering GP online consultation, and to discuss how can best support you in this endeavour. We are in the process of engaging CCGs across the patch, but if you would like to discuss this support opportunity further now, please contact Tim Burdsey, Technology Project Manager at tim.burdsey@nhs.net We look forward to hearing from you—and to working with you, to help realise your digital ambitions for primary care and for your wider local health and care system.