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Found 25 results
  1. News Article
    More than 100,000 patients, including children, have been treated in so-called virtual wards over the last year, NHS officials have said. Leading medics said that the use of the system to monitor patients at home has been a “real game changer”. Officials say virtual wards can help patients avoid unnecessary hospital trips altogether, or enable them to be sent home from hospital sooner. Using various equipment and technology, clinicians can monitor vital signs such as a patients’ heart rate, oxygen levels and temperature remotely. NHS England’s national medical director, Professor Sir Stephen Powis, said: “The advantages of virtual wards for both staff and patients have been a real game-changer for the way hospital care is delivered and so it is a huge achievement that more than 100,000 patients have been able to benefit in the last year alone, with the number of beds up by nearly two thirds in less than a year. “With up to a fifth of emergency hospital admissions estimated to be avoided through better supporting vulnerable patients at home and in the community, these world-leading programmes are making a real difference not just to the people they directly benefit but also in reducing pressure on wider services.” Read full story Source: The Independent. 11 March 2023
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    Norfolk Community Health and Care it is using a remote monitoring service from Inhealthcare which allows patients to monitor their vital signs at home and relay readings via a choice of communication channels to clinicians who monitor trends and intervene if readings provide any cause for concern. Analysis of the six months before and after introduction showed a significant reduction in hospital bed days, A&E attendances, GP visits and out-of-hours appointments. Lead heart failure nurse at the trust, Rhona Macpherson, spoke to Digital Health News about the impact of the services on patients and nurses. For Macpherson, the service has helped promote self-management. “We give each of the patients a set of scales, blood pressure monitor and pulse oximeter and we get them to do their observations,” she said. “So we’re promoting self-management and looking at things but also it means that we can get accurate information on what’s happening with their observations. “We then set parameters to alert if they go outside of the parameters, and it just means we can intervene much more quickly than we would do, and we can see what’s going on between our visits as well as what’s happening when we’re actually there.” The service has transformed working practices for nurses, increasing efficiency and saving valuable time. Macpherson said: “We’re using the technology to try and make ourselves a little bit more efficient, so it’s saving on the travel time and face to face visits. “We can do a lot more with telephone. We’ve got the option of using video, but telephone is actually quite useful. So it’s less face to face visits, less travel and also, we’re trying to empower the patients to do their own observations and monitor themselves, rather than us just doing it for them.”
  6. Content Article
    The practice of video consulting was equivocal. Accounts of, and preferences for, video consulting varied as did the extent to which it was sustained after initial take-up. People made sense of video consulting in different ways, ranging from interpreting video as offering a new modality of healthcare for the future to a sub-optimal, temporary alternative to in-person care. Despite these variations, video consulting became a recognisable social phenomenon, albeit neither universally adopted nor consistently sustained. The nature of this social change offers new perspectives on processes of implementation and spread and scale-up. The findings have important implications for the future of video consulting. The authors emphasise the necessity for viable material arrangements and a continued shared interpretation of the meaning of video consulting for the practice to continue.
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    The AHSN North East and North Cumbria (AHSN NENC) Well Connected Care Homes Programme commissioned a small-scale evaluation of a new digital health intervention that aims to enhance the appropriateness of healthcare received by care home residents and the skills of care home staff. The goals were to: support care homes in becoming internally and externally ‘well connected’ in the digital age; to enhance the quality of care experienced by care home residents, and by significantly improving communication between care homes and the external health environment. This would provide better and more efficient cost-effective care. It had the following elements: to improve record keeping of care home residents by using tablet-based apps to allow electronic recording of aspects of care plans to train qualified and unqualified care home staff to make and record relevant clinical records (NEWS scores) to promote use of electronic communication of patient clinical information between care homes and primary care (GP electronic patient records), emergency care (including out of hours), and ambulance services and community services.
  9. Content Article
    What will I learn? What is telehealth? How could telehealth help me? What is telecare? How could telecare help me? How to get telecare products and services What do I need to consider when buying telecare products? What should I do next?
  10. News Article
    The Royal Surrey County Hospital is preparing to open its first virtual ward. From this summer 15 patients will receive treatment at home using apps and wearable technology, as an alternative to a stay in hospital. The ward will be overseen by a consultant, working with therapists, nursing staff and pharmacists. The hospital, in Guildford, plans to extend the ward to 52 patients by April 2024. Health providers across England have been asked to deliver virtual wards at a rate of 40 to 50 beds per 100,000 people by December 2023. It is hoped they will free up beds more quickly, speeding up admissions from A&E and for elective surgery. Read full story Source: BBC News, 7 June 2022
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    In a recent study, Trish Greenhalgh's team looked at why some remote consultations by video are efficient, effective and well-received but others are logistically cumbersome, technically inadequate and associated with deficiencies in care, such as missed diagnoses or a poor patient experience. While it’s impossible to generalise, remote consultations seem to be less suitable for people who are very young or very old are very unwell with a high-risk condition, such as pneumonia have complex health or wider needs want or need a physical examination have difficulty communicating (though the hard-of-hearing may prefer a video link where neither party wears a mask) need supervised check-ups, for example, for controlled drugs do not own, or wish to use, technologies like smartphones lack privacy at home. Her research has shown that GP consultations should not be remote by default, but that with attention to infrastructure, training and planning, remote consultations could become a realistic option for a much wider range of people than the healthy young professionals towards whom they were originally targeted.
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    Last week a receptionist saved a patient’s life. She put him straight into a face-to-face appointment early in the day. The doctor saw him and sent him to A&E urgently. He was operated on the same day. Receptionists are are given an impossible task, to fit a large number of patients into a small number of slots, and they have to stay calm. When the slots run out – which sometimes happens by 9am – they then have to persuade one of the doctors, already at the end of their tether, to add any patient they are especially worried about to their list. So it’s not surprising that when during the early part of the pandemic demand for appointments dropped by 30%, some very stressed and overworked GPs found their lives were a lot nicer without patients. And now that appointment levels have finally (as of May 2021) gone back to normal levels, some are finding the demand very difficult to cope with. This could explain GPs’ persistence at keeping patients at arms length. Telephone consultations are less intense somehow, less tiring. Some GPs feel they can control the day better by using telephone consultations and only bringing in some patients. But patients are experiencing this persistent distancing as rejection. And these rejections are hurtful. Some people have held on to problems for six months or more and then finally felt free to book an appointment when the restrictions ended in August. Except the restrictions haven’t ended, not in general practice. GPs seem unable to let the remote triage go. GPs say: “We are seeing patients face-to-face. We’ve been seeing them throughout the pandemic,” which is true. But only some patients. Plenty of patients who would have benefitted from a face-to-face appointment or an examination have not been seen. Patients are not idiots. They know telephone consultations are not as good. They know, especially older patients, that proper doctoring involves an examination. They know that the rapport and connection with a doctor can only come from a face-to-face appointments. And they wish to book an appointment with their GP themselves, without facing multiple barriers. Read full story Source: The Independent, 6 November 2021
  15. News Article
    Patients being assessed remotely in general practice, rather than face-to-face, has been raised as a risk in reports on five deaths by a single coroner since the pandemic hit. Senior coroner for Greater Manchester Alison Mutch has written five prevention of future deaths reports highlighting concerns that doctors were missing details in telephone appointments which may have been spotted, had the patient been seen in person. The reports cover a variety of conditions, including covid, a broken femur, and anxiety and depression. In March 2020, NHS England guidance instructed GPs to adopt a “total triage” approach, where face-to-face appointments should generally only follow a phone, video or digital consultation. But, in May, NHSE wrote to GPs to ask them to “ensure they are offering face to face appointments”, adding remote appointments “should be done alongside a clear offer of appointments in person”. There have been growing calls in the media for increased face-to-face appointments, while, in March 2021, a report by Healthwatch concluded: “While telephone appointments are convenient for some, others are worried that their health issues will not be accurately diagnosed.” Maureen Baker, former chair of the Royal College of GPs and Patient Safety Learning trustee told HSJ she was “not aware pre-pandemic of any major concerns with remote consulting”, adding: “It’s not that things don’t go wrong. They do, but things can and do go wrong in face-to-face consultations as well.” “Many practices have been using remote consulting very successfully for many years [but for GPs introducing remote consultations during the pandemic] the concern is that practices will have had to change and implement it very quickly.” Read full story (paywalled) Source: HSJ, 9 September 2021 You may also be interested in a recent blog from Trish Greenhalgh: 'Why remote consultation with a doctor is difficult – and how it can be improved'
  16. News Article
    Monica Evans's initial misdiagnosis could have proved life-threatening – and she is just one of many to have suffered during pandemic. Since The Telegraph began reporting on the struggles of patients around the country to access GP services during the pandemic, they have been inundated with messages and letters. There have been multiple stories of serious misdiagnoses made after telephone consultations with doctors that took place in lieu of face-to-face assessments; of interminable waits to get through to practices on jammed phone lines; and of lengthy delays while worried patients have waited for referrals to be made. Those who shared their experiences have also shared their fury, frustration, fear and dismay. Some who could afford to have felt they had no option but to turn to private healthcare, unable to obtain the help they needed from an NHS struggling with Covid and all its knock-on effects. Others have been left with nowhere to turn. GPs have spoken, too, about their dissatisfaction with a system that has discouraged face-to-face consultations. Amid an outpouring of anger from both patients and doctors, NHS England yesterday rowed back on plans for "total triage" of patients to keep them out of surgeries whenever possible. But for many the damage has already been done. Read full story (paywalled) Source: The Telegraph, 13 May 2021
  17. Content Article
    Researchers from the Faculty of Health at the University of Plymouth together with collaborators from NHS Trusts in Devon and Cornwall have been working on developing an online toolkit of resources – ‘The Telerehab Toolkit’. The toolkit is designed to support health and social care practitioners in the remote assessment and management of people with movement impairment and physical disability, including people recovering from COVID-19. This project has been funded by the UKRI Medical Research Council. The content of the toolkit is based on interviews and discussions with over 100 practitioners, patients and their family members, a survey of 247 UK practitioners and a review of the latest evidence. It contains sections for practitioners and for patients, with information and guidance on online and telephone appointments as well as links to other useful resources.
  18. News Article
    Long delays for coronavirus patients to get through to NHS 111 call handlers while other seriously ill patients were told to stay at home have prompted a safety watchdog to launch an investigation of the phone triage service. The Healthcare Safety Investigation Branch (HSIB) has launched an inquiry into the handling of coronavirus calls by NHS 111 – the first port of call for patients when they become unwell. During the pandemic the NHS 111 service set up a dedicated COVID-19 Clinical Assessment Service (CCAS) but concerns over the safety of advice given to patients saw nurses and non-medical staff stopped from taking patient calls in August last year. Now concerns from a number of patients and families have led the independent HSIB to launch a review of the service and to identify any learning and improvements. HSIB told The Independent the investigation was at an early stage and it was not yet certain of any direct link to patient harm. It said the number of patient cases could grow but that it had initial family concerns related to difficulties getting through to NHS 111, long delays in getting clinical call backs after an initial triage call and concerns that some patients were told to stay at home when they were seriously ill. Read full story Source: The Independent, 23 March 2021
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    Hundreds of people believe the helpline failed their relatives. Now they are demanding their voices be heard. Families whose relatives died from COVID-19 in the early period of the pandemic are calling for an inquiry into the NHS 111 service, arguing that many critically ill people were given inadequate advice and told to stay at home. The COVID-19 Bereaved Families for Justice group says approximately a fifth of its 1,800 members – more than 350 people – believe the 111 service failed to recognise how seriously ill their relatives were and direct them to appropriate care. “We believe that in some cases it is likely these issues directly contributed to loved ones dying, due to causing a delay in receiving treatment, or a total lack of treatment leading to them passing away at home,” said the group’s co-founder Jo Goodman, whose father, Stuart Goodman, died on 2 April aged 72. Many families have said they had trouble even getting through to the 111 phone line, the designated first step, alongside 111 online, for people concerned they may have COVID-19. The service recorded a huge rise in calls to almost 3m in March, and official NHS figures show that 38.7% were abandoned after callers waited longer than 30 seconds for a response. Some families who did get through have said the call handlers worked through fixed scripts and asked for yes or no answers, which led to their relatives being told they were not in need of medical care. “Despite having very severe symptoms including skin discolouration, fainting, total lack of energy, inability to eat and breathlessness, as well as other family members explaining the level of distress they were in, this was not considered sufficient to be admitted to hospital or have an ambulance sent out,” Goodman said. Some families also say their relatives’ health risk factors, such as having diabetes, were not taken into account, and that not all the 111 questions were appropriate for black, Asian and minority ethnic people, including a question to check for breathlessness that asked if their lips had turned blue. Read full story Source: The Guardian, 21 September 2020
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    This webinar will be of interest to: anyone currently working in a nursing/allied health professionals (AHP) clinical informatics role those who aspire to develop their career in this area those who are seeking to set up such a role within their organisation those currently working with CNIOs/AHP informatics leads. Attendees will learn: more about how CNIO/AHP informatics roles are currently set up in the NHS – time commitment, reporting structures etc what the profile is of those holding such roles about possible challenges in connections between CNIOs/AHPs in informatics roles and CCIOs and CIOs thoughts on whether the CNIO/AHP informatics role should be formally recognised further views from senior leaders on the future of these roles.
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    The virtual service was implemented initially as a work-based project by the Hospital Liaison Nurse (HLN) over an 18-month period between 2017 and 2019. It was designed to keep the patient very much in the centre of their care with regular patient/carer remote contact, ongoing assessment, monitoring, clinical decision making and person-centred care planning. In a consultative capacity, the HLN was enabled to work remotely and maintain ongoing close patient/carer contact, effective case management and improved communication across multiagency professionals. This included ongoing virtual collaborative working across care providers and professionals working within primary, secondary and tertiary health and social care services. Overtime, by embedding person centred care and coordination into clinical practice; it became clear that the approach of the HLN’s role shifted from reactive to proactive care provision. This was likely due to early recognition and earlier response to the subtle signs of deterioration in the patient condition. The initial findings highlight the potential of virtual care coordination, to essentially respond to the ongoing changing health needs of adults diagnosed with an ID and comorbidities and enable timely planning for the individual’s future longer term needs. This shared learning example relates to NICE guidance and quality standards: (QS153) on Multimorbidity (Statement 3 on coordination of care and (NG56) Multi-morbidity: clinical assessment and management. In particular this project takes into account NICE recommendations in relation to equality and diversity considerations and making reasonable adjustments as follows: healthcare professionals should take into account the needs of adults who may find it difficult to fully participate in a review of medicines and other treatments (i.e. those with learning disabilities, cognitive impairment or language barriers.
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