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The Parliamentary Under-Secretary of State for Health (Dr Daniel Poulter)
It is a pleasure to serve under your chairmanship, Mr Havard.
It is also a pleasure to respond to this debate, and I congratulate the hon. Member for West Lancashire (Rosie Cooper) on securing it and on highlighting an important focus of future health care policy. She is right to highlight the Nicholson challenge: for the NHS just to stand still and to continue performing at the same level so that patients continue to receive the high-quality care that we all believe and know they deserve, it needs to make £20 billion-worth of efficiency savings and to put that money back into front-line patient care. A key part of the debate is that better IT will improve the way we communicate with patients and keep people well and better supported in their own home and community, on the basis that preventive health care is much better than curative health care, both for the patient and, financially, for the NHS. Of course, I would be delighted to meet the hon. Lady and people involved in the IT industry at a later date to discuss things further.
Although we know that simple things such as in-ear thermometers, improved hoists in hospitals and better-quality equipment in operating theatres has improved the quality of patient care over many years and driven down the cost of providing health care, the hon. Lady is right to highlight the fact that we need to harness and better utilise more modern types of technology such as telehealth and mobile technology to support people better in their own homes and to drive down the cost of care.
Last week, my right hon. Friend the Secretary of State for Health outlined the NHS mandate, in which he set out the vision for the NHS and addressed some of the key challenges that we face. In her speech, the hon. Lady rightly highlighted that we have an ageing population with many people living a lot longer with long-term medical conditions such as diabetes, cancer, heart disease and dementia. The challenge for the NHS is ensuring that we deliver care in a better way that meets people’s care needs while ensuring that, where we can, at the same time as producing high-quality care, we reduce costs so that there is more money to go around to look after more people.
My right hon. Friend the Secretary of State announced in the publication of the mandate that a real priority for the NHS is to improve the management of long-term conditions by helping people to better understand their conditions and to take control by supporting them to self-care, thereby realising the massive potential benefits offered by information technology both in supporting people to better understand and look after their conditions in the community, and in their own homes, and in supporting, better educating and better looking after the people who look after patients—the carers. That is an important part of providing high-quality health care.
We already know that there are 15 million people with long-term conditions, accounting for some 70% of all in-patient beds. We also know that many such hospital stays could be avoided through better management, including the better use of mobile technologies to prevent people from becoming so unwell in the first place that they need to be admitted to hospital. That would also help to prevent the revolving door of hospital admissions that sometimes happens when people do not necessarily have the support that they need and deserve when they are discharged from hospital, perhaps after a hip operation or similar stay.
Improving access and the quality of health care available to all patients is a key aim for the NHS, not just in meeting the Nicholson challenge but in improving day-to-day quality of care. Increasingly, technology will play a part in that: not just breakthroughs in simple day-to-day medical devices but changes in how we reach people in remote rural settings and in their homes and communities through the use of telemedicine, telehealth and mobile devices. We can and should take advantage of the deeply interconnected nature of modern society to improve people’s experience of health care and significantly increase our efficiency in delivering it.
There are infinite ways in which technology can transform how people access health and social care services. “Digital First”, a report published in July by the Department of Health, estimates that the NHS could save up to £2.9 billion by implementing just 10 simple actions to transform how people access health care. Those savings could be made almost immediately and with minimal investment by making use of existing technologies to reduce inappropriate face-to-face contacts.
There are many examples of simple things that can be done, such as having a doctor or nurse talk to a patient on the phone when they call to book an appointment or as an initial assessment. About one third of patients do not necessarily need a face-to-face GP appointment. Such conversations can reassure callers that they are okay and not that unwell, and that perhaps they should see how things go overnight or later in the day and call back if they need further help. They also help the patient access health care in the most appropriate way, as the GP triages the patient remotely.
Texting and e-mailing people to remind them of appointments has already been shown throughout the NHS to reduce the number of people who fail to turn up to their medical appointments. One big challenge in health care is getting patients to attend and comply with treatment, particularly those with longer-term conditions who must make multiple trips to a hospital or care setting. E-mails and texts are an effective way to remind people about their appointments and help educate them, removing the burden from the acute setting by ensuring that they understand how better to manage their conditions.
Those are simple changes, using the technologies that people use every day and are already familiar with, that can free hundreds of millions of pounds and provide more convenient access to NHS services, particularly for patients who live in more remote and rural parts of the country.
Technology can also improve the working lives of professionals. The funds that we are making available to nursing staff will enable them to access information faster so that they can spend more face-to-face time with patients, an important point that the hon. Lady made in her speech. Doctors, nurses and all health care professionals want to spend time looking after their patients. They do not want to be bogged down in paperwork. Technology, whether used on the ward or to access and look after patients remotely via telehealth or mobile technology, is a good way to ensure that front-line health care professionals have more time to do what they want to do and what they are trained to do: care for and look after the sick and patients.
I have seen at first hand the potential of telehealth and telemedicine to transform and save people’s lives. Earlier this month, I visited the telehealth hub at Airedale NHS Foundation Trust, which I know is on the other side of the Pennines from the hon. Lady’s constituency, but I am sure she will not mind my using it as an example. The hub is staffed 24 hours a day, seven days a week, by skilled nurses specialising in acute care. A consultant is also on hand if needed.
The aim of the service is to care for patients closer to home and keep them there whenever it is safe to do so. In other words, it ensures that people are properly supported and well advised in their own homes and other care settings, such as residential homes, so they do not become as unwell as they might otherwise. They are given appropriate health care advice, guidance and support in their homes and care settings, which helps reduce the burden on acute services in the area. It is particularly important in more rural areas, where the distances that professionals must travel to look after patients are so great that the only effective way to get around to as many patients as possible, in both financial and human care terms, is to use the benefits that telehealth brings to Airedale and the surrounding areas.
Evidence suggests that many patients are admitted into hospital when, as we have discussed, that is not always the best environment or the most appropriate place for them. Using telemedicine allows patients to manage their conditions with the hospital’s support. It can prevent time-consuming, costly trips to hospital for outpatient appointments. The patient’s GP is instantly informed and kept up-to-date about any consultations that occur via the telehealth care hub.
Importantly, the Government do not want such initiatives to take place in isolation. We believe, as I know the hon. Lady does, that we must ensure that they become day-to-day occurrences in the NHS as the years go on. Technology and the better use of information provide immense opportunities for improving the quality and accessibility of NHS care, not just in remote rural settings but in every care setting that we can think of.
The Government’s information strategy for health and social care, “The Power of Information”, is another example that highlights the importance of harnessing innovative new technology and delivering better health for patients. The strategy, of which I know the hon. Lady will be aware, was published in May, setting out ambitions for people to be offered online and mobile access to records, electronic communication with professional teams, online health and care transactions and the ability to rate services and provide feedback about how effective and convenient they were for the patient.
A small number of actions will need to be led nationally, such as setting common standards to allow information to flow effectively around the system. More detailed implementation planning will be led by organisations including the NHS Commissioning Board to ensure that current good localised initiatives in different parts of the country are rolled out nationally. We learn from areas such as Airedale, where looking after people in their own homes through the better use of technology is going well. Those examples should be rolled out to become the norm in the NHS. I know that the NHS Commissioning Board will be central to driving that through, which is why improving information technology was at the heart of the NHS mandate launched last week.
Mainstreaming assistive technology across the NHS is particularly important. As we have discussed, it is not good enough to have high-quality localised initiatives; we need a systematic, NHS-wide approach that embraces technology. My right hon. Friend the Secretary of State for Health announced at the Age UK conference last week that plans have been agreed that will ensure a further 100,000 people will be supported by telehealth in 2013, a sixteenfold increase in the number of people being helped by telehealth and telecare. It will make Britain the largest market in the world behind the USA, which is something that we can all be proud of.
The recently published results from the whole system demonstrator programme are potentially game-changing. We now have robust academic and scientific evidence that such technology can drive improvements not only in quality and value in the NHS but in patient satisfaction levels and outcomes. We all know that the most important people in all these discussions are the patients whom the clinician looks after and the telehealth provider wants to look after. Importantly, when we are designing telehealth services, like all other NHS services, we need feedback from patients in order to ensure that where services are working well, they can be rolled out elsewhere in the NHS, and that where improvements could be made and things are not going so well for patients, the NHS can learn from that and adapt technology to improve care in future.
At the Age UK conference last week, my right hon. Friend the Secretary of State announced some significant steps on the road to supporting the 3 million people who stand to benefit from telehealth and telecare by 2017. As the hon. Lady said, the key is improving care for older people. They are the biggest users of NHS services, so they will see the most immediate changes and feel the most immediate benefits from telehealth. We have a growing elderly population and growing numbers of people with multiple long-term conditions. In order to meet the challenge of looking after them properly and providing dignity in elderly care, we must ensure that we keep them well at home and in their communities. One significant part of the answer is doing more for telehealth. The Government are well on the road to doing so. I welcome further discussions with the hon. Lady about what more we can do to look after people, particularly the frail elderly, in their own homes.
Mr Dai Havard (in the Chair)
Thank you, Minister. I am sure that you will have interesting discussions with your colleagues in the devolved Administrations about interconnectivity as well.
Question put and agreed to.