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GPs sign up heart failure and hypertension patients for redundant remote monitoring DES

Exclusive Heart failure or hypertension are the main areas where GPs are recruiting patients for the remote monitoring DES this year - even though the enhanced service will not be renewed from April, Pulse has learnt.

Information from 29 CCGs obtained by Pulse revealed eight (28%) have chosen heart failure and seven (24%) hypertension, with hyperthyroidism, hypothyroidism and COPD also popular conditions.

The data - gained under the Freedom of Information Act from NHS England - show most CCGs have chosen one chronic condition to focus on, although some CCGs have offered practices a choice of which group of patients they wish to recruit for the DES.

Under the DES, practices must create a register of patients with those chronic conditions and record their preferences for receiving and monitoring tests.

This was meant to prepare practices for the rollout of remote monitoring of these patients next year, but the DES was cancelled in next year’s GP contract deal, with the funding transferred to a new unplanned admissions DES.

The data - which is the best available from NHS England area teams - show GPs are engaging with the DES, with between 74% and 100% already signed up at a total of 40 CCGs with information available.

For the 29 CCGs that already specified which condition they will be go for, most have come down on a single chronic condition

For instance, in Bristol, North Somerset, Somerset and South Gloucestershire CCGs, practices have been offered either three or two out of the conditions heart failure, COPD and diabetes.

In Kent and Medway CCG, 25 practices chose heart failure and 28 hypothyroidism, while 22 selected respiratory conditions in general and a further 45 asthma and 14 COPD specifically.

The DES was introduced in a move to drive forward use of remote monitoring technology to better support patients with chronic conditions in managing their health and reduce GP visits.

But now the DES is not going ahead next year, how telehealth and telemonitoring will now be deployed in these chronic conditions is unclear, especially since NHS England announced it had abandoned work in seven pathfinder sites in attempts to meet a Government target of 100,000 users of telehealth this year.

The Government says it is still committed to telehealth with plans to roll out the technology to three million users by 2018 under the 3millionlives project, but take-up has been slow, with concerns it will prove more costly than it is worth – and could end up putting more rather than less pressure on practices.

In scrapping the DES under the new contract deal, NHS England said: ‘We will continue to promote remote care monitoring in other ways. For example, remote care monitoring forms a core component of integrated care for the 3millionlives programme.’

Dr Michael Dixon, chair of NHS Clinical Commissioners and a GP in Cullompton, Devon, told Pulse the contract would allow practices to use their discretion on whether they should focus on telehealth in the future, although he conceded in an ideal world those that do not wish to pursue it would be able to drop preparations now rather than at the end of the year.

Dr Dixon said: ‘It does mean there will be some people doing work between now and April, spending time in order to get their enhanced service, who will then be stopping dead on April 1 when the enhanced service disappears.

‘That’s an inevitably when you change things. In an ideal world the best thing would be to drop the things we’re not going to be doing next year now. However, unfortunately the mechanisms for doing this don’t really exist.

‘On the other hand I think telehealth is going to be the future, in many respects. I think we have yet to find exactly what those are and in some cases I think it’s been a bit oversold – but with technology we tend to overestimate the importance in the short term but underestimate it in the long term.

‘The important thing is that enthusiasts do push the borders and then the rest of us can see where it’s particularly useful and follow pace. What this will do is leave it to practices’ discretion, so those who really want to push the boundaries carry on and those with too many other things to do can choose what the priorities are for their patients.’


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