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Telehealth DES ‘will place pressure on practices’

Remote care monitoring will not reduce practice workload and the evidence for its benefit is limited, the BMA has warned.

The Government has proposed to introduce the scheme in April 2013 with a single national disease area, such as hypothyroidism, with a further locally agreed priority area to be established for the second year.

The official BMA submission to the consultation on the Government’s proposed contract changes says that it does not think this will achieve the Government’s stated aim of reducing unnecessary patient attendance at the practice.

It said that the administration involved in setting up remote care monitoring arrangements, such as agreeing how test results will be delivered and recording it in the patients’ records, will create ‘significant new workload for practices in setting up the required systems’.

The BMA added: ‘Patients will continue to book face-to-face appointments to discuss their condition despite the availability of remote monitoring; the evidence that the number of face-to-face appointments decreases with the availability of remote care monitoring is very limited.

‘In terms of the evidence, the conclusion from studies (including one of the largest telehealth and telecare studies ever conducted; the UK Whole System Demonstrator trial) is that the evidence does not warrant full scale roll-out, but more careful exploration. There are uncertainties about the cost, quality and safety of telehealth interventions, their effects on patient-clinician relationships, and their scalability and sustainability.’

The GPC also called for the arrangements for 2014/15 to be clarified. It points to the DH’s directions, which state that future conditions ‘will be specified by the [NHS Commissioning] Board’, despite claims that they will be agreed locally.  

The response added: ‘We would like clarity on this and feel it is essential that conditions within this scheme are decided locally, to take priority areas and the circumstances of each practice into account.’