Reducing unnecessary face to face contacts by using by using what we persist in calling the new technology (I wonder if people will be using the same phrase in 500 years time?) is one of the opportunities we have in our health system . We all bank online, text and coordinate our arrangements over the internet . Most people Skype and many ichat on a daily basis; and yet hospital appointments come through the post , there is no Utube video link provided to click on to see what a procedure or investigation is likely to entail and very few people are invited to email their doctors and nurses. Email of course isn’t the answer to all our communications! Yet the future is here in patches – renal patient view (RPV) is a great example and with the support of NHS Kidney Care is getting even better with the ability to write to, as well as read, the electronic clinical record. So that now, for instance, troublesome blood pressure can be managed and progress reviewed in partnership between patients, doctors and nurses without face to face visits. John Connelly and John Stoves’ system of virtual electronic consultation and the “green Coventry” transplant follow up clinics which were given a plug in the British Medical Journal’s leading article “The Greening of Medicine” on 16 January 2012 are further examples that have been show-cased on NHS Evidence. Oh yes and the videos are on NHS Choices.
I was at the DH/NHS Health Innovation Exchange programme launch on 30 January and Sir Ian Caruthers who led the recent innovation review for Sir David Nicholson made the point that we need the NHS to work towards reducing inappropriate face-to-face contacts and to switch to higher quality, more convenient, lower cost alternatives; well actually quoting directly from “Innovation Health & Wealth, Accelerating Adoption and Diffusion in the NHS“ Sir Ian said “ we will require the NHS to work towards …… “ and then went on to talk about the virtual consult service in Bradford that he used as a cast study in the report.
From April 2013, compliance with all the high impact innovations, and that includes offering non face-to-face appointments will become a pre-qualification requirement for CQUIN payments . (Commissioning for Quality and Innovation) CQUIN payments are a way of rewarding the Trusts for providing higher quality care, the quality measures are agreed at the start of the year, then measured and made public with money following quality. The kidney care CQUINs from April of 2012 have already set the ball rolling with access to RPV (LINK) as one of the easier quality targets to achieve this year. Money for old rope you might say but for most NHS organisations the whole CQUIN payment will amount to between £5 and £7 million and that’s the sum trust stand to be eligible for adopting the “new technology“.