Sir Bruce calls for support for technology enabled care services programme

Professor Sir Bruce Keogh has outlined NHS England’s plans for further developing Technology Enabled Care Services (TECS).

In a letter written to around 250 key stakeholders, NHS England’s National Medical Director calls on them to support the programme that takes the NHS into a new and exciting technological era that will help empower patients and improve health outcomes.

Sir Bruce has told a broad range of organisations from across health, social care, industry, and the third sector: “Present and emerging technologies offer opportunities for us to transform the way we engage in, and control, our own healthcare.

“Imagine the degree of personal control that could be afforded by a smart phone configured for medical applications, coupled with wearable biosensors and capable of sensing, analysing and displaying vital signs and alerting you and your clinicians to significant changes or deterioration wherever you are, rather than through check-ups at a hospital or GP practice. Any escalation in a condition could be identified and addressed in a timely and proactive way. It would lead to better health outcomes while being more convenient for the patient, their carer and their clinician.

“This is the future of healthcare. Twenty years from now, we will use technology to access our health services as a matter of course. That future is fast approaching as technologies constantly evolve, adapt and improve.”

Sir Bruce points out that a growing older population – with an estimated three million people living with three or more long-term conditions by 2018 – is only going to increase pressure on the NHS, adding: “One opportunity lies in the fact that people increasingly want to own and control their own healthcare. By harnessing the power of digital technology we can help by empowering people to manager their care in a way that is right for them.”

The TECS programme has been born out of its predecessor, the 3millionlives programme, which Sir Bruce says “went some way towards making a clear case for tele-health and tele-care – and there are now a number of examples of tele-interventions being used very successfully.”

NHS England undertook a review of the programme in April 2013 which has led to a shift in the strategic direction of the TECS programme.

“The TECS programme has been re-focused to address the demand from health and social care professionals for support and practical tools to commission, procure, implement and evaluate technology enabled care services,” writes Sir Bruce. “Our ambition is to create the right commissioning environment that supports and encourages the innovative use of technology to improve health outcomes, empower patients, and deliver more cost-effective services as part of a modern model of integrated care.

The TECS Stakeholder Forum’s collective views and proposals on how to address the barriers to wider adoption now form the basis of the TECS Improvement Plan 2014-17.

“I am eager to share the important proposals which you collectively identified as being key to delivering improved patient care and operational efficiency through TECS. I am confident that these proposals are the right way forward and will move us closer towards achieving the ambition to improve the lives of people with long term conditions through the use of TECS.”

Sir Bruce explains: “To ensure continued progress, we have brought together a TECS Implementation Group consisting of experts and leaders from across these sectors whose remit is to support the strategic development and delivery of the proposals within the Improvement Plan. In addition, we have formed the TECS Executive Steering Group which meets regularly to provide clinical, technological and strategic leadership for the programme at a director level in NHS England.”

An online toolkit, aimed at helping commissioners and health and social care professionals maximise the benefits of TECS, will be launched later this autumn.

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  1. Dr Mark Tan says:

    It’s all well and good dreaming about how technology can help with care. However, the basis for the connectedness and integration which is written about lies in the interoperability of the IT systems, of which the NHS has very little to offer. As Dr Johnson has eluded to, NPfIT failed at creating health information interoperability, despite 11billion and 10 years. However, this idea of integrated care through IT is not new, and started in the 1970s. Unfortuantely though, short-sightedness and funding cuts (among other factors) meant that it was abandoned on grounds that it could be managed just like any other NHS project, left to individual regions and initiatives. Information technology does not work like that, and I don’t think Sir Bruce realises the commitment (and funding) needed to fully integrate IT systems necessary for TECS to work.

    Regarding patient self-care, a good lesson is from Denmark. Yes people may say they want to be in charge of their own health. However, Denmark’s eHealth programme since 2001, has not seen sufficient uptake. Keep in mind Denmark is a leader in telemedicine and telehealth. It will take tremendous commitment from exceptional thinkers and dreamers, plenty of financial support without funding cuts, an allowance to override the bureaucracy inherent in such a behemoth of an organisation to make this dream a reality.

    Finally, all this takes one thing for granted; that the NHS is willing to invest now to save in the long term.

  2. bruce ure says:

    Your aim is to make better use of technology to slash costs. As a media company we have been successful in persuading Councils to make considerable savings by carrying fee paying local business adverts on their websites. To date, having contacted a number of NHS TRUSTS there appears to be a lack of will to reduce their costs by doing the same to reduce their costs.
    As the NHS has to make savings of £22 billion by 2020 can you kindly give me the name, and phone number of someone who has the authority to discuss and develop this POSITVE SAVINGS PROGRAMME for the NHS

  3. Dr Paul Johnson says:

    The SWD telehealth program should never have been performed withe the evidence of the day and primative technology used. It was 20th century thinking and technology. It was impossible to discover how it passed ethics approval let alone funding (31 million GBD). Just like the connecting for health before it (13 billion). Thank goodness the SWD was not extended to 3 million lives.

    If TECS has been ‘born out of SWD’ then we have right to know who the TECS experts are as we await the plan.

    On the other hand, the Future View contains potential- IF the innovation ‘centers’ are to use wearable wireless monitoring with smartphone, which is available now SIR Bruce (not necessary to speculate in the future) then it should be recognized that this is truly innovation ‘outside the box’ -disruptive innovation to many -creative innovation to others. Since it moves self-care into the hands of the public -not just patients – if health promotion and disease prevention is to be taken seriously (With an ROI on primary prevention over trying to treat NCD resulting from poor life-style, a collective responsibility of society -public and corporate -of 5-7 fold the case not to invest heavily in prevention amounts to criminal neglect beyond the social injustice of healthcare today.

    These ‘beacon sites’ should be inclusive participatory personal community-wide (250-500,000) including simulators for evaluating whole- person whole-community programs adopting apparently long forgotten n-of-1 trials which shorten and economize evaluation. BEFORE any national roll-out is considered. Economic (cheap compared to the gross excesses of the past), rapid and based on an unprecedented level of contextualized practical clinical science. Another advantage is that this inclusive community-wide approach only requires one progressive community to participate and does not ‘threaten’ conventional care UNTIL PROVEN. Last chance saloon for England’s population health.
    More if required.

  4. Dean Ayres says:

    I have taken an avid interest in telehealth, telemedicine, telecare and telecoaching over the last 10 years. Often it is aimed at those with longterm conditions such as COPD or Heart Failure.

    We may be missing a trick, telehealth (and we must be wary about these meanings) could be used by the those in the last few weeks of life, to ensure that support is provided in a timely fashion. Those who are heavy users of services (for example those that make frequent calls to the Ambulance Service, 111, GP and Social Services and others) can benefit from teleheath and telecoaching technologies.

    Would a lonley older person prefer a 30 minute chat with some one over Skype than a scant few words with the carer who is meant to visit for 15 minutes (and do a number of tasks). Virtual coffee mornings are not difficult to arrange and do not require huge costs.

    I have previously taught people in thir 90’s to use this stuff (if you can manage the remote for the TV you can do telehealth), Technology need not be that hard!

  5. Gill Bennett says:

    We are embarking on a consortium scheme with builders and education to build and supply a living through to end of life care facility linked to an education facility and will be building and developing new technology into build and outreach services with PASA approved partners and would like to be involved or have people from the DH leading on this talk with us

  6. Pauline Hardinges says:

    All sounds good but what about people with mental health problems how will they cope? What about people who have no one to look after them or is this new era not designed for frail elderly without the ability to manage these concepts.

  7. Paul Hardy says:

    Yes, yes, yes! Let us work smarter not harder. There are loads of opportunities, can we have more visioning, then help and support to implement.

  8. Angela Thompson says:

    As a previous particicipant in the 3 million lives campaign and as a supporter of the use of technology to improve patient outcomes and experience how can i engage and represent my organisation? Particular interests are supporting patients with long term conditions through the use of telehealth, skype and video-conferencing, as well as the use of apps.

    Best wishes

  9. Simon Arthur says:

    We at West suffolk CCG beleive that appropriate and early adoption of TeleHealth and Telemedecine.
    Please can we be on the mailing list when the Toolkit is launched

  10. Chris Russ says:

    Eager to get involved. I presently work for a CCG in Lancashire who are actively looking at how telehealth can support patients with Respiratory conditions, in particular COPD and Asthma.

    I would welcome the opportunity to be involved in this work and look forward to seeing the toolkit when released.

    • Martin Clark says:

      Hi Chris, Medtronic is currently working in the telehealth space with CCGs interested in large-scale service developments.
      We have recently completed a trial involving COPD patients and we have seen a significant reduction in GP visits as patients start to better self-manage their COPD.
      If you want to drop me a note, perhaps we can discuss how we might support you in Lancashire.
      Best wishes,

  11. Caroline Poole says:

    As a major provider wanting to build its offer of TECS, how can I find out more detail about the plans to date, and get involved?

  12. Edward O'Gorman says:

    Good Afternoon
    I work for Barnsley Telehealth service and we provide Telehealth services in Barnsley, Bassetlaw (Retford) and Birmingham

    Having read the information re: TECS and that it is NHS England’s intention to form a “TECS Implementation Group consisting of experts and leaders from across these sectors whose remit is to support the strategic development and delivery of the proposals within the Improvement Plan”

    Is it intended to ask for volunteers to form part of the groups or has this team already been brought together?

    The reason I ask is that I believe I could transfer my knowledge and skills that would assist in the provisioning of a new technology service aligned with the needs of patients and their care

    Having spent 35 years working for BT and 5 years working in the NHS I have seen first-hand how technology can assist patients to achieve a better standard of living.

    There is growing evidence that technology is working and the results we (Barnsley Telehealth) have achieved in Retford have been quite outstanding


    Edward O’Gorman

    • Nick Clarke says:

      I work for a charity running care homes, day centres and homecare services mainly for older people. I see great scope for technology in general to increase independence and quality of life. I note that intention is to support commissioners of services, as a social care provider we struggle with adopting a strategic approach to the issue and would welcome support