Giving clinicians and patients the remote control

It is well recognised that the way the NHS manages care for long-term conditions (LTCs) is unsustainable (NHS England, 2016), and the need to establish new models, as laid out in NHS England's ‘House of Care’ framework (NHS England, 2016), is widely understood. Yet, despite the rationale and the consensus, implementing a solution at the local level remains a huge challenge. However, this need not be the case. Here, the author explores how remote monitoring could play a crucial role in re-engineering NHS pathways to cope with the growing problem of multimorbidity.

Trend lines undoubtedly show that the number of people with LTCs and multimorbidity continues to grow, placing intolerable pressure on services and pathways. More than 15 million people in England have at least one LTC, while the number of individuals with three or more is forecast to reach 2.9 million this year (NHS England, 2016). The implications are naturally significant. People with LTCs already account for 50% of all GP appointments, 70% of all bed days and around 70% of acute and primary care budgets in England (NHS England, 2016). As the population ages, these numbers are only going to increase. Recent research predicts that, by 2035, 2.5 million (17%) people over the age of 65 years will have four or more chronic illnesses. Around two-thirds of over 65s—a massive 9.7 million—will have at least two (Kingston et al, 2018). But the problem is not one for the future; it is one the UK faces in the here and now. The ability to establish effective models of LTC care is vital to the sustainable delivery of safe, timely and high-quality care. The question is: how can it be done? An evidence-based solution is available.