The East of England SHA, which has responsibility for commissioning NHS Direct on behalf of all SHAs, has approved funding for NHS Direct to run three new innovation pilots in 2010/11.
This is as a result of a new process developed by the East of England SHA and NHS Direct, whereby an idea for a new innovative service is developed, piloted and rolled out if the evaluation proves it delivers benefits to the wider NHS and social care.
The first three innovation pilots are:
This web-based project is one of the first of its kind in the UK, aimed at helping prepare patients for medical tests or treatments. Patient decision aids are designed to increase patients’ awareness of the expected risks and outcomes of their tests or treatments, supporting them to make informed choices about their care.
Introducing online decision aids for use across the NHS in England, will complement the ongoing work of the 18 weeks team who have been developing symptom-based commissioning pathways for each of the highest volume 18 week specialties.
If patients don’t have internet access or don’t feel confident using the online decision aids, NHS Direct health information advisers will support them to use the tools over the telephone.
Decision aids have been used widely in other parts of the world for a number of years. They can deliver many benefits including:
It has been estimated by leaders in this field that implementing decision aids for the top 12 most common procedures across the NHS would save £150 million per year.
Phase 1 of the project will pilot web-based patient decision aids for localised prostate cancer, benign prostatic hyperplasia and osteoarthritis of the knee, and phase 2 will trial decision aids for prostatectomy, breast cancer surgery and amniocentesis.
This project aims to improve the health of patients with long-term conditions or those at risk of developing them, by providing them with telephone and web-based motivational support. The service will be delivered by NHS Direct health advisors or health coaches, and will bring together the latest information, advice and techniques from both the NHS and the third sector. This 6-month pilot will help improve the health and wellbeing of up to 1,000 patients across a number of PCTs.
The Wellness service is designed to work either as a stand alone personal care plan or run along side local, face-to-face services such as Health Trainers, Healthy Eating and Exercise campaigns. In addition, the development of a user friendly website with webchat/social networking type facilities, will encourage peer support and enable patients to help each other rather than rely solely on health professionals.
There isn’t a service quite the same as this in the UK, but similar projects in the USA have delivered compelling results: a return on investment of $3-5 for every $1 invested in improving patients’ health and wellbeing.
The telehealth project is an extension of a small, but successful pilot being run in South East Essex, where NHS Direct health advisors remotely monitor and support patients in their own homes, who have Chronic Obstructive Pulmonary Disorder (COPD). The results to date in South East Essex have been impressive, so NHS Direct now plans to run a much larger project across two or three PCTs covering patients with long term conditions such as Chronic Heart Disease and Diabetes, as well as COPD.
This is a turnkey or ‘off the shelf’ type of service. The aim will be to asses whether it is nationally scaleable and can continue to deliver the huge patient and service benefits seen in South East Essex. At the same time, it is important that we can offer commissioners a fully managed ‘expert’ service at an affordable entry level, by capitalising on economies of scale, with commissioner commitment that as savings are generated, the service can be expanded.
NHS Direct is working with a number of PCTs and Acute Trusts on these three innovation pilots, but if you would like your organisation to be involved as well, please contact your Regional Director.
