Bainbridge warns of need for telecare

Health and social care services have five years to develop the telehealth and telecare services they will need to cope with an ageing population, Dr Mike Bainbridge, NHS Connecting for Health’s clinical architect, has warned.

Speaking at a fringe session at this year’s NHS Confederation conference, Dr Bainbridge said that ageing combined with an increasing burden of chronic disease threatened to make current models of healthcare unsustainable within a few decades.

He said costs would start to rise in 2010 and that by 2050 “delivery using current models could cost four times what it does now – or 40% of GDP.” All developed countries were facing similar issues, he added, “but only in Britain are we seeing joined up thinking about how to handle them.”

Dr Bainbridge said that where most countries were still focusing on their acute and nursing home sectors, Britain was looking at getting care out into communities and homes and running whole system demonstrator trials of telehealth and telecare systems.

The whole system demonstrator project is underway, in Kent, Cornwall and Newham, but Dr Bainbridge said the need to get such systems in place was urgent. “We have to do this over the next five years if we are not to see the NHS go over the falls – the equivalent of Niagara Falls – with or without a barrel,” he said.

Bainbridge also argued that healthcare IT systems would increasingly need to deliver information to patients, as well as to clinicians, administrators and regulators.

Like many other speakers at the conference, he seemed fascinated by the possibilities opened up by Microsoft and Google developing platforms for patients to hold and share their own healthcare information.

“There are issues with citizen-entered data,” he acknowledged, admitting that professionals would need evidence about who it related to, to the quality of the devices that had gathered it, and its trustworthiness – as well as help to cope with the volume of material generated.

However, he said the NHS would not be able to resist the trend. “The data is going to start flowing over the next few years, so we are going to have to deal with it,” he argued.

Similarly, he said one of the key reasons for running the whole systems demonstrators for telehealth and telecare was to test how data generated by new monitoring devices could be directed into records and to monitoring and alarm services; and to examine how these should be managed and regulated.

Dr Bainbridge hinted that Lord Darzi’s Next Stage Review of the NHS would support the shift to community, home and personal care.

This was supported by other speakers at the conference, who said improving primary care would be one of the first “world class commissioning” challenges for PCTs, and that there would be no let-up on the GP-led health centre agenda, despite opposition from doctors.

However, like many other speakers Dr Bainbridge was unable to give details of the review or the Swindells Informatics Review, which he said would be published “any day now.”