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Technology Supported Setf Care (at Scale)

Partnering with healthcare, third sector and industry, the NHS in Liverpool has added capacity to community nursing services by building a remote telemetry hub. This hub, which is clinically staffed, provides patients (and their families) with: • education • information & advice • support to enable them to manage their long-term health conditions e.g. COPD, heart failure and diabetes. Patients (and/or families) use digital, peripheral devices to record vital signs which are monitored by clinical practitioners in the hub who use the data to decide upon the appropriate intervention. This is a mainstreamed, core funded service which has increased service capacity by in excess of 12,000 patients over the last 2 years, and currently supporting 1,100 at any one time. https://www.youtube.com/watch?v=fiw4zHefZXY
Geographical scope: 
Regional level
Region involved:
Countries involved:
Organisation name: 
NHS Liverpool Clincial Commissioing Group
Organisation address: 
The Department. 2 Renshaw Street Liverpool UK L1 2SA...
Kind of organisation: 
Local public authorities
Time for deployment: 
Between one year and three years
Preparation of implementation: 
Following a period of insight gathering, stakeholders were engaged to re-design COPD service/practice models. Focus was on patients managing their condition, with support from NHS community matrons. Designers worked alongside NHS service teams, technology companies and patients/families, to...
Investment per citizen / service user / patient: 
Between 100 – 1.000 EUR per targeted citizen / patient
Cost calculation: 
85 EUR for Provision of equipment (one-off cost) 59 EUR for monitoring (per month) After c12 months, as the patient gains confidence to manage their condition, ongoing costs reduce further for a “lighter touch” intervention 19-15 EUR for Provision of equipment (as an additional one-off cost) ...
Evidence of practice: 
Agreed evidence. Evidence is based on an agreed established monitoring system/process before and after implementation of the good practice
Evidence creation: 
Over 3 years 2234 patients with COPD, HF and diabetes patients were recruited through GP practice-based case finding. A study cohort of 1808 patients was matched to a pseudonymised control cohort that mirrored the study cohort in recruitment date, disease, age, previous emergency admissions,...
Maturity level: 
The practice is “on the market” and integrated in routine use. There is proven market impact, in terms of job creation, spin-off creation or other company growth.
Maturity level detalis: 
This service is funded from mainstream NHS budget i.e. it is now considered a core service of a large NHS commissioning organisation The operating, service and cost models are established within a large NHS provider Trust and capable: • increased scale • broader offer (to other service and...
Time of impact: 
Long term and sustainable impact – e.g. a long time after the pilot project ended and routine day-to-day operation began
Kind of impact: 
Better health (societal)
Aspects time of impact: 
Positive impact has been achieved in a number of the areas identified in this question. As stated above there has been positive impact upon the lives of patients and their families. Their health has improved and likelihood of hospitalisation as a result of condition exacerbation reduced. This...
Transferability level: 
The innovative practice has been transferred in other locations or regions or national scale in the same country
Transferability details: 
NHS Liverpool CCG is currently using the established service to seed pilot deployment: • to other service/condition areas • support timelier patient hospital discharge Pilot deployment is intended to support development of use cases to secure additional investment for service/practice...
Type of Practice: 
Good practice
Stakeholders concerned: 
Primary care centres
Specialised physicians
General practioners
Nursing homes
Informal caregivers
Private companies
Regional public authorities
Local public authorities
Reach of initiative: 
10,000 - 99,999
Age group: 
18 – 49
50 - 64
65 - 79
Baseline information: 
Liverpool is a vibrant, diverse and resilient City even though almost two-thirds of the population live in the UKs most deprived neighbourhoods and experience worse health outcomes in comparison with similar cities. All-cause mortality rate 25% higher than the national average for example,...
Source of funding: 
National funding