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Successfully delivering care closer to the home could provide better, healthier outcomes for patients and help ease NHS budgetary pressures by saving £3.4 billion a year, according to a CBI Public Services report published.

Katja Hall, CBI Chief Policy Director, said:

“The UK’s healthcare system is being squeezed by a combination of demographic, social and budgetary pressures that are likely to intensify, so business as usual is not an option.

“We urgently need to look at new ways to increase levels of home care which can deliver better outcomes for patients and savings for the NHS. The use of technology, like interacting with patients through their TVs and equipping healthcare staff with smartphones to improve remote working, can help achieve this.

“Some commissioners are already working with the private sector to successfully put these advanced healthcare systems into practice, but there are still too many barriers preventing them from becoming widespread.

“Opening up the market will allow a diversity of providers to deliver high-quality, innovative care to patients and better value to the taxpayer.” 

The demographic and social pressures on the UK healthcare system include:

• The number of people over the age of 85 is expected to double over the next 25 years
• Care for diabetes is projected to account for almost a fifth of the NHS budget by 2035
• Almost half of men and over 40% of women in the UK could be obese by 2030

Alongside these pressures the NHS must deliver efficiency savings of £20 billion by April 2014, including reducing unscheduled hospital admissions by 20%, reducing the average length of hospital stays by 25%, and by maximising the number of people managing their own health.

• Remote working, including the effective use of smartphone technology, has the potential to save £1.9 billion pounds annually, by minimising the time that clinicians spend travelling, filling in forms and checking records, therefore maximising the time spent with patients.
• Wider adoption of homecare could save £1.3 billion annually by lowering unnecessary hospital admissions, facilitating early discharge from hospital and by preventing those with long-term medical conditions from suffering complications. This would also support the elderly to live independently in their own homes.
• Telecare and telehealth solutions could save £240 million annually
• Telecare systems, such as those used by Wakefield Council, supply patients with pendant alerts and fall sensors on beds and seating which alert carers and relatives to a need for help.
• Telehealth systems, such as Motiva used by Newham Council, interact with patients through their TV, making it easier for them to follow a prescribed course of treatment and for clinicians to monitor their wellbeing.

A control trial of telehealth and telecare involving nearly 7,000 participants resulted in much better patient outcomes, including reductions of 45% in mortality, 21% in emergency hospital admissions and 24% in elective admissions.

The CBI report sets out eight recommendations to remove barriers in order to make the delivery of care close to the home more widespread:

1. Monitor should review the financial incentives and disincentives that inform the length of hospital stays – currently an acute trust which discharges a patient earlier than the Department of Health expects is likely to receive reduced tariff payment.
2. Monitor should work with the independent sector to ensure financial and regulatory checks are not overly burdensome so as to act as barriers to market entry or innovation.
3. The NHS Commissioning Board (NHSCB) should establish a ‘Challenge and Learning Network’ for Clinical Commissioning Groups (CCGs) so that commissioners can share experiences and best practice.
4. The NHSCB should work with commissioners and their industry partners to establish common metrics to make it easier to compare clinical products and services.
5. The NHSCB should issue guidance to help CCGs structure their relationships with the independent sector in a positive way – a narrow focus on the in-year unit price, rather than the cost savings over the lifetime of the service and the uneven sharing of financial risk can be counter-productive.
6. The Department of Health should set up a secondment scheme between providers and NHS commissioning teams, similar to those established by the Cabinet Office, to develop better commercial awareness in the public sector.
7. Health Education England should place a greater emphasis on home and community care in medical training and education.
8. CCGs should engage with providers who successfully harness technology to facilitate remote working – for example, community nurses should be able to upload clinical data remotely when they return to their car, rather than returning to the office every few visits.

A a link to a full copy of The right care the right place: delivering care closer to home is below.

 Notes to Editors:

The CBI is the UK's leading business organisation, speaking for some 240,000 businesses that together employ around a third of the private sector workforce. With offices across the UK as well as representation in Brussels, Washington, Beijing and Delhi the CBI communicates the British business voice around the world.

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