Death of face-to-face doctor appointments? NHS 10-year plan reveals millions of GP visits and hospital consultations could be conducted through Skype-style videos to save cash
- Patients will be encouraged to have online appointments with specialist doctors
- Tens of millions of NHS appointments are to be carried out by video-link instead
- But GPs have warned that some symptoms can be spotted only by direct contact
Tens of millions of NHS appointments are to be carried out by video-link instead of face to face.
Health chiefs believe up to a third of the 90million outpatient consultations each year do not require a hospital visit.
They hope to save time and money by switching these over to Skype-style video services on smartphones or computers.
The plans were unveiled in Liverpool yesterday by Theresa May and health chiefs under a ten-year strategy for the NHS, which sets out how a £20billion cash injection will be spent
Patients will be encouraged to have online appointments with specialist doctors and manage long-term illnesses themselves.
However, GPs have warned that some symptoms can be spotted only by direct contact.
And Baroness Altmann, former director- general of Saga, said the scheme could be ‘devastating’ for the elderly, who are less computer savvy.
‘Sometimes machines really can’t replace the human touch – older people value that and need it,’ she added.
The plans were unveiled in Liverpool yesterday by Theresa May and health chiefs under a ten-year strategy for the NHS, which sets out how a £20billion cash injection will be spent.
Harnessing new technology will be a key part of the blueprint to deliver cost savings.
Theresa May visits Alder Hay Children’s Hospital wards. NHS England believes the total, which has doubled in a decade, can be cut by a third through ‘service redesign’ and a revolution in online healthcare
CAN GPS NOW DISH OUT DANCE CLASSES?
Health chiefs have also announced social prescribing by GPs will become more common under the new 10-year plan for the NHS.
Social prescribing allows family doctors to dish out gardening, dance or cookery lessons and even exercise to their patients.
The practice aims to improve patients’ quality of life, health and wellbeing by recognising health is affected by a range of social, economic and environmental factors.
The new NHS plan revealed that the range of support available across the country will widen, with the hope of allowing nearly one million patients to access social prescribing schemes by 2023/24.
Other policies include:
- Wearable monitoring equipment and hi-tech devices to save patients from going to hospital;
- A pledge to save 500,000 lives over ten years with improved care for cancer and heart disease cases;
- Scrapping bureaucratic bodies introduced by former health secretary Andrew Lansley;
- Longer waits for patients in A&E if their condition is not urgent;
- A promise of a new era of personalised medicine;
- A focus on preventing ill health, targeting alcohol and smoking;
- Possible curbs on private firms providing NHS services, such as Virgin Care.
Outpatient appointments have long been a mainstay of healthcare and around 94million take place annually at a cost of £8billion.
NHS England believes the total, which has doubled in a decade, can be cut by a third through ‘service redesign’ and a revolution in online healthcare.
Its plan states ‘the traditional model of outpatients is outdated and unsustainable’, adding: ‘We will therefore redesign services so that over the next five years patients will be able to avoid up to a third of face-to-face outpatient visits, removing the need for up to 30million outpatient visits a year.’
NHS England believes patients with chronic problems could be better looked after through online consultations with specialist doctors – ‘e-Clinics’.
Mrs May met staff and patients at Alder Hey Children’s Hospital in Liverpool, where she spoke at midday yesterday to announce the official plan for ‘the NHS of the future’
COULD BUREAUCRATIC BODIES INTRODUCED BY FORMER HEALTH SECRETARY BE SCRAPPED?
The 10-year plan could see the scrapping of the bureaucratic bodies introduced by former health Secretary Andrew Lansley in 2012.
Lord Lansley brought in the Health and Social Care Act 2012 – branded a ‘disaster’ by Labour, who have long called for it to be reversed.
The move, which provoked controversy when it was announced, allowed newly created clinical commissioning groups (CCG) to tender out bigger contracts.
But this has led to many NHS contracts being dished out to private firms, including Virgin Care, critics argue.
The NHS plan said that changing current legislation, which could see more than 100 of the local bodies merged, would lead to more ‘rapid progress’.
It added that current legislation puts ‘considerable weight’ on organisations working independently while its plans relied on collaboration.
Simon Stevens, head of NHS England, warned there are too many NHS bodies working on their own – even though they could be more efficient if they worked together.
These are already in place for kidney patients in Hackney, Newham and Tower Hamlets in East London and have cut the number of appointments by 50 per cent.
Patients have a Skype appointment with a consultant after a scan rather than going to see them in a hospital clinic.
In another pilot scheme, patients with Type 1 diabetes have been taught to monitor their condition through wearable sensors to avoid the need for regular check-ups. They can then also be seen online.
Officials want GPs to refer more patients to community services rather than hospital consultants. Examples include physiotherapy, mental healthcare, end-of-life care or rehab following a stroke.
Simon Stevens, chief executive of NHS England, said: ‘It’s using the smartphone technology many people already have in their pockets so they can easily see a GP over the internet and even get expert help from consultants without the need for an inconvenient hospital visit.
‘This is all part of putting more power in the hands of patients in a new era of more personalised and targeted treatment from genetic testing for children with cancer to community nurses visiting the homes of our most frail.’
Health Secretary Matt Hancock said: ‘Technology will truly transform our NHS, with every patient entitled to online GP consultations and wearable technology bringing forth a new era of personalised care. The current model of outpatient services is outdated, wasting too much time and causing too much inconvenience for patients. It also eats into the valuable time of our doctors and nurses.’
But Baroness Altmann said: ‘Any changes mustn’t be at the expense of vulnerable elderly people who could lose out with a focus on new technology. For those older people who never learned how to interact with computers, being cut off from human connection in medical care can be devastating.
‘This is a sensible suggestion but only as long as people are able to use Skype – but a lot of older people have not used a computer and never will, especially the oldest elderly.’
Joyce Robins, of the Patient Concern campaign group, said: ‘Phone and virtual consultations are far from ideal for many of the elderly. They need face-to-face contact.’
From childbirth to mental care, what are some of the most important measures laid out in the 10-year blueprint?
A package of measures for maternity services promises to make the NHS ‘the best place in the world to give birth’.
More nurses and specialist staff will be brought in over the next five years as part of a plan to redesign neonatal services from pregnancy to early motherhood.
The plans include allowing new mothers to use a smartphone to access the traditional ‘red book’ issued by the NHS for each new baby, containing their vital details.
Up to 285,000 new mothers will have better access to physiotherapy. There will also be moves to improve breastfeeding rates.
The measures are expected to halve stillbirths, maternal and infant deaths and serious brain injuries in newborn babies by 2025, saving 4,000 babies’ lives.
SMOKING AND DRINKING
Alcohol and tobacco addiction are two of the biggest causes of early death, and NHS chiefs believe they can boost the health of the nation by encouraging Britons to make better lifestyle choices.
Doctors and nurses will be on alert for suspected problem drinkers among casualty cases or those in wards or clinics, and patients could be referred to alcohol care teams. Smokers in hospital will be offered prescription drugs or counselling.
The NHS wants to double the number of volunteers to up to 156,000 over the next three years. Health chiefs believe they have a huge impact on patients and staff, while greatly enhancing their own lives.
Volunteering has been shown to help older people stay active and reduce cognitive decline while younger recruits can gain invaluable experience.
The health service plan will urge hospitals to recruit many more younger volunteers, particularly those with mental health problems, learning difficulties or from deprived communities.
NHS England will encourage hospitals to offer more volunteering opportunities and by investing £2.3million in Helpforce – the charity the Daily Mail launched its Christmas campaign with, encouraging more than 30,000 readers to sign up to give their time to the NHS.
Four-hour target for A&E treatment could be axed
By Sophie Borland and Daniel Martin for the Daily Mail
The four-hour treatment target in A&E may be scrapped and replaced with a two-tier system that could leave non-urgent patients waiting even longer.
Simon Stevens, the head of NHS England, hinted at the radical change yesterday ahead of the launch of the ten-year plan, claiming the current policy failed to distinguish between the most urgent and the less serious cases.
In its place would be separate standards for emergencies, such as heart attacks and sepsis, and less urgent cases such as broken bones.
It is three years since the NHS last met its targets to admit to a ward or discharge 95 per cent of A&E patients within four hours of arrival.
However, doctors last night warned the proposed changes would mean patients ‘continue to suffer from delays and overcrowding’.
Mr Stevens told Radio 4’s Today programme: ‘On A&E services we need a tougher, faster set of standards for major conditions than we have at the moment.
‘The problem is it doesn’t distinguish between turning up at A&E with a sprained finger versus turning up with a heart attack.’
Prime Minister Theresa May, speaking at the launch of the NHS’s long-term plan at the Alder Hey Children’s Hospital in Liverpool, said: ‘We are seeing the NHS treat more people but demand has outstripped that. So we have been slipping against the targets. As we look ahead for the NHS, let’s make sure we are setting standards that are right for the future.’
A review due in the spring will look at whether targets should be changed and there are fears in the NHS that the current standards could be watered down.
Last night, Chris Moulton, vice-president of the Royal College of Emergency Medicine, said: ‘While many patients will benefit [from the plan], those attending A&E will continue to suffer from delays and overcrowding.
‘We welcome moves to relieve pressure on emergency departments, [but] it is disappointing to find that despite the proposed measures to do this, it has still not resulted in a firm commitment to restoring four-hour performance to 95 per cent – a sensible target that is very much achievable given the right resourcing.’
The NHS will boost mental health care for under-18s with conditions such as eating disorders, self-harm and depression.
Health officials have agreed to increase the proportion of all those with a diagnosable mental health condition who get treated from one in four (25 per cent) to one in three (35 per cent) by 2020-21.
The plans include new waiting-time targets for mental health treatment and stronger support for young adults, including a 24/7 helpline.
An extra £2.3billion has been promised to pay for talking therapies for an additional 350,000 young people and 380,000 adults within five years.
Young people will no longer be forced to restart their treatment with adult services when they turn 18.
Theresa May set the NHS a target to diagnose three quarters of cancer cases early within ten years, saving 55,000 lives.
At present, 52 per cent of cancers are diagnosed at stages one and two, when the tumour is small and has not spread to surrounding tissue.
This will increase to 75 per cent by 2028. Screening programmes will be more accessible, easier to use, and based on the latest research and technology.
New tests for bowel cancer, mobile lung screening units, and the rollout of rapid diagnostic centres across the country with same-day testing will offer cutting edge options for early diagnosis to those at risk.
SOUP AND SHAKE DIET
A low-calorie ‘soup and shake’ diet to reverse Type 2 diabetes will be prescribed to 5,000 patients to reverse the condition.
NHS England is putting the three-month, 800-calories-a-day regime at the heart of its diabetes strategy after half of patients went into remission in trials.
The number of Britons with diabetes has doubled in 20 years. Almost 3.7million people are living with diabetes, up from 1.9million in 1998.
HOW WILL THE PLAN SAVE LIVES? THE AMBITIONS IN NUMBERS
The NHS and Government say their new 10-year plan will save up to 500,000 extra lives over the next decade.
This is how they hope to do it:
- Using more high-tech treatments and diagnostic testing, including computers with artificial intelligence, to prevent 150,000 heart attacks, strokes and dementia cases
- Putting 100,000 people with heart complaints through healthy living and exercise programmes every year, with a view to preventing 23,000 premature deaths
- Improving diagnosis to catch 75 per cent of all cancer cases ‘early’ while they’ll still respond well to treatment – the figure is currently 50 per cent
- DNA testing for around 30,000 people who have dangerously high cholesterol due to genetic causes
- Investing an extra £4.5bn a year in primary and community care, reducing pressure on hospitals
- Investing an extra £2.3bn a year in mental health services and giving help to an two million more people suffering from anxiety, depression and other mental health problems