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Discussion – Evidence published by Lords Select Committee

We’re delighted at Simple Shared Healthcare to announce that our evidence to the House of Lords Select Committee on the Long Term Sustainability of the NHS has been published on  The submitted evidence overwhelmingly reflects the views of our Community of Practice members.
View the evidence on the Select Committee website here or continue reading below.

Simple Shared Healthcare Limited – Written evidence (NHS0104)

 I write on behalf of Simple Shared Healthcare Limited, a not-for-profit social enterprise, limited by guarantee and committed to improving the quality of self-care.

  1. Our interest cuts across the committee’s  areas of interest as follows;
    1. Resourcing issues – productivity and demand management.
    2. Models of service delivery and integration
    3. Prevention and public engagement – motivating people to take greater responsibility for their own health – Keeping people healthier for longer.
    4. Digitisation.
  2. The business case for each service commissioned by the NHS to achieve clinical and preventative outcomes assumes a particular level of patient engagement and adherence with their own healthcare.
    1. The typical level of patient engagement and adherence presents the opportunity for significant room for improvement across all conditions, pathways and treatments. 
    2. Through increasing the level of engagement and adherence to the best practice health care currently delivered by the NHS, better clinical outcomes can be achieved faster and more cost effectively than is otherwise the case.
    3. Such improvements can be achieved using evidence based techniques without re-engineering clinical pathways, changing clinical practice, or introduction of costly and/or unproven technology.
    4. The current evidence base built using the NHS owned methodology ‘Simple Telehealth’ uses psychological methods and zero footprint technology (uses the patients own mobile phone) to help patients.  It motivates, engages, educates and increases adherence to their shared healthcare plans.
  3. The application of this methodology enjoys support within the clinical community and is used in some primary, secondary, community and mental healthcare settings in England, Scotland and Wales.  The NHS ‘Simple Telehealth’ methodology has been assessed and adopted by the United States Federal Government’s Veterans Health Administration for national rollout and there is keen interest from other countries.  The clinical community have also formed a Community of Practice through which they build a knowledge base and freely share their practice, achievements and evidence with others.
  4. Practical use of the methodology through the ‘Florence’ system in England has been cited by the CQC as outstanding in a number of primary and secondary care inspections and improvements in engagement and adherence bring about productivity, efficiency and prescribing improvements  
  5. The evidence of clinical outcome improvement and high patient satisfaction through the impact of improved engagement and adherence is widespread ranging across all ages,  geographic regions and demographics.  A number of case studies and links to medical journal articles can be seen in our case study library and on our news page.
  6. However the current fashion for the adoption of the latest technology and apps for self-care needs to be treated with caution in terms of attaining clinical outcomes and improving productivity for the NHS. The NHS has wasted many millions of pounds investing in technology for self care that has no basis in evidence and scant clinical support. In some cases today, managers are still persuaded by professional sales techniques citing overstated benefits to invest in equipment and apps for which there is no or little evidence or even evidence to the contrary or has been proven to be ineffective previously in other areas. See our blog on the matter  and a BMJ article;
  7. The long term sustainability of the NHS is critically dependent upon the level of Self Management Support provided to improve the engagement and adherence of patients.  This impacts directly on the quality and efficacy of healthcare, productivity, cost of care episodes, avoidance and delaying of health complications  and significantly the  sustained and lasting impacts of patient behaviour change.
  8. Should the Self Management Support results achieved to-date of improved engagement and adherence with over 40,000 patients via use of the NHS’s Simple Telehealth methodology be replicated at scale, but only achieving a fraction of the improvements evidenced, the impact on the sustainability of the NHS would be substantial and achieved at an insignificant cost.

 23 September 2016

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