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With the NHS Long Term Plan looking to digital technology as a way of providing more modern, convenient and cost-effective patient care, NHS Liverpool Clinical Commissioning Group (CCG) has been ahead of the curve; working with procurement experts in the Healthcare Improvement Solutions team at NHS Shared Business Services (NHS SBS), to successfully expand its pioneering telehealth initiative for thousands of patients living with long term conditions.
“The commitment and professionalism of the NHS SBS team was exemplary…they were undoubtedly viewed as a trusted expert within the team, rather than an ‘external’ advisor.”
John Webb, Digital Programme
Manager, NHS Liverpool CCG
The Challenge
Through its More Independent programme, NHS Liverpool CCG has been at the forefront of implementing telehealth for patients with chronic obstructive pulmonary disease (COPD), chronic heart failure and diabetes. By using new technology to help monitor symptoms remotely, over the past six years the programme has helped thousands of patients to manage their health at home under the supervision of experienced clinicians.
With the evidence showing that the programme resulted in fewer hospital admissions and a reduction in healthcare costs, NHS Liverpool CCG was keen to expand the model further. To do so, it required a technology provider with the capacity to support between 4,000 and 5,000 patients in a single year, but in a more cost-effective and adaptable way.
Flexibility and interoperability were all important. The technology needed to facilitate several different tiers of monitoring and be capable of being downloaded to a patient’s own smart device, as well as working on equipment provided by the supplier.
It was also important for the technology to integrate with both GP and hospital systems, and that the provider was able to offer simple ‘telehealth in a box’ solutions, which could simply be handed out in hospitals.
Futureproofing was also a key consideration. In addition to the three conditions the programme is currently focused on, the technology selected also needed to be capable of being tailored to other health problems.
As finding the right provider was absolutely critical, NHS Liverpool CCG turned to NHS SBS to deliver an effective and compliant end to end OJEU (Official Journal of the European Union) procurement process.
The Solution
Considering all of the elements that would ensure the programme’s future success, NHS SBS set about developing a tailored procurement strategy to facilitate the extension of telehealth in Liverpool.
The NHS SBS team helped the CCG manage every aspect of the procurement process, from leading an initial market analysis exercise, to developing the service specification and facilitating its peer review by external experts.
Once the tender was live, NHS SBS managed the submission process via its e tendering portal. This included facilitating communication between suppliers and the CCG, and managing the evaluation process and moderation meeting.
After a shortlist of potential suppliers was identified, NHS SBS chaired bidder interviews and product demonstrations, prepared recommended bidder reports at PQQ (pre-qualification questionnaire) and ITT (invitation to tender) stage, drafted bidder debrief reports, and developed and published the contract award.
The team also provided guidance on key regulatory and legal issues, such as TUPE (Transfer of Undertakings [Protection of Employment]) implications and compliance with complex procurement legislation.
The Result
Following the rigorous procurement process, NHS Liverpool CCG appointed Leatherhead-based digital health solutions provider Docobo as its supplier.
The careful preparation and painstaking attention to detail that NHS SBS and NHS Liverpool CCG invested in the procurement exercise paid immediate dividends.
For example, because the requirements were clear and the supplier’s capability and agility were assured, implementation took place ahead of schedule, within a month of the contract being signed and well before the CCG’s previous contract came to an end.
Similarly, the robust analysis of all potential suppliers meant NHS Liverpool CCG could be confident that the only constraint on the service would be how rapidly the NHS could absorb and manage change, without any of the usual concerns about the technology itself.
Indeed, the procurement process laid the groundwork for a collaborative environment with the technology provider, which made agreeing functionality, pathways and service improvements easy.
In addition to the initial telehealth referrals from Primary Care, the service has since established successful referral routes from both community and hospital respiratory and cardiac teams. It has also allowed the trial of telehealth in care home settings to enable the remote monitoring of frail elderly residents to improve their clinical care.
With the service already monitoring around 1,000 people at a time and plans in place to double the capacity of the clinical monitoring hub, the programme in Liverpool is well on the way to its target of supporting up to 5,000 patients every year.
Telehealth has enabled NHS Liverpool CCG to support NHS providers in the area to do more for less. Indeed, just one nurse, supported by a healthcare assistant, can now monitor more than 200 patients remotely.
The service also provides levels of monitoring that is tailored to an individual patient’s needs, with, for example, the option for lower-risk patients to access support from their own phone or tablet, rather than via dedicated telehealth technology. This not only makes the service more accessible for patients, but also means interventions are more cost-effective, enabling larger numbers of users to be supported.
Summarising how NHS SBS supported the telehealth procurement process, John Webb, Digital Programme Manager at NHS Liverpool CCG, said:
“I don’t believe NHS SBS could have done any more. Our Procurement Manager followed up on any queries we had and sought definitive answers, so I could always rely on their quality.
“In particular, they worked well beyond normal hours to ensure deadlines were met – at significant inconvenience to themselves. The commitment and professionalism of the NHS SBS team was exemplary.
“The team at NHS SBS was also excellent when it came to communication and relationship-building with NHS Liverpool CCG staff and the wider project and evaluation team, such that they were undoubtedly viewed as a trusted expert within the team, rather than an ‘external’ advisor.”
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