Telehealth costs more than conventional treatment
Budget for NHS cost-cutting scheme to triple
A cost-cutting government scheme to monitor millions of NHS patients remotely in their homes is three times more expensive than expected, and is unlikely to save the predicted £1.2 billion a year, a study has found.
By Melanie Hall
One of the Coalition’s key health ambitions — to treat three million people with long-term conditions remotely — would cost £92,000 per patient, way above the £30,000 threshold set by the medical regulator, according to research published in the British Medical Journal.
The Department of Health has promoted the “telehealth” scheme, which would involve installing machines in patients’ homes to monitor their conditions and send results electronically to doctors, as a money-saving measure that also improves quality of life and reduces emergency hospital admissions, GP appointments and visits to accident and emergency departments.
However, a trial study of almost 1,000 patients already monitored in this way found that telehealth costs more than conventional treatment.
The researchers said the evidence showed that telehealth “does not seem to be a cost-effective addition to standard support and treatment”. It follows research published last month showing that the scheme
does not improve quality of life for patients with long-term conditions.
Researchers looked at the care of 965 patients with heart failure, chronic obstructive pulmonary disease and diabetes. Of those 534 received telehealth equipment and support as well as face-to-face care over a year, and 431 received only the conventional care.
The study found that the cost for a healthier year of a patient’s life was £92,000, three times more than the £30,000 set by the National Institute for Health and Clinical Excellence.
The report’s authors said the gain by people using telehealth was minimal, but costs for the group were higher.
Prof Martin Knapp, from the London School of Economics and Political Science, the study’s author, said telehealth would not save the Government money in the short term, and that the Department of Health’s prediction made in 2011 that it would save the NHS £1.2 billion was “premature”.
“That projection would have been based on the limited evidence at the time, on small studies funded by the manufacturers,” said Prof Knapp. “Quite a lot were conducted in the US where it’s a different setting.
“It was a premature expectation. We are not going to see savings immediately.”
However, Prof Knapp said that the scheme could become more cost-effective in the long-term as it was rolled out more widely, thanks to economies of scale. “I remain optimistic about telehealth in the long term,” he said.
But he added that he could see the difficulty for health-care commissioners in funding telehealth. “If there’s going to be a push on telehealth, it will need to come from central Government,” he said.
A Department of Health spokeswoman said: “This part of the study confirms that to introduce the technology in isolation, at high cost and in low numbers, does not bring the cost reductions we believe are there to be made.”
She said the department’s approach would bring in telehealth “at scale”, which would “create improvements in services, care and costs”.