Telehealth Commissioning in the UK

Our journey starts with telehealth in the UK. Thanks to a research grant from the British Academy of Management (BAM), we are conducting a research project on the role of Clinical Commissioning Groups (CCGs) in the implementation of telehealth. For those of you who are not familiar with the health sector in the UK, CCGs are NHS (National Health Service) organizations in charge of commissioning health care services in their local area. CCGs were created in 2012 with the latest health sector reforms. The majority of their members are General Practitioners (GPs), who, together with their major health care partners, such as local councils, are responsible for the design and planning of health care services for their communities.

Simplified model of telehealth pathway

In particular, CCGs are now faced with the paramount responsibility of bringing health services closer to patients. It is within the patient-centred care agenda that telehealth constitutes a key strategic resource for commissioners, thereby stressing the importance of learning more about how commissioners can roll out telehealth services successfully. That is because telehealth has the potential of reducing avoidable admissions and outpatients services utilization as well as enhance the delivery of primary care services to patients. 

Yet, there are mixed results on the cost-effectiveness of telehealth. Some would say it is worth the money, particularly, because it enhances the patient experience in terms of self-disease management, thereby reducing the number of contacts with GPs and outpatients visits. Others would argue that there is not enough evidence that telehealth can meet expected efficiency and cost-saving targets.

Let us not forget that small telehealth pilots or projects cannot create the necessary critical mass of users to deliver expected results in terms of cost gains. In addition, telehealth is much more than a toolkit; it is a complete new health service pathway requiring a certain amount of effort in the reorganization of the health service. The responsibility of how telehealth can be embedded within full stream service delivery rests with CCGs, who, in consultation with their local partners, decide what are the best and most sustainable pathways for their patients. Having this in mind, the research project we are leading aims to  produce evidence on the main issues that are most likely to affect the adoption and scalability of telehealth services.