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Country Study: the United Kingdom Strategic Intelligence Monitor on Personal Health Systems, Phase 2 Country Study: The United Kingdom Author: Maria Lluch Editors: Fabienne Abadie, Maria Lluch, Francisco Lupiañez Villanueva, Ioannis Maghiros, Elena Villalba Mora, Bernarda Zamora Talaya 2013 Report EUR 25443 EN European Commission Joint Research Centre Institute for Prospective Technological Studies Contact information Address: Edificio Expo, C/ Inca Garcilaso 3, E-41092 Seville (Spain) E-mail: [email protected] Tel.: +34 954488318 Fax: +34 954488300 http://ipts.jrc.ec.europa.eu/ http://www.jrc.ec.europa.eu/ This publication is a Scientific and Policy Report by the Joint Research Centre of the European Commission. Legal Notice Neither the European Commission nor any person acting on behalf of the Commission is responsible for the use which might be made of this publication. Europe Direct is a service to help you find answers to your questions about the European Union Freephone number (*): 00 800 6 7 8 9 10 11 (*) Certain mobile telephone operators do not allow access to 00 800 numbers or these calls may be billed. A great deal of additional information on the European Union is available on the Internet. It can be accessed through the Europa server http://europa.eu/. JRC71181 EUR 25443 EN ISBN 978-92-79-25741-4 (pdf) ISSN 1831-9424 (online) doi:10.2791/88672 Luxembourg: Publications Office of the European Union, 2013 © European Union, 2013 Reproduction is authorised provided the source is acknowledged. Printed in Spain Acknowledgements We would like to thank everybody who contributed to the development of this report. The list of stakeholders who helped us with the field work was long and the time they dedicated to the elaboration of this report is greatly appreciated. 1 TABLE OF CONTENTS 1. SIMPHS2 background and rationale for this report ...................................................................7 1.1 Research approach and objectives....................................................................................................................... 7 2 Introduction to the UK...........................................................................................................................9 2.1 Socio-demographic background............................................................................................................................. 9 2.2 Chronic diseases prevalence and associated costs .................................................................................... 9 2.2.1 Overview of contacts with the healthcare system related to CVD, COPD and diabetes 11 2.3 Social and Healthcare organisation .................................................................................................................. 13 2.3.1 Primary care in the UK ......................................................................................................................................... 13 2.3.2 Integrated care and management of chronic conditions ................................................................. 15 2.3.3 Role of ICT/EHR in promoting integrated care in Scotland .............................................................. 19 2.3.4 Role of ICT/EHR in promoting integrated care in England................................................................ 21 3 ICT and IPHS in Scotland.................................................................................................................... 23 3.1.1 RMT in the Highlands ............................................................................................................................................ 23 3.1.2 The Telescot experience ...................................................................................................................................... 31 3.2 Conclusions on telehealthcare in Scotland ................................................................................................... 35 3.2.1 Diffusion of innovation ........................................................................................................................................ 35 3.2.2 Governance................................................................................................................................................................. 36 3.2.3 Impact............................................................................................................................................................................ 37 3.2.4 Final remarks............................................................................................................................................................. 38 4 ICT and IPHS in England ..................................................................................................................... 39 4.1.1 The Whole Systems Demonstrators (WSD) programme in England.......................................... 39 4.1.2 Additional telehealth and telecare results in England complementary to WSD.................. 44 4.2 Conclusions on telehealth and telecare in England................................................................................. 47 4.2.1 Diffusion of innovation ........................................................................................................................................ 48 4.2.2 Governance................................................................................................................................................................. 49 4.2.3 Impact assessment................................................................................................................................................ 50 4.2.4 Final remarks............................................................................................................................................................. 50 5 Conclusions and Policy implications.............................................................................................. 53 2 ANNEX I - SOCIO-ECONOMIC DATA, UK................................................................................................ 57 ANNEX II – DESCRIPTIVE STATISTICS ON CVD, COPD AND DIABETES ......................................... 63 ANNEX III – QUALITY OUTCOMES FRAMEWORK (QOF) CLINICAL AND ORGANISATIONAL DOMAINS AND PAYMENTS.................................................................................................... 73 Annex IV – COST BENEFIT ANALYSIS FOR CARDIAC REHABILITATION IN ENGLAND.............. 75 ANNEX V - ASSESSMENT INSTRUMENTS TO CALCULATE EFFECTIVENESS IN THEMES 2 AND 3 FOR WSD EVALUATION...................................................................................................... 77 ANNEX VI - TELEHEALTH MAPPING IN ENGLAND ................................................................................ 79 ANNEX VII – TELECARE MAPPING IN ENGLAND ................................................................................... 89 REFERENCES ..................................................................................................................................................108 LIST OF FIGURES Figure 1 UK (and home countries) average disease prevalence (2009/10) - % population ........... 10 Figure 2 Total deaths by cause, 2007, UK................................................................................................................... 10 Figure 3 Decrease in death rate from CHD, men and women under 65, 2002-07, UK and Europe............................................................................................................................................................................ 11 Figure 4 Hospitalisations in England for selected diseases (inpatient) compared with total hospitalisations. 2009-2010............................................................................................................................ 12 Figure 5 Waiting period, length of Stay (LOS) and mean age comparison of hospitalisations for selected conditions with total hospitalisations. England 2009-2010............................... 12 Figure 6 Community telehealth Pods in Bute displaying language choice................................................ 24 Figure 8 Home pod for COPD with peripherals.......................................................................................................... 25 Figure 8 RMT application diagram .................................................................................................................................... 26 Figure 9 COPD home pod used in Telescot.................................................................................................................. 32 Figure 10 Telehealth technology in Newham show flat.......................................................................................... 40 Figure 11 WSD evaluation details........................................................................................................................................ 42 Figure 12 Evaluation of the telehealth pilot in North Yorkshire and York (NYY)....................................... 45 Figure 13 Age structure of the UK population (in thousands of persons) selected years ................... 57 Figure 14 Age structure of the UK population (in thousands of persons) selected years ................... 57 Figure 15 Employment evolution in the UK (2000 -2007).................................................................................... 58 Figure 16- Evolution educational level in the UK (2000-2007)...........................................................................
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