Written evidence from Air Products Healthcare
(COM 124)
1. Air Products Healthcare welcomes the
opportunity to contribute to the Health Select Committee's inquiry
into NHS commissioning. Air Products works in partnership with
the NHS to provide the Home Oxygen Service to over 52,000 patients
across England and Wales. In July 2010 Air Products was awarded
a Framework contract to supply telehealth products and services
to the NHS.
2. Air Products works constructively and
collaboratively at both local and national level with the Department
of Health, The National Health Service and its agencies and representatives
to ensure that the best Home Oxygen Service, at the most competitive
price, is available to patients and their carers throughout the
six UK regions we are responsible for.
3. Air Products provides respiratory therapies,
home medical equipment, infusion services and assisted technologies
to more than 325,000 patients in their homes across the world.
Our specialist teams serve patients with conditions including
chronic lung disease, asthma, emphysema and sleep apnoea. We strive
to improve patients' quality of life through the provision of
oxygen therapy, nebuliser therapy, sleep therapy and many other
innovative care technologies.
4. Air Products firmly supports the continued
drive to treat patients nearer to home and reduce the burden on
the NHS with potentially unnecessary and costly inpatient bed
days.
5. Air Products is a pioneer in the provision
of technologies which assist in the management of patients at
home to prevent exacerbations of their conditions and to give
early warning to care teams of deterioration in the patients'
conditions.
EXECUTIVE SUMMARY
6. Over the past decade, the NHS has used
innovative homecare technology to increase patients' independence,
reduce costly stays in hospital, and drive down the overall cost
of care for the local and national NHS. If the Health Service
is to meet the huge financial challenges it faces in the years
ahead, it must continue to harness cost-saving care technologies.
Commissioning structures must be designed in a way that ensures
specialist clinical knowledge about the quality and efficiency
benefits of care technologies is effectively fed to service commissioners.
7. We warmly welcome proposals to place
commissioning responsibilities in the hands of local health professionals,
and agree that service planning decisions should be taken by those
who are most familiar with patients' needs and interests. However,
when GP consortia are commissioning services in complex care areas
such as respiratory homecare, it is crucial that commissioning
decisions are informed by specialist expertise, documented best
practice, and patients' and carers' experience. This submission
addresses how commissioners will access the information and clinical
expertise to commission services about highly complex care technologies.
How will Commissioners access the information
and clinical expertise required to make high quality decisions
about the shape of clinical services?
8. Patients requiring sustained homecare
support suffer from a range of complex conditions, and all have
a unique set of health needs. Many have more than one Long-Term-Condition,
and all require varying degrees of complementary clinical support.
A range of homecare therapies exists to meet such needs, but harnessing
these therapies effectively requires specialist knowledge and
technical understanding. To provide GPs with the information they
need and ensure the success of new NHS structures, engagement
between GP commissioners and homecare specialists should be seen
as crucial.
9. Air Products' experience of delivering
the NHS Home Oxygen Service has consistently found that services
are more effective when they are designed in collaboration with
clinical specialists and service users. Channels that we have
found particularly useful in improving service design include
our patient forums, which provide a means for patients to influence
the service, and our clinical engagement events, which help local
clinicians' develop their knowledge of complex homecare technologies
(and which qualify for CPD accreditation). As a result of this
approach the Home Oxygen Service is far more effective and patient-focused.
10. We propose that, as part of the new
commissioning arrangements, structures for joined-up working and
sharing clinical and technical expertise are formally established.
In order to arm GP commissioners with the knowledge and expertise
to make the most of the care technologies available, we propose
the establishment of working groups to support GPs in commissioning
local homecare services. These groups, which should comprise commercial
homecare providers, clinical specialists, and patients/patient
representatives, should not take a direct commissioning role,
but should ensure that commissioners have access to a full range
of specialist expertise and frontline experience when planning
services in this complex clinical area.
11. We fully support the principle that
local services should be tailored to local needs. Air Products
provides the Home Oxygen Service to patients in locations ranging
from tower blocks in North London to rural villages in Derbyshire.
When it comes to high quality homecare, one size does not fit
all. Nevertheless, there are elements of homecare provision that
are consistently effective, and country-wide commissioning should
reflect this.
12. GPs' patient relationships and local
understanding will make them effective commissioners. Their time
is not effectively spent redesigning service specifications that
already work in other regions of the country. Their expertise
will be better used designing elements of services that benefit
from local tailoring. Furthermore, many complex homecare services,
such as telehealth and telecare, must be commissioned in a way
that reflects the complexity of the technology involved. When
there are ways of doing this that are nationally consistent and
not locally sensitive, there is a value in introducing national
service frameworks that GPs can work from to plan these services.
13. We propose that, where nationally consistent
best practice is identified, national service frameworks are developed
to support local commissioning of highly technical care services
such as telehealth. These frameworks should not be seen as restrictive,
one-size-fits-all guidelines; they should set out a core service
framework that has been proven to be consistently effective. This
will empower GPs to tailor the service to the specific needs of
their local community.
14. As with commissioning local homecare
services, it is crucial that specialist knowledge and frontline
experience of patients and clinicians informs the development
of national service frameworks. We propose that national working
groups are established to create them. These groups should (as
appropriate) comprise commercial telehealth providers, clinicians,
NHS commissioners, and patients/patient representatives. This
will enable us to harness all available expertise in working toward
the consistent development of innovative care technologies.
KEY RECOMMENDATIONS
15. A summary of the submission's key recommendations
is below:
(i) Formalised working groups, comprising commercial
homecare providers, clinical specialists, and patients/patient
representatives, should be set up to support GPs in commissioning
local homecare services.
(ii) Where nationally consistent best practice
is identified, national service frameworks should be developed
to support the local commissioning of a highly technical care
services such as telehealth.
(iii) Wherever these frameworks are seen to be
valuable, national working groups should be established to create
them. These groups should (as appropriate) comprise commercial
service providers, clinicians, NHS commissioners, and patients/patient
representatives. This will enable us to harness all available
expertise to support the development of innovative care technologies.
October 2010
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