Creating COVID-19 capacity without bricks and mortar

COVID-19 presents an extraordinary challenge to our health and care systems. It demands that we behave differently and find alternative solutions to familiar and unfamiliar problems. Technology is critical to meeting the challenge and can fundamentally change the way we provide and access care services both now and in the years ahead.

Much focus is rightly being given to how we increase and sustain acute and critical care capacity. However, we must also think about how we can bolster capacity in community-based services and use them to reduce demand for acute hospital beds and maintain wider service provision during the pandemic.

At Channel 3, we believe technology has a key role to play in strengthening acute and non-acute services and creating more capacity for patient care. If ever there was a time to put into action the NHS’s vision of digitally expanding care capacity, it’s now.

• Social distancing and shielding measures for patients mean we need ways to provide care and interact with patients differently.
• Effective community-based care helps protect acute and critical care bed capacity for those who need it most.
• Giving people easy access to appropriate help in the community helps us to manage demand on wider NHS services.

In this short article, we offer practical examples of how to overcome these challenges through:

1. Remote monitoring and care of COVID-19 patients and those at-risk using wearable tech.

2. Welfare tracking, remote intervention and care delivery for vulnerable people.

3. Connecting people with essential services via chatbot technology, diverting pressure from the NHS.

1. Creating virtual community wards for COVID-19 patients

We know that unless the peak of the outbreak is carefully managed, critical cases of COVID-19 are likely to overwhelm current hospital provision.

To address that problem, Channel 3 has worked with Doccla to create a “virtual ward” for out-of-hospital provision by taking data from wearable devices and creating a clinical dashboard that can be monitored remotely by clinicians in hospital, community or primary care. Patients remain in their homes, but clinicians can still measure and monitor parameters such as temperature, heart and respiration rates, SP02 levels, interbeat intervals, heart rate variation, blood pulse wave and others. These measurements give clinicians visibility of progress or deterioration whilst keeping patients safely isolated. The solution uses the latest wearable technology for passive monitoring of vital signs to ensure high patient compliance.

The beauty of this approach is that it enables providers to increase capacity at both ends of the patient journey, keeping patients at home for as long as possible and then providing reliable monitoring for those who are fit to leave acute services but still need careful monitoring. It helps clinical teams make informed decisions more quickly and efficiently. What’s more, it doesn’t require integration into any existing IT systems, making it easy to implement at pace.

2. Delivering community care at a distance

The coronavirus pandemic has brought new restrictions into community healthcare and nursing. Social distancing and isolation rules mean normal day-to-day services cannot be delivered as usual. Combined with increasing workforce pressures, these rules require organisations to find new ways of providing the capacity they need to maintain safe and effective services.

Medical device software provider L2S2 has an app-based solution that collects information from patients and offers multiple ways for clinicians to deliver care services remotely. In a joint project, Channel 3 and L2S2 are using the app to expand capacity and deliver care to children and families that use CAMHS and learning disability services. These service users face increasing challenges because of enforced isolation and the lack of access to their care teams. Using L2S2 technology, caregivers can provide services via a platform that offers bespoke content such as individual assessments, video consultations and personalised therapies.

In another initiative, the L2S2 app will help remotely monitor the health of patients in care homes, reducing the need for face-to-face GP visits. Carers log observations regularly via the mobile app, providing GPs with real-time data and thereby allowing for faster and more accurate tracking of deterioration and/or reassurance of stabilisation.

3. Releasing NHS capacity by utilising community assets

Healthy London Partnership is using chatbox technology to connect people in need with community assets and services. Whilst the solution has been tailored for COVID-19, it draws on a year of work around digitally-enabled social prescribing. The chatbot helps direct people toward a full suite of professionally vetted online tools, including reliable COVID-19 advice and a wealth of voluntary and community support. The bot uses supportive, coaching language to engage with users in a way that helps them stay well and reduces their need for NHS and care services, releasing capacity within the system. It is being developed in collaboration with OneReach and Virtual Health Labs and can be easily deployed through channels like WhatsApp, Facebook, primary care systems and public websites.

The service offers different options for “human in the loop” assistance if the chatbot cannot resolve an issue, and it uses open APIs and other automation tools to collect and organise a directory of local services. By connecting people in need with the huge range of existing voluntary and the groundswell of community spirit the COVID-19 crisis has unleashed, this solution is potentially game changing when it comes to freeing up NHS capacity to support those with acute needs.

Address today’s challenge and build capacity for tomorrow

Today’s COVID-19 crisis requires everyone – providers, commissioners, voluntary organisations, the private sector and members of the public – to rapidly implement more joined-up ways of working. Getting the right solutions in place for today will also enable transformation in the years ahead, not just for the coronavirus pandemic.

Working out how to find and roll out the right solutions can feel daunting. Channel 3’s advice is to focus on your immediate needs first, keep it simple and get the basics right.

In this article we’ve highlighted examples of technology that stand alone, don’t require immediate integration into other systems and can be used by simply downloading an app or logging on to a dashboard. They can be easily scaled up and can rapidly release workforce capacity. What’s more, the technologies are adaptable and intuitive, making them ideal for supporting the ongoing transformation of services and the way in which people will access care in the future.

Life after the pandemic will be different, but now is our chance to harness ideas, enthusiasm and the power of technology to make a real transformation in the provision of healthcare in the UK.