NHS could save up to £46 million

The NHS is set to save a potential £45,970,000 per year if they are to use a new technology known as cardiac telemetry.¹

In 2005 the Cumbria and Lancashire Strategic Health Authority (now part of NHS North West), supported by the Diagnostic Futures Programme at the Department of Health, undertook an Audit and Research Programme to evaluate the ease of use and effectiveness of telemedicine diagnostics when used in a primary care setting.¹

Telemedicine ECG machines were placed in fifteen General Practices and two walk-in centres within the area in the North West of England covered by the Cumbria & Lancashire SHA. During the six-month pilot, the 12-lead telemetric ECG machines were used in the same manner as their usual equipment so that no change in practice would take place to influence the results. The recording obtained was transmitted along a phone line to a call centre where trained staff were available 24 hours a day, 365 days per year to interpret the results. Transmission time was 45 seconds. A verbal report was then received immediately so that if urgent action needed to be taken it could be done so without undue delay. The results were then provided with a full written interpretation within minutes by email or fax for inclusion in the patient record. ¹  

The audit identified three main clinical indications for undertaking ECGs in the community setting (as currently being practiced in Lancashire & South Cumbria) ; ¹  

• acute symptoms (e.g. chest pain, shortness of breath, dizziness)
• screening procedures for long-term conditions (e.g. hypertension)
• as a pre-requisite for clinic referral (e.g. memory clinic).

By implementing this technology, the potential savings to the NHS are immense. Data from the pilot showed 82% of patients receiving ECG’s did not need to go to hospital following the test – giving the patients rapid reassurance, and reducing their stress and anxiety. Though each ECG machine costs £500, the cost of an unnecessary primary care referral to A&E costing £101, can be avoided using this technology. ¹  

In a news release the government's National Director for Heart Disease, Roger Boyle, commented that “When you need an ECG to diagnose a problem with the heart rhythm or the cause of a pain in the chest, you need it there and then. You also need somebody to interpret it accurately. But in rural areas like parts of Cumbria and Lancashire, access to expert interpretation is not always immediately available.

“This pilot has helped to demonstrate not only the benefits to patients - accessing care in the local community and preventing unnecessary trips to hospital - but also the potential financial benefits to the NHS. Cardiac Telemedicine is an excellent way to ensure that expert advice is available in a matter of minutes, not only to the patient but also to the healthcare professionals involved with the care." ²

Further research is now underway to look at other benefits from telecare including using mobile phones, instead of landlines, allowing patients to do their own ECG’s using hand-held devices and giving patients a wristband-watch device for tele-monitoring.

1. Cardiac Telemedicine in Primary Care, Delivering Benefits for Patients and the NHS in Lancashire & Cumbria: A Report for Commissioners http://www.lsccardiacnetwork.nhs.uk/National%20Key%20Documents/Cardac_Telemedicine.pdf

2. News release: Cardiac Telemedicine Will Save Hundreds of Lives According To New Study

http://www.northwest.nhs.uk/news/news.aspx?storyID=1256