Recent newspaper headlines have warned that the UK should be “braced for the coldest winter in years” (Daily Express, 20/11/17), so it’s only a matter of time before NHS ‘winter pressures’ start making headlines too. But why does the colder weather increase demand for health services and how can technology help?
Respiratory and cardiovascular problems
Conditions such as COPD or heart failure are often worse in cold weather; a third of all excess winter deaths were caused by respiratory disease in 2016/17 (Office for National Statistics, Excess winter mortality in England and Wales: 2016 to 2017). Remote monitoring of patients using Connected Health (also known as telehealth) systems can enable clinicians to identify indicators of exacerbations at an early stage, avoiding deterioration and the need for more complex intervention such as hospital admission. Patients with long term conditions record their vital signs at home on a regular basis, and any results outside of parameters set for them will raise an alert and a clinician will be notified. They can then give advice over the phone, or visit as required. Clinicians can also log in at any time to view patients’ results online, enabling them to identify trends and inform their decision making using objective data. Using remote monitoring in this was has also been shown to reduce time spent travelling for both clinicians and patients, which is of even more benefit in adverse weather conditions.
Slips and falls
Falls are the largest cause of emergency hospital admissions for older people, with nearly 65,000 people aged 60+ in England, Wales, and NI experiencing a hip fracture in 2015. One third of these people died within 12 months (Later Life in the UK, Age UK, August 2017). The winter months can see an increase falls, particularly among older people, not just due to icy footpaths but hazards in the home such as ill-fitting slippers and tangled blankets. Using telecare systems which include pendants and fall detectors enable help to arrive quickly, minimising the consequences of falls. A ‘long lie’ after a fall can have complications including hypothermia and pneumonia, particularly in the winter months. Telecare can also help people to leave hospital as soon as they are clinically ready after a fall, by managing risks in the home 24 hours a day.
Around a million people in England aged 60 or over live in fuel poverty, and there is a strong relationship between poor insulation and heating of houses, low indoor temperature and excess winter deaths of older people (Later Life in the UK, Age UK, August 2017). Our Lifeline Vi home units feature an integral ambient temperature alarm which can raise an alert at the monitoring centre if the temperature in the home falls below a safe level. Tunstall’s monitoring centres offer proactive services, including calling vulnerable people to assess their wellbeing during periods of extreme weather, offering advice on keeping warm and well at home and signposting them to other services or benefits that may be able to help them, such as the winter fuel allowance.
These are just a few examples of the ways technology can help relieve the pressures on health and social care during winter months, but the bigger opportunity is to use technology as a platform for more integrated services, enabling a more joined-up and preventative approach. So whilst of course the approaches described above can save lives, a more strategic approach has the potential to save many more and help the NHS get in better shape to be ‘braced for winter.’