A new paper, published in the British Journal of Healthcare Management, has found a direct correlation between the use of novel interventions such as clinical health coaching and a reduction in hospital admissions in patients with Chronic Obstructive Pulmonary Disease (COPD). Results from the three-year programme, led by Totally Health, the UK's leading provider of clinical health coaching services, showed a two-thirds (67%) reduction in unscheduled COPD admissions.
Eligible patients had a history of two or more prior unscheduled COPD admissions in the previous 12 months, with study data showing a decrease from 3.13 to 1.02 admissions per patient. The study not only demonstrated clinical benefits and patient gains in terms of quality of care, but also outlined that the combination of interventions was a clear driver in reducing costs. Gross Quality Innovation Productivity and Prevention (QIPP) savings to Leicester City CCG were recorded as £117,550 over 12 months.
Furthermore, patient feedback from the study suggested that patients were overwhelmingly more knowledgeable about their condition, more confident in managing it and motivated to change behaviour in a positive direction as result of being involved in this intervention.
In excess of one million people across the UK have chronic obstructive pulmonary disease (COPD), a chronic respiratory disease characterised by acute exacerbations that commonly require hospitalisation for acute care. England had over 116,000 hospital admissions for COPD in 2013-2014 with a mean average length of stay of over six days (HSCIC 2015). With an average cost of £400 per bed, per day (DH, 2015), the cost to the NHS would have been around £300 million just to contend with COPD hospital admissions in England alone.
In addition, prevention of acute exacerbations of COPD has been shown to enhance quality of life, improve health status and slow the downward trajectory of the disease (Spencer et al, 2004).
The study was based on a "managed model of care" introduced and commissioned by Leicester City Clinical Commissioning Group (LC CCG), in partnership with the local community trust, Leicester Partnership Trust and Totally Health (TH) and Spirit Healthcare. The multifactorial approach including telemonitoring, specialist nurse case management and telecoaching, enabled patients suffering from COPD to be proactively monitored.
Emma Jane Roberts, Chief Operating Officer at Totally Health, "This project provided a unique opportunity to evaluate and measure the benefits of a novel approach to improve quality of life for patients with a chronic condition and alleviate both financial and staff pressure caused by hospital admissions. The results showed significant success for interventions such as clinical health coaching in helping to engage patients and educate them about their condition - enabling them to have increased control and more confidently self-manage their health. However, despite the demonstrable benefits, clearly shown in the results of this study, clinical health coaching and similar novel interventions are not widely available via the NHS."
Dr Durairaj Jawahar, GP and COPD Clinical lead for Leicester City Clinical Commissioning Group, "Our patients get the support of managing their own condition at home. We know patients are happier and recover quicker when their care is managed at home. We are really pleased that the service has evidenced the benefits and the programme has enabled patients to avoid an admission."
Professor Azhar Farooqi, GP and chair for the Leicester City Clinical Commissioning Groups; "The success of this new system is fantastic news for patients. We fully support innovation and working with service providers outside of the NHS to help us deliver the enormity of the long term conditions agenda."
Clinical health coaching is a personal and confidential service where a registered, experienced and qualified nurse provides one-to-one advice, usually via the telephone, to a patient diagnosed with at least one long term medical condition. The aim is to educate patients about how they can "self-manage" their condition, to reduce the day-to-day impact and improve their quality of life.