Healthcare Brief market insights - August 2020
A summary of key developments, including the use of digital solutions both during and as we emerge from the pandemic; a Care Quality Commission insight report reflecting on the response to the COVID-19 pandemic in the delivery of health and social care; Kennedys’ recently published thought leadership report: ‘The future of care: is technology the answer?’; implementation of new Liberty Protection Safeguards system postponed; and publication of the latest edition of the Ogden Tables.
Digital solutions in healthcare as we emerge from the pandemic
The stepping up of the use of technology to facilitate remote consultations and treatment, for example via prescribing, has been one of the tools that has helped see patients through the pandemic. Social distancing and a reluctance to attend hospitals and GP surgeries has necessitated the adoption of technology by patients.
It has been reported by NHS Digital that there has been a surge in the number of people using NHS technology during the outbreak. NHS Digital report that 38% of people have increased their use of NHS technology since the start of the pandemic.
Visits to the NHS website and use of the NHS App, which is a simple and secure way to access NHS Services, has, according to NHS Digital, soared. By way of example, NHS Digital report that in March 2020 there were 119,512 registrations to the NHS App. An increase of 111% from February 2020 when there were 56,655 registrations.
Patients who have previously resisted use of such technology have, through necessity, made use of such services. It remains to be seen as to whether the adoption of technology that we have seen in recent months will continue on a similar scale. If so, then perhaps this will provide a route to assisting in the provision of pre-pandemic stretched resources.
Contacts: Ed Glasgow, Rob Tobin, Camilla Long
- Digital solutions in healthcare as we emerge from the pandemic
- The future of care: is technology the answer?
CQC provide insight on implementation of technology in the delivery of health and social care during the pandemic
On 16 June 2020 the Care Quality Commission (CQC) published their second COVID-19 Insight report reflecting on the response to the COVID-19 pandemic in the delivery of health and social care, and in particular the positive engagement into collaboration between services and the implementation of technology. Of particular interest are the observations of the response within primary care.
In response to COVID-19, the report notes that during March 2020 “general practice increasingly moved to new ways of working, including implementation of ‘total triage’ and online/remote consultation.”
Further, it notes “NHSX reported that, by 1 June 2020, 87% of general practices were live with technology to enable online consultations”, with more than 2/3 of practices seeing appointments booked online using GP Connect.
Consequently, observations made by the CQC inspection team include:
- “A fall in the number of face-to-face GP appointments and a rise in those conducted remotely, especially by phone and email
- Changes to prescribing, with more medicines being prescribed for longer periods of time
- Practices rapidly adapting to the use of technology - accelerating the intention behind NHS England’s Digital First Programme.”
In initial feedback from conversations CQC has had with GP practices they have said the switch to remote consultations by phone and video has been working well, and there has been positive feedback from clinicians and patients.
CQC observes however, that “there have been falls in referrals onto the 18-week pathway, in patients seen in hospital on the two-week cancer pathway, in CAMHS referrals and in A&E attendances.” They suggest the impact of this may include:
- “Missing early identification of serious illnesses, including cancer
- Difficulties in managing long-term conditions effectively
- The potentially lower uptake of childhood immunisation.”
Contact: Tom Armstrong
Catastrophic injuries The future of care: is technology the answer?
Launched in May 2020, our report, ‘Catastrophic injuries The future of care: is technology the answer?’ looks at who currently bears the cost of funding personal care for those with catastrophic injuries, and the need to better manage these costs in future. We explore how care needs are assessed, how the injured person seeks financial compensation to meet those care needs, and how those care needs are delivered though a changing combination of personal care and assistive technology.
With care packages potentially costing in excess of £400,000 per year, efforts are needed to manage the financial and human costs of caring. With over seven million people in the UK providing care for their family members this is not simply a matter which impacts on the injured person but also on the wider family members who may be called upon to provide informal or gratuitous care.
For most people outside of a compensation scenario, the optimal care package will include some element of both personal care and assistive technology. Achieving a balance between the two will depend on the individual case. There is no ‘one-size-fits-all’ approach. Future care packages for catastrophic injury claims should similarly consider how technology and human care can be optimised in combination to achieve the best possible outcomes.
Contacts: Rob Tobin and Christopher Malla
Related item: The future of care: is technology the answer?
Liberty Protection Safeguards: implementation of new system postponed until April 2022
In June last year, the Minister of State for Care set out the intended plan for implementation of the new Liberty Protection Safeguards (LPS), writing that the intention was for the new system to come into force on 1st October 2020.
In a written statement made on 16 July 2020, the Minister of State for Care provided an update on, which included that:
“It is now clear that successful implementation is not possible by this October. We now aim for full implementation of LPS by April 2022. Some provisions, covering new roles and training, will come into force ahead of that date. I will continue to update the sector and stakeholders on timings.
The Government will undertake a public consultation on the draft regulations and Code of Practice for LPS. That will run for 12 weeks, allowing sufficient time for those that are affected, including those with learning disabilities, to engage properly.”
To allow sufficient time following publication of the final Code of Practice, to prepare for implementation, the Minister is considering “a period of approximately six months for this.
Related items: Healthcare Brief December 2019: market insights
- NHS “needs to prepare” for new deprivation of liberty rules, highlights Kennedys
- The Mental Capacity (Amendment) Bill – reducing or shifting the burden of costs?
Contacts: Rob Tobin, Amanda Mead, Matthew Angus
8th edition of the Ogden Tables published
On 17 July 2020, the eighth edition of the Ogden Tables was published, superseding both Ogden 7, published in 2011, and the supplementary tables following the Discount Rate changes in England and Wales on 20 March 2017.
Noted as perhaps the most significant development in this edition is the provision of new tables - now 36, (previously 28). As explained within the update document, the Additional Tables (published only on the Government Actuary’s Department website in Excel format) “are provided for men and women at discount rates of -0.75%, -0.25% and 0%.” These new tables include multipliers for loss of earnings to pension ages 68 and 80 and loss of pension commencing at ages 68 and 80.
Also, amongst the key changes is the reduction in life expectancy. The Chairman’s Introduction to the eighth edition states:
“Somewhat surprisingly, given the previous upward trend in projected life expectancy data, the expectations of life (and hence the multipliers derived from them at all discount rates and ages) in this edition of the Tables are lower than in the 7th edition of the Tables, notwithstanding the 10 year difference in the data.”
“For younger claimants, the approximate reduction in life expectancy between the 7th and 8th editions of the Tables is about one year for men and two years for women. This reflects a difference in overall predicted life expectancy of 1-2%. However, for older claimants, the difference in predicted life expectancy can be as much as 8-9%.”
Contact: Christopher Malla