Professional Comment

Remote Monitoring In Care Homes – Learning From The Lessons of Covid-19

By Fay Sibley, Head of Healthy Ageing at the Health Innovation Network ( who leads on the NHSX Innovation Collaborative for London.

As a result of the tremendous challenge Covid-19 has placed on the health and care system, remote monitoring technology and capabilities development has accelerated at rapid speed. The short-term benefits of this are obvious in settings like care homes for older people, whose residents have made up 39% of all Covid-related deaths in England . This critical progress has made it possible for care home staff to access clinical monitoring of complex health conditions and palliative care, while reducing the transportation of elderly residents to and from crowded hospitals and GP surgeries with high rates of infection.

With all of the work that has been done in response to this need, an evidence base has begun to emerge, slowly but surely building the case for remote monitoring interventions not just as an effective short-term solution to a current problem, but as a long-term improvement to care in care homes.

However, this sort of lasting improvement to the adult social care sector is not without its significant road- blocks, which prominently include the need for major improvements to IT systems in care homes that vary significantly across the board in terms of the digital maturity of staff, the size of the home and type of care provided. For these roadblocks to be addressed properly, local authorities and CCGs must be aware of this variation and take a targeted approach to supporting these interventions in care homes.

To facilitate a more joined up approach, NHSX has pioneered a new Innovation Collaborative, which is partnering with all seven regions of the NHS in England to help health and social care staff embed remote monitoring interventions. In the London region alone, we are supporting roughly 600 care homes and a total of 21,000 older people in the country’s capital to remain safe and well in their homes.

The hardware and digital platform necessary for remote monitoring to occur allows care home staff to monitor and record vital signs of care home residents, which are then stored on a shared platform accessible to health professionals like GPs. In turn, care home staff have access to clinical information like heart rate, blood pressure and temperature, which allows them to identify signs of a resident becoming unwell and consult a health professional earlier. The result is a more efficient, collaborative approach to planning and prioritising the care of care home residents, in a way that could permanently reduce the distress and practical obstacles of transporting those who are more often than not extremely frail or unable to move around on their own.

Care home managers in south London have reported this new technology and the collaborative approach to using it with primary care have been game-changing during the Covid-19 pandemic, as well as made it easier to reassure families who have expressed uncertainty about the vaccine. Upskilling existing care home staff has been simple, requiring less than an hour of training to become onboarded.

GPs involved with piloting remote monitoring technology in care homes have acknowledged the huge potential benefits to both care home residents and primary care clinicians, including the possibility of integrating with clinical systems already in use by many GP surgeries, such as EMIS, to avoid increasing workload. It also offers an exciting possibility to roll out these services to larger portions of the population and other areas of healthcare.

“It’s been a game changer for us,” says Rick Mayne, the Registered Home Manager for Sherwood Grange Care Home in Kingston, south west London, which is home to more than 50 residents with varying needs. “My staff embraced it as it only took around 30 minutes training for them and then a few minutes to get them on the system. Usually we do observations once a week as our residents are generally well. However when they received their Covid vaccine we took their observations three times that week so we could reassure them and their families that they were well. For a non-clinical person it’s been great.”

As a result of NHSX’s Innovation Collaborative, all five sustainability and transformation partnerships (known in some areas as integrated care partnerships) in London are working together to:

• build on the learnings and improvements around digital health brought by Covid-19;
• accelerate the scale of digital innovations that will contribute to redesigning outpatient and remote care for the better; and
• increase workforce productivity by helping to save staff time.

As well as leading on this pan-London approach, our role as the Health Innovation Network has been to review and summarise research on the topic of increased remote monitoring technology use in care homes, as well as to conduct a market comparison of viable solutions and their spread across London. We are also, importantly, supporting the dissemination of learnings from this experience, so the benefits of remote monitoring can continue to reach those who need it most in the future.