The document discusses trends in long term conditions like COPD and diabetes that are increasing healthcare costs and burden. It introduces an innovation to improve pulmonary rehabilitation through online programs that could double recovery rates, correct inhaler errors in 95-98% of patients, and provide outcomes similar to in-person programs at lower costs. The challenges are implementing changes, gaining clinician acceptance, and scaling the program across organizations.

2. The Brief
• Scale of the problem
• What are the trends?
• The do nothing scenario
• What is the innovation
• What can the future look like?
• The Challenges
• Wessex

3. 2%

4. Scale of the problem
• There are 15.4 million people with long term conditions
and prevalence is rising
• COPD alone accounts for >£1bn/yr, responsible for 13% of
acute medical admissions
• Over 90% of patients with asthma and COPD unable to use
their inhalers correctly
• Current PR programs £400-£600 /yr with limited
penetration
• Diabetes predicted to rise to 5 million over next 5 yrs –
average cost £2500 pp/yr

5. What are the trends?
• No improvement in inhaler technique in 40yrs
• Rising hospital admissions
• More complexities and more patients with co-
morbidities
• Less money in the health service
• Everything else in our lives is going digital but
the Health

6. The do nothing scenario

7. What is our innovation?

8. Our innovation

9. • Double the rate in recovery of
CAT scores during exacerbation
• All inhaler errors corrected in
95-98% patients
• On line PR with same outcomes
as class based programs
• CAT score improvements 5-12
• Reduced exacerbations
• Reduced consultation time

10. • Analytics philosophy
• Disease burden
• Disease phenotype
• EWS
• Pandemic Plan

11. COPD Example
90% of patients unable to use therapy
correctly
98% of patients using therapy correctly
150-200 patients per CCG receive face to
face pulmonary rehab to completion at a
cost of £200-@400 per head. Dropout rate
45-55%
1000s of patients receive pulmonary
rehab for a lifetime with double the
walking distance improvement achieved
against standard class based programs
Limited access to specialist services Open 7 days a week including
physiotherapy and psychology modules
Variation in the quality of care delivered.
In some studies, 90% of clinicians failed to
deliver correct inhaler education
Reduces inequality with an NHS approved
set of educational modules and inhaler
videos
Leads to the creation of an ever expanding
clinical team with multiple touch points
Improves quality and reduces cost
Reactive health service Provides medical intelligence to manage
the system efficiently

12. Challenges
Implementation
• Change
• Clinicians
• Organisational
• Pathway changes necessary
Scaling
• CCG by CCG
• STPs and Vanguards
• 3rd Party
• Champions

13. WHAT ARE WE WAITING FOR?
Wessex