COMMERCIAL: An internal audit report found 2,000 telehealth units bought by NHS North Yorkshire and York have been significantly underused.

The audit report, obtained by the Yorkshire Post, also reveals problems with the procurement process. The units were bought in early 2010. The audit report is dated October 2011.

In a summary of the project’s status, the report says: “There has been significant slippage in terms of the number of Telehealth units installed and the amount of savings released as a result when compared to the initial projections… There have been issues in obtaining engagement from within primary care which has resulted in low referral rates from practitioners… A further contributing factor in terms of driving the project may have been the absence of a Project Board and regular accountability to the PCT board.

“Tunstall’s original bid envisaged 1,500 units being in use by the end of 2010/11. At the end of June 2011 a total of 350 from the 2,000 units purchased were in use. The total savings planned to be achieved by the end of 2010/2011 was £3,442,229. This was based on the rollout out of 2,000 units. As at 31 May 2011 a total of £196,899 is estimated to have been saved via reductions in inpatient, outpatient and A&E episodes.

“The slower rate of rollout out compared to that initially identified in the tender bid has impacted on the savings achieved to date. However, the potential savings once all units are deployed are currently forecast to be in excess of those originally estimated.”

The report states: “The revised plan is now to implement all 2,000 units by March 2012.”

In its conclusion, the report summary states: “The review has identified that probity was achieved in terms of the approval of expenditure to fund the project and the procurement of the units themselves. The approval and procurement elements of the process complied with procurement regulations and the PCTs own standing orders and standing financial instructions.

“The review has not been able to form a conclusion on all questions arising from the project; most notably the decision to procure 2,000 units and the accountability for this. A lack of documentation and business case together with the loss of corporate memory by the departure of key officers involved in the project has contributed to this.

“As a significant number of the units procured have not been installed, and therefore benefits from the system have not been fully achieved, it is not possible to conclude at this stage that value for money has been achieved. This is compounded by the fact that the PCT has incurred revenue costs for the units held in storage that have not generated any savings to date. However, it is probably too soon to form a final conclusion on value for money and this will need to be fully considered as part of a full project evaluation once the rollout is complete.

“At this point in time it can be concluded that the procurement process and evaluation of suppliers was designed to ensure that value for money was ultimately achieved for the health economy.

“Lessons learned from the process have been shared with management. These are to be incorporated into guidance on business cases currently in
the process of being developed and are to be shared with the Clinical commissioning Groups and PCT senior officers.”

The units were sold to the PCT by Tunstall. A Tunstall spokesman told the Yorkshire Post the work had “trailblazed the mainstream of adoption of telehealth in the NHS” and “could in no way be described as unsuccessful”.