Fatima Holt explains how telecare is helping to manage chronic obstructive pulmonary disease in a primary care setting, for more timely and effective care

Chronic obstructive pulmonary disease kills 30,000 people every year inEnglandandWalesalone, making it the fifth biggest killer in the UK. Moreover, it is the only major cause of death whose incidence is on the increase - 95 per cent of all cases are linked to smoking. Given our ageing population, the mortality rate is set to rise.

According to the National COPD Audit (2004), the cost to the NHS of treating the disease is£818m a year. There are on average 25,000 primary care consultations and 1,000 hospital admissions in a typical trust area, and more than 30 per cent of emergency admissions are re-admitted to hospital within 90 days.

In the light of this audit, the health secretary announced that a new national services framework for COPD will be developed for 2008 to improve the quality of and access to COPD services.

There is clearly an enormous burden on the NHS, economically and in terms of primary and secondary care provision, with extended hospital stays and avoidable hospital admissions placing a strain on resources.

It is an issue NHS trusts across theUKare addressing with urgency by finding alternative models of care to treat COPD cases in a more timely way in the primary care setting.

Heads and beds: the cost of COPD

COPD is the third most common long-term disease affecting individuals inMilton Keynes,after diabetes and heart disease. Its burden on the NHS is significant, costing the PCT more than£450,000 a year to treat emergency admissions.

But while the cost to the NHS is high, the effect of COPD on individuals - characterised by difficulty in breathing - is more dramatic, with marked impairment of quality of life in many cases. In severe cases of COPD, patients are totally reliant on oxygen to even walk or talk. Constant visits to the hospital for check-ups can be stressful for the patient and eat away at valuable NHS resources.

New government guidelines promote a greater need for care at a community level and the Department of Health has put forward new models that tailor care to the needs of the patient, while simultaneously reducing some of the burden on the NHS.

With this in mind, a pioneering telehealth initiative has been launched inMilton Keynesto reduce avoidable hospital admissions and enable people to better manage conditions such as COPD at home.

During the initial roll-out of the scheme, 10 Tunstall Genesis monitors were providedto patients with COPD to support a more proactive and preventative model of care. The monitor allows patients to measure their own vital signs such as heart rate, weight, blood pressure and oxygen levels, and also asks a range of clinical questions to further determine their condition.

As a result, if patients with COPD experience a change in their health status, proactive medical intervention can be taken at an early stage. Staff at the community alarm centre view patient data using remote client access, and the nursing team is notified if assistance is required.

Telehealth technology has enabled healthcare professionals inMilton Keynesto manage COPD more effectively and to support patients in their own homes; it has benefited patient and trust alike.

Valuable NHS resources have been liberated and patients have a higher quality of life. Since launching the telehealth service, 26 hospital admissions and 10 GP visits have been prevented in just four months, reducing the burden on acute, primary and community sectors.

By allowing people with COPD to monitor their vital signs at home, anxiety levels are reduced and patients are empowered by gaining a better understanding of their condition, which in turn has reduced the number of acute exacerbations as well as part of the burden on healthcare providers.