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Thousands of patients with cystic fibrosis and coronavirus are being given devices and apps so that medics can monitor their condition remotely, as part of the NHS drive to give more people connected, supported, personalised care in their own homes.

This latest initiative to support patients digitally was outlined in the NHS Long Term Plan last year, setting out an ambition for greater use of connected home-based and wearable monitoring equipment, combined with apps, software and data.

According to the health service, experts believe this kind of innovation has the potential to empower people to manage their conditions at home and help NHS clinicians to predict and prevent events that might otherwise lead to a spell in hospital. This turns healthcare from being reactive into preventative healthcare, reducing hospital admissions and helping people stay healthier for longer.

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People with cystic fibrosis (CF) are among those classed as at extreme risk from COVID-19 and have been advised by the Government to follow specific shielding advice.

From this month, CF patients aged six and above will be given a spirometer to measure their lung capacity and an app that lets them share this information with their doctor as part of the new NHS At Home initiative.

NHS England has accelerated the roll-out to help ensure people can stay safe at home during the coronavirus crisis, while at the same time ensuring that those whose condition worsens can get the right help fast.

NHS Chief Executive Sir Simon Stevens said: “For patients and their families living with cystic fibrosis this is a landmark moment, offering people vital health help at home.

“The Covid-19 outbreak has hit every household in the country but for some people with certain conditions, this virus will have been especially unsettling and dangerous, which is why the NHS is looking to make sure those at greatest risk can get safe, tailored care, despite the ongoing pandemic threat.

“As the NHS in England moves from having responded successfully to the first wave of the virus, to helping people to recover and to restoring routine services, it is common sense, convenient and innovative forms of treatment like at-home lung checks that we are making increasingly available to people across the country.”

“The expansion of home spirometry by NHS England and NHS Improvement to 4,000 people with cystic fibrosis across England is great news,” Dr Janet Allen, Director of Strategic Innovation at the Cystic Fibrosis Trust, added.

“We’ve been working closely with NHS England and NHS Improvement to ensure more people with CF have this equipment at home during these difficult times, so that clinical teams can continue to make important decisions about their care.

“It also builds on research we’re running – a study called Project Breathe – to help us understand whether measuring things like lung function, oxygen levels, activity and weight at home can reduce the number of hospital appointments for people with CF.”

In addition, a separate trial will see some patients with COVID-19 given devices which can help spot any dip in their blood oxygen-levels while they recover at home.

The NHS is trialling the use of oximeters, combined with app-based check-ins with clinicians, which will make it easier to spot whether people need to be re-admitted to hospital.

The new oximeter service is being trialled with more than 150 patients in sites in Watford, Hertfordshire and North London, with the NHS’s digital transformation unit, NHSX, working with British digital health start-up Huma.

Clinicians in ‘virtual wards’ are able to track patients’ vital signs – including temperature, heart rate and blood oxygen saturation – in near real-time, receiving alerts if they suggest a patient is deteriorating so that further assessments and care can be arranged.

Tara Donnelly, Chief Digital Officer of NHSX, commented: “This is a great example of how new technology is supporting healthcare professionals to provide the right care at the right time. With COVID-19, it’s vital that we make use of digital tools that can help support patients who don’t need immediate hospital care and allow close monitoring of their condition.

“The feedback we are getting from patients is that the remote monitoring with clinical oversight is really reassuring to them, and they are grateful to be at home while they recover, rather than in a hospital bed.

“The clinical team is finding it helps give them very rapid feedback on their patients and they are able to keep an eye on a number of people at a glance, which is working much better for them than the previous system which relied on phone calls.”

The service has since been extended to additional sites in West London, with plans for further pilots in other areas of the country including higher-risk patients who have recently tested positive for COVID-19.

If the trials show the model to be safe and beneficial for patients, they could help to inform a national rollout ahead of the coming winter.

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