The Potential Economic Impact of Virtual Outpatient Appointments in the West Midlands: A scoping study

Abstract

The Strategy Unit was recently approached to examine the case for a shift from traditional outpatient services to the use of virtual and remote access technologies for appropriate outpatient appointments. An essential part of this assessment was broadly scoping the potential socio-economic impacts of the shift – something that is arguably not always given enough consideration when thinking about transforming services. This work was commissioned by Andy Williams, Accountable Officer at Sandwell and West Birmingham CCG. The notion for such a shift emerged from discussions between the West Midlands CCG Accountable Officers and the Directors of Adult Social Services in relation to the wider economic impact of the NHS and how it could be improved. The introduction of virtual style appointments provides the opportunity to reduce the negative socio-economic impacts attributable to traditional outpatient services. These are in the form of; effects on productivity for businesses through work absenteeism (time off to attend and travel to/from outpatient appointments); the direct cost incurred by the individual from travel and parking, and the environmental effects of the CO2 emissions from the travel. If implemented effectively, there is the potential to also reap benefits in NHS provider efficiency and cost effectiveness. Virtual and remote access technologies such as Skype are also developing to be increasingly more refined, reliable and sophisticated. They are also becoming more accessible to patients as familiarity with such technologies continues to improve across age ranges. These factors offered the rationale for the scoping study. In addition to analysing the outpatient data, a key component of the study was the review of the evidence base for previous initiatives of where virtual appointments have been tested. It was found that the evidence around relevant interventions largely consisted of small-scale pilots in a variety of acute specialties. Using these findings, the study was able to produce high level estimates for the potential impact of a shift upon: Economic productivity impact (£ GVA), NHS impact (capacity and DNAs), Patient travel and parking costs (£) and Reduced environmental impact (CO2 emissions). The analysis provides an analytical framework for assessing the socio-economic impact of making outpatient services more accessible to patients who are in employment. It does not represent a complete business case for a service change but does estimate that considerable gains could be made – particularly in terms of productivity, which could be of significant benefit to the local economy. To determine whether this can be delivered in practice and reap the possible benefits for the health and care system, as well as the local economy, we are looking for systems who are interested in piloting and evaluating such an approach at a scale not currently available in the evidence base. This latest study built on our economic analysis undertaken with our partners at ICF International, which aimed to understand the current and potential impact of NHS spending on the wider Black Country economy.