'Florence Light and Telehealth' with Dave Sanzeri from Stoke-on-Trent CCG

Dave Sanzeri is a big influencer in the NHS and especially in Telehealth and he is Head of Commissioning at Stoke-on-Trent CCG.

I wanted to get an insight into his thoughts on Telehealth, Florence and the future of digital healthcare and he offered to arrange a call with me back in May 2017 to share these. I’d like to share his thoughts with you.

Q: Who will benefit the most from Telehealth, patients or the NHS?

“It’s got to benefit patients first. The benefits come for the individual first and then because the individual is participating more in their health and taking more responsibility of their own health and importantly then using health services differently, that’s where the benefit for the NHS comes from.

“You don’t get any benefit simply by someone signing up for Telehealth, it’s how their behaviour changes as a result of using it, that’s where the benefit package starts to be realised. It helps confidence grow in patients so they can participate in their own care.

“Patients recognise the time is right to take their rescue medication so they take it a day or two earlier than they would have done before. In those two days they don’t become anywhere near as ill as they would have been after another two days.”

Q: What’s the one key thing you would advise a clinician on the benefits of telehealth?

“I would say there’s a rule of three, in no particular order…

“One, create a partnership with the patient.

“Most GP’s will tell you that care has to be a partnership with the patient. We’ve always said, having a multidisciplinary team approach to the care of a group of patients is always going to be much easier if the clinicians and the patients both have access to a range of indicators which show how a patient is progressing, how well they are and what the triggers are that cause any response in their health.”

“Two, it saves time when used as an integrated part of a care plan.

“When you introduce Telehealth, people focus on the time it takes to put the patient on it but if it’s used to understand a patient’s blood pressure or respiratory cycle or to understand why a patients struggling to give up smoking or why can’t they lose weight it eventually saves time.

“If a GP wants to know how a patient has been over the last week, it’s difficult to do that if the only 2 blood pressure readings you have are the one you took last week and then the one you’re going to take today.

“It will ask them to take and record their blood pressure twice a day or to weigh themselves every morning. Recording the readings over a week means if there’s one which has been recorded wrong, it’s going to show up but generally you should be able to see a trend.

“That means that what you want to discuss with that patient can be richer in a consultation. What it may also allow you to do, instead of having the patient in twice in a period of two weeks, it may allow you to only have them in once.”

“Three, it supports the model of care.

“If the model of care was we want to make better use of information, we want to be evidence driven, we want patients to participate in their health, we want it to be much more anticipatory and prevention linked and so on, introducing Telehealth supports that.

“When it’s used effectively, it’s integrated into a plan and clinicians and patients know what it’s there to achieve. Telehealth means patients start to use medications or exercises or stress relief techniques, whatever it is their clinician has taught them rather than just putting their stress relief technique on the shelf and out of embarrassment telling the GP they did absolutely everything they were asked to do.

“It’s much more likely to support you so the model of care gets delivered.”

Q: What’s the future of Telehealth and Florence?

“It’s only constrained by our imaginations for me. Florence and what it has to offer individuals is only constrained by our lack of imaginations.

“Where’s ‘my Florence’ which doesn’t require me to go on it with a GP? Why can’t I access the plans I want, for myself? If I want a weight loss plan, why can’t I be told by someone – why don’t you try Florence? It’s not a clinical plan, it’s a help plan.

“I’d like to see people signing up for a plan for weight management and telling it what their targets are like they would with a GP.

“Why can’t I use it to give up smoking? This industry now has uncontrolled expansion.

“I have my Fitbit and when I get home it will tell me all sorts of things about my day. Florence does so much more than that but I’d like to be able to attach it to something like a Fitbit programme. A Fitbit in itself may change my behaviour slightly but it doesn’t have that interaction with me that Florence would have.

“You could have Florence as a clinical tool where there are some quite clear clinical outcomes and so on. You could have Florence Light, where by you introduce people to a limited number of plans where by you get people using it and they might then move to a more controlled Florence later.

“You could have Florence as a clinical tool where there are some quite clear clinical outcomes and so on. You could have Florence Light, where by you introduce people to a limited number of plans where by you get people using it and they might then move to a more controlled Florence later.

“And then what about a ‘Florence for Me’ if I don’t need clinical supervision? If I’ve not been feeling well, I could then go to my doctor and say, actually my blood pressures been quite high for a while or I’ve been monitoring my weight and it’s looking like this.”

Florence Light

So, here it is; Florence Light. A simple to use, refined app which has a list of plans ready for you to use. A massive thank you to Dave Sanzeri for his time and for sharing his thoughts with us.

If you’d like to chat more about Florence Light, please get in touch.

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