Working with NHS England and key partners from the digital sector, Modality Partnership is collaborating with Sanius Health to develop a digital solution that will benefit patients and help overcome the capacity issues facing primary and respiratory care.
Alongside Sanius Health, Modality is enabling earlier interventions for severe asthma patients ‘by giving people the technology to remind them to use their inhalers, to monitor their adherence, to give them constant feedback on how their asthma is, and to alert them when things might be getting out of control’.
Modality is one of the largest providers of primary care in the UK, serving about 450,000 patients nationally. Leading in primary care at scale, their footprint covers approximately a million people across different primary care networks. Tom Ratcliffe is a GP Partner with Modality, and clinical lead for the Group’s digital transformation programme.
Modality is innovating in a number of key areas, particularly lifestyle medicine and digital health. Working GPs like Tom have been involved in designing Modality’s processes from the start, resulting in processes that work smoothly even in time-pressured primary care environments.
Challenges Facing Patients
Even outside of the strains of the pandemic, healthcare has seen a lot of changes over the past decade. One key challenge now facing patients is the increasing complexity of care. A lot of elements of care have been moved out into the community and are dealt with by various multidisciplinary primary care teams. This means that it's sometimes harder for patients to coordinate the care they need.
‘Whilst the number of appointments in primary care is rising, we've also seen a fall in the number of qualified GPs over the last five to ten years,’ notes Tom. ‘Although the total number of appointments that we're delivering every month is higher than it's ever been, the demand is outstripping supply,’ so access remains difficult.
Finally, the model of general practice is changing. Because of the intensity and complexity of the work and the makeup of the workforce, more people are working part-time in patient-facing roles in primary care. They're often taking on other responsibilities that are critical to delivering primary care, which means less of their time is spent in clinic. As a result, continuity can be a challenge and seeing the same clinician on a regular basis is harder than it used to be.
Innovations to Watch
Tom is excited to see digitally-enabled patients gain more control over their healthcare information, improving their ability to manage their long-term medical conditions.
Those whose long-term conditions are relatively well controlled can remotely input the relevant data and then only be followed up in person if necessary. This saves time and energy for patients and means that the practice can focus valuable primary care capacity on those who need more attention.
At the other end of the scale, patients whose long-term conditions are not well controlled will have easier access to in-person care. Technologies that enable these patients to be closely monitored remotely can help improve outcomes and improve access for those who need it most.
Modality Partnership with Sanius Health
Focusing on people with severe asthma, Modality has begun work with Sanius Health to empower self-management and enable earlier interventions. Affecting around 5-10% of people with asthma, if not intensively managed, severe asthma necessitates regular use of reliever inhalers, regular treatment with steroid tablets, and may result in hospitalisation.
‘For the vast majority of people with asthma or even severe asthma, we have all the treatments that we need to manage their asthma well and to prevent serious harm or adverse outcomes,’ notes Tom. ‘But, often, there are issues with people remembering to take their inhalers, not being on the necessary intensity of treatment, or not realising when their asthma is starting to get out of control.’
The reasons patients might struggle to keep on top of symptom management are multifaceted:
‘From a public health perspective, we know that if you live in an area of increased socioeconomic deprivation, you’re at higher risk of severe asthma and adverse asthma outcomes.’ This is in part due to environmental factors such as air pollution, damp housing, and not being able to afford to heat your house properly - the latter of which is exacerbated by the current cost of living crisis. On top of this, ‘when you're dealing with the day-to-day crises of living in poverty, remembering to take your inhaler or noticing your asthma is getting worse might not be at the forefront of your mind.’
Modality’s large and diverse patient population across the organisation means they are perfectly placed to examine how these interventions work in different population groups and work closely with the patients who need their support most.
This pilot may be small-scale, but the Sanius and Modality partnership has the potential to be significant for respiratory care:
'The potential for reducing A&E attendances could have a very beneficial impact going into next winter when, if current trends continue, the NHS will be under even more pressure than it has been this year. In primary care, it will help us make the best use of our increasingly scarce resources by enabling us to pick up problems with patients before they necessitate emergency appointments.’
‘Giving people more control over their long-term conditions will promote self-care and self-management. This is an aspiration that is frequently spoken about but, in practice, difficult to realise. Using cutting-edge technology, developed and tested in a live clinical environment, gives us a chance to make this a reality for patients.’
Looking Forward
Key members of Modality Partnership, including CEO Vincent Sai, attended this year’s Health Systems Patient Flow Summit 2023 where they, alongside Sanius, explored how innovative partnerships and ways of working can improve patient flow and enhance healthcare for all.
To learn more about Modality Partnership, visit: www.modalitypartnership.nhs.uk
