Taking charge of health: Warrington’s digital leap

Investing in population health management and proactive care is the most efficient way of creating the most value from every pound we spend on health. By focusing on early intervention and patient empowerment, Warrington is setting a new standard in population health management. In this article, Dr Dan Bunstone delves into their strategy, exploring its foundations and implementation

CREDIT: This is an edited version of an article that originally appeared on NHS England

Our hypothesis was that investing in solving ‘simple’ health problems today would avoid much more costly, and often catastrophic health problems tomorrow.

Swathes of research describe the significant efficiencies to be gained for the whole system by investing in proactive primary care. The NHS Confederation quote around a £14 return on £1 investment, which is astonishing but entirely justified. In Warrington alone, a cohort of 880 patients are estimated to cost over £2 million a year.

So last year, we launched a primary prevention service using the Healthy You app. Using the UCL partners risk stratification search we identified 2,603 people in these categories:

• GP record – blood pressure above 180/140 at last reading.
• Last record was high yet has not been optimised.
• Medication not optimised to treatment target.

Around 1,000 people were recruited onto the app, a remote monitoring technology developed by Etc.Health (part of British Telecom). HealthyYou enables patients to submit their blood pressure readings and supports them to create an average home blood pressure, flagging patients who are ready for review to the clinicians. From the 1,000 patient cohort, we’ve treated over 500 patients’ blood pressure to target meaning their risk of heart attack and stroke is significantly reduced.

We’ve reduced the average systolic blood pressure in the cohort by around 12mmHg and have reduced the average ‘Q-Risk3 lifetime’ by around 3% (QRisk3 estimates your risk of getting cardiovascular disease over your lifetime). A 3% risk reduction means 30 less cardiovascular events in our first cohort of 1000 over the next 3 years, with an expected saving of over £400,000 to the wider health and social care economy.

For the Warrington Innovation Network Primary Care Network project we started small, and grew out from a single surgery, to a primary care network and ultimately with the support of the integrated care board, we are now set to roll-out across the whole of Warrington from April 2024 fully funded from Cheshire and Merseyside Integrated Care System.

Securing the funding and buy-in wasn’t easy but by developing a compelling business case, backed up by robust data and analytics, we were able to win hearts and minds throughout system and clinical leadership.

Ultimately, we know well that investing in population health management and proactive care is the most efficient way of creating the most value from every pound we spend on health.

Resources within health and social care are limited and we must continue investing today for a healthier tomorrow.  There is increasing interest in proactive care, and the ability to manage our patients remotely. Starting small is much better than not starting at all, so it’s worth trying something at practice level and seeing how this will scale to primary care network and beyond.

In a world where healthcare resources are perpetually stretched thin, Warrington’s foray into digital population health management stands as a beacon of hope. It’s a clarion call to embrace technology, to prioritise prevention, and, ultimately, to invest in a healthier future for all.