cost of viewing, The

James Parker investigates the growing use of a combined personal TV and phone system in the NHS, and discovers that questionmarks exist about charging patients, despite the benefits to both patients and staff.

The Government, once again flushed with success after its second landslide Election now however has the debatable honour of seeing through the promises it made during its first term in Government. One crucial set of pledges, for hospital patients at least, is that contained in the NHS Plan, published in July 2000. Amongst other promises aimed at improving healthcare environments, the Plan states that every hospital bed will have not only its own telephone but its own television.

And now several companies have taken up the gauntlet thrown down by the Government, marketing new bedside television and telephone systems heavily to the NHS. One such organisation, Patientline, claims to be a leader in the market, offering a system which provides telephone, radio and digital television, via a wall mounted screen and a combined remote control and telephone.

Around 20 satellite and terrestrial channels are provided by the system, plus six FM radio stations and an answer-- phone service.

The system also provides for internet access, using a keypad found on the reverse of the patient's remote. Although this aspect of the system is not yet up and running in any hospitals (of which 36 in the NHS have installed Patientline), this is where the system could truly come into its own, with patient records viewable on-line for clinician access by the bedside, as well as allowing patients access to information on the internet, plus email. Together with similar bedside communication system manufacturers Wandsworth and Hospital Telephone Services, Patientline has been awarded a 'licence' by NHS Estates to provide its systems to hospitals.

THE COST

Although Patientline typically costs around klm to install across a major acute hospital, all of the installation and operating costs rest on the manufacturer, as opposed to its NHS clients. It derives all its revenue from patient phone calls, either incoming or outgoing, and TV access, both via a system of smart cards. While the ability to install such systems `free of charge' and thus easily meet NHS Plan requirements, has fallen on welcoming ears across the NHS, the charges have raised some eyebrows in patient research undertaken by Patientline itself, prior to installing the systems.

The company found that 67% of patients surveyed said that the premium rate (50p per minute) for incoming calls did not equate to "good value for money", however 77% found the outgoing calls good value. Premium rates are set by British Telecom, thus it is uncertain whether they will go up or down in price. However Patientline hopes that relatives will buy phonecards for patients making outgoing calls as a common part of visiting, much as they would buy flowers.

BENEFITS TO STAFF

Despite varied reactions from patients surveyed, (most of whom however found the system to be an improvement on previous available methods), nursing staff are on the whole very pleased with Patientline, according to the company's research. Of 57 nurses surveyed, 44% said it saved their time (on relaying calls etc), and 94% said patients were "happier or more occupied" with the system installed. This is quite an endorsement, and one NHS manager HD spoke to -- project director at Carlisle Hospitals Trust Miles Timperley - seems similarly content: "We went to consultation with the Community Health Council and patient groups, and there was unanimous support".

The trust has installed the system throughout the new Cumberland Infirmary PFI scheme, and Timperley affirms that the trust was "upfront about the charges," but adds that he "would like to see cheaper incoming calls," and that at the time of choosing Patientline two years ago there was little competition available. Timperley says that it has "eased the burden" on nurses, and that the trust will be looking at the possibilities of using the internet on the system.

Nurses have final control over patients' use of the system, deciding whether patients are able to operate it, and helping to ensure that they are not disturbed by unwanted calls if necessary. They can also, in exceptional circumstances, allow patients free access to the system if they believe a patient cannot afford to use it. The system can help to empower patients traditionally forced to watch the same programmes as everyone else in the ward, by giving them a sense of control over their immediate environment As Patientline's chairman Derek Lewis puts it: "It is about extending patient choice".

Copyright Wilmington Publishing Ltd. Jul 2001
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