Report objectives:
This report summarises the key findings of a Pan-London evaluation to assess levels of implementation and identify key barriers and enablers to the streamlined implementation of the BP@home program across London. Specifically, we mapped the reception and distribution of BP@home monitors, investigated the views and experiences of primary care workers involved in the implementation of the programme, and quantify changes in outcomes using SNOMED codes. This data was synthesised and used to develop a list of evidence-based recommendations for the consideration of NHSE leadership team.
Methods:
We used a mixed methods research approach and six phases of investigation to address these aims, including desktop research, personal interviews and focus groups, action research, data analysis, synthesis and reporting.
Results:
The evaluation showed that there are different levels of readiness and implementation across the 5 London ICSs. The roll-out of BP@home programme has been challenging due to a number of key factors across the pathway, including the limited IT infrastructure, insufficient human and financial resources, and the lack of adequate and specific SNOMED codes. These challenges were further increased by the competing demands on limited capacity in Primary Care, especially during the Covid-19 pandemic. However, respondents also identified some facilitators, including the onboarding material provided by NHSE, the inclusion of the UCLP criteria the EHR and the provision of conditional incentives in certain ICSs. A more structured and holistic approach to onboarding patients is needed to ensure high quality compliance and satisfactory results for patients. Another key recommendation devised by respondents was to offer BP monitors on prescription, along with the creation of specific SNOMED codes.
Conclusion:
At the time of redaction of this report, there are local evaluation plans in each ICS & a national evaluation of @Home programme was recently commissioned by NIHR. There is an urgent need to develop & use system-wide codes to track activity as well as carry additional research especially regarding patients’ experience and perspectives as recipients of the BP@home programme.