Telehealth to Reduce Compound Pressures on the NHS and Social Care: A Multi-Methods Study Protocol

Abstract Telehealth and remote monitoring are increasingly used in the management of long-term health conditions and can improve access to care. The Mersey Care Telehealth Service (MCTS) provides technology-enabled support for people with heart failure, diabetes and chronic obstructive pulmonary disease (COPD). The service has been operating for over a decade; however, the COVID-19 pandemic has led to its rapid expansion. This study aims to gather evidence on the impact of the MCTS, explore barriers and enablers to effective service delivery and evaluate its cost-effectiveness. This study comprises of four work packages (WP). WP1: A retrospective observational analysis to evaluate whether the MCTS is associated with reduced unplanned healthcare utilisation and to examine how outcomes vary by sociodemographic characteristics and service delivery type; WP2: Longitudinal analyses to compare patient-reported outcomes, including mental health, quality of life and wellbeing, between telehealth users and a comparator group of non-users who meet the eligibility criteria for telehealth; WP3: Remote semi-structured interviews with MCTS staff and patients will be held to explore the barriers and enablers influencing the effective service delivery; WP4: An economic evaluation will determine whether the MCTS is cost-effective compared with usual care, and will assess how cost-effectiveness varies by patient characteristics and service delivery type. This multi-method evaluation will provide robust and comprehensive evidence of the impact, equitable delivery, implementation approach, and cost-effectiveness of the MCTS. Insights seek to inform service improvement, commissioning decisions, and future telehealth strategy within the NHS.