DOCTORS CHECKED ON MY HEART WITHOUT ME LEAVING THE HOUSE

Gavin Redhead, 57, a retired council advocate for vulnerable young people, lives with his wife

Julie, 51, a local government officer, in Lancashire. he has heart failure and benefits from nhS remote monitoring. he says:

I WAS born with a hole in my heart and grew up being told there could be no running, no overexertion.

Still, I became a Sea Cadet, left school and met my wife Julie and worked for the local authority for years. But my heart problem was always there. I saw consultants every six months for monitoring but it was an arduous two-hour journey each way into Manchester.

In 2009 I developed arrhythmia — an irregular heartbeat. I was fitted with an implantable cardioverter-defibrillator (ICD) which monitors the heart’s rhythm, paces it and shocks the heart back into normal rhythm if it stops.

It monitors remotely and data is sent to consultants while I carry on with my life. The small matchbox-shaped device implanted under the skin by my heart is linked wirelessly to a handset with which I can trigger a download of information to send on. Doctors can access it, too.

I saw the consultant every 12 months instead of six. In 2016, he told me that the device had picked up an erratic heartbeat and the ICD had prepared to shock me but went back to a normal rhythm before it fired. I had no recollection of it — but it could have saved my life.

Sadly my heart condition worsened. One night, I got to bed and felt very unwell. I couldn’t even call for Julie so I texted her. She called 999.

In hospital I was told I had irreversible damage and my heart would eventually fail. I was given about eight tablets, including ACE inhibitors that relax blood vessels and ease the pressure on the heart; beta blockers, which block adrenaline, as well as MRAs to stop the build-up of fluid, linked with heart failure.

Doctors feared I’d need a heart transplant but decided that, thanks to my ICD, I could carry on living normally as the remote monitoring would reveal when more urgent help was needed.

I gave up work in 2019 due to fatigue. Now I’m a patient advocate with the Pumping Marvellous charity, helping others with heart failure.

I may still need a heart transplant one day. But remote monitoring has saved my life. Without it, I’d be terrified wondering when my heart might stop, or start beating irregularly. Instead I can enjoy the time I have with my family.

increase training for new and existing staff to roll out the programme. However, Pritesh Mistry, a policy fellow at the King’s Fund think tank, warns that staffing is an issue.

‘You need staff for both virtual and hospital care, and the question is, how are we going to go full- steam ahead introducing more technology when we already have significant workforce shortages?’ he says.

‘ The people best placed to be introducing these changes are the people who are delivering services to others.’

The other question is whether home monitoring will actually free up beds.

‘The beds that home monitoring free up are generally not surgical beds, staffed by medical teams who could do then more operations, but general medical beds,’ admits Nigel Edwards.

‘Where it could make a difference is getting people into hospital from ambulances, which is currently a problem because of bed shortages.’

But the technology is not popular with everyone.

In the previously mentioned 2019 BMJ Open study of gP patients, only 22 per cent of patients taking part asked if they

wanted to take part in remote monitoring ultimately agreed.

And within four weeks 7 per cent of these patients had asked for the technology to be uninstalled.

‘In my experience, there seems to be a 50:50 split among patients,’ says Nick Hartshorne-Evans. ‘Half of patients embrace the technology and the other half are sceptical, phobic about technology and worried they are just being palmed off.’

Digital inequality is also a glaring issue, with older people, low-income families and disabled people more likely to be affected. Some don’t have internet access, others may not have the skills and confidence to use the technology. But there is another point. ‘Telehealth is generally perceived as a good thing as long as patients have the choice,’ says Pritesh Mistry. ‘ It’s not a magic bullet and it won’t work for everyone.

‘There is a concern that this will become the default approach rather than an option for patients, so we must ensure that for those who don’t want to use technology to monitor their health there is a suitable, well-funded alternative.’