How Flo is making a difference

Our film, Flo: telehealth with a human touch, clearly shows the impact using this system is having on individual lives. We spoke to Sian Clark from Nottinghamshire and Rachael Forbister from Sunderland about the many different ways Flo is being used to support people’s health. They are both health care managers who have helped to introduce Flo into their respective areas of the health service.

Sian Clark, Assistive Technology Innovation and Operational Manager, Mansfield and Ashfield Clinical Commissioning Group

We first introduced Flo in 2012 as a way of monitoring blood pressure, pulse and weight for patients with heart failure. With this group of people it’s really important to keep an eye on weight as any rapid increase in fluids could be a sign they might need an admission. Getting in there earlier means we can treat people more effectively at home and try to avoid further admissions.

It was so successful. We reduced nurse visits by a third because patients were managing their own health through Flo and supporting themselves at home. The nurses could also quickly see on the system if anything was going on with the patient, so they could make their visits more appropriate.

After that we used Flo to help patients manage other conditions, focusing on long-term conditions where care was led by GP practices or community nurse teams. So patients with asthma, patients with chronic obstructive pulmonary disease (COPD), hypertension, we really focused on that remote monitoring and self-care. 

With some conditions, like COPD, Flo gives a huge amount of reassurance to patients and also to carers. It doesn’t always have to be the patient who does the texting, which has helped with some older patients.

There’s a lovely example of a chap who’s 81 with respiratory problems. He used to have a lot of flare ups with his condition, and his wife, who’s 15 years younger than him and out at work every day, used to be so worried about leaving him. She started off using Flo for him, texting in oxygen readings and getting advice messages back. Now she’s taught him to text and he’s using Flo himself. He hasn’t had any bad episodes since he started using Flo, it’s shown him what signs to look out for and how to manage his condition.

We’ve had over 2,400 patients use Flo now. So we’ve got lots of lovely stories like that which have really helped to spread the word about Flo and get people working in the health service on board.

In April this year we became an operational service, continuing to grow the number of patients using Flo and to offer support to any health and social care organisation in Nottinghamshire to help them use Flo. Being jointly funded by all six Nottinghamshire clinical commissioning groups (including vanguard sites) ensures economies of scale and ability to share best practice, as we continue to evidence the benefits. We’re still rolling Flo out in GP and community services, but now a colleague of mine has dedicated time to look at how Flo can be used in hospitals. We’re also working with the mental health services, and Flo is being used by recovery teams working with drug and alcohol users. So it has expanded quite a bit.

Rachael Forbister, Telehealth Lead, NHS Sunderland Clinical Commissioning Group

In Sunderland Flo is used for all sorts of things, from conception right through to end of life care. Similar to Nottingham, our matrons and community nursing teams at South Tyneside Foundation Trust are using Flo to support patients with all sorts of long-term conditions. We’ve also pioneered using Flo in new ways, and have done a lot of innovative work with pregnant women.

We’re using Flo to monitor mild hypertension or gestational diabetes in pregnancy, to help mums-to-be stop smoking, and to support breastfeeding once the baby’s born. Using Flo with pregnant women has really helped our midwives, freeing up time in particularly stretched clinics. They can prioritise time for patients who need it rather than just giving out routine appointments. 

There’s a great story about a lady who was expecting twins which was written up in the local paper. Using a simple kit and her mobile phone she was able to use Flo every day to monitor her blood pressure, which was high, and it meant she could continue to work. After the twins were born her blood pressure remained high, but the doctor carried on using Flo to monitor her and manage what medication she should be on. It meant she didn’t have to come in for regular clinic appointments with her newborn twins.

And there’s loads of other innovative work. Flo is helping kids with Type 1 diabetes around the region. Working in partnership with South Tyneside Foundation Trust, children and their parents in our mental health services are now using Flo. And people with learning disabilities are using it too, to remind them to take medication or encourage them to do exercise. We've also started to use Flo for weight management in ten GP surgeries, and it’s proving really helpful for diabetes patients who need to lose weight.

There can be some resistance from health professionals at first. It's hard for people working in busy environments who don't have time to step back and look outside the box to see how to improve services and introduce change. Finding doctors and nurses who can champion Flo to their colleagues has been essential. And it helps that the system is so simple and easy to use.

In Sunderland we’re lucky to be one of the new NHS vanguard sites. We have a Clinical Commissioning Group, a hospital, a university and a local authority all working together in a ‘care academy’ to improve health for Sunderland. We’ve made the license for Flo available to all organisations in the care academy, as well as Age UK and the Carer’s Centre. Flo now has a major place in all of the health and social care we’re providing across the region.

We’re proud to have been pioneers of using Flo in the North East and it’s great to see it really making a difference for our patients and their family and carers.