Parijat De is a Consultant Physician in Diabetes, Endocrinology, and Lipid Metabolism at City Hospital, Birmingham since January 2003 having trained as a Specialist Registrar in Wales. He has sub speciality interests in Adolescent diabetes, Insulin Pump, Telemedicine and Diabetes renal disease. He is involved in research and projects involving a variety of disease areas in diabetes and both undergraduate and MRCP training. He has also initiated various community based integrated diabetes initiatives in Sandwell & West Birmingham CCG (amongst the first such in the UK) which now forms part of the award winning DICE model of diabetes care delivery adopted throughout the CCG. He is currently the clinical lead in Diabetes, Endocrinology and nephrology in SWBHT.


In Sandwell and West Birmingham Hospitals NHS Trust, diabetes prevalence is high with a large ethnic minority population. Social deprivation is significant and compliance is a major stumbling block in the achievement of diabetes and Blood Pressure (BP) targets. Given the above, we took the opportunity to become part of the West Midlands Academic Health Science Network Integrated Care Flo Exemplar project via Simple Telehealth/Flo (STH/Flo) mobile phone texting service. Our aims were to improve adherence to BP treatment via engaging patients in their own health through text reminders and regular encouragement, and determine the clinical and cost effectiveness of this simple, yet unique method of virtual clinical consultation.

Since April 2015:

100 patients have enrolled for BP monitoring

26 for blood glucose and insulin reminder


Medications have been adjusted (added new agent or increased dose) in 27/100 (27%)

46/100 (46%) patients have been discharged with good BP control preventing 107 outpatient appointments (saving £11,663 vs. £2,329 Flo associated costs)

Total savings £9,334

High patient satisfaction & increasing usage

Improved utilisation of manpower resources and healthcare professional time – thus clinically and cost effective model of care delivery recognising the importance of supporting patients outside of face-to-face care to improve outcomes.

Flo’s use continues to grow at SWBHT, 5 new teams are ready to join (Pharmacy, Respiratory, Paediatric Diabetes, Haematology and Occupational Therapy). This simple Telehealth technology can be easily replicated in any NHS Trust or CCG, as has been shown within our own Trust.

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