Hospital at Home service to be expanded by NHS Greater Glasgow and Clyde

The equivalent of 1200 extra bed days has been created thanks to a pilot initiative launched 12 months ago by Glasgow City Health and Social Care partnership (HSCP) on behalf of NHS Greater Glasgow and Clyde.

Hospital at Home provides the care patients would receive on a ward in their own homes. So far the pilot has cared for 329 patients in the community and numbers are about to increase as the programme expands.

Eligible patients are identified either in A&E - thus avoiding admission - or inpatients might be identified as suuitable, or patients can be referred by their GP. Patients need to be over the age of 65 to be eligible for the service.

An example of a Hospital at Home patient would be an elderly person who has fallen at home, has a severe infection, delirium, or who has seen an acute functional decline due to an existing health condition.

The service enables people to receive treatments that would otherwise require them to be admitted to hospital, such as an intravenous drip or oxygen supply. It also provides access to hospital tests under the care of a consultant in their own home.

Care is delivered by a team of nurses (including advanced nurse practitioners and consultant nurse), GPs, pharmacists, occupational therapists and consultant geriatricians.

Hospital at Home patients receive an average of ten visits each during their period within the service, with the average length of Hospital at Home treatment being around five days.

The plan now is for the initial pilot to be rolled out to other areas within the health board.

Susanne Millar, chief officer of Glasgow Health & Social Care Partnership, said: “We know that for many older people a hospital admission presents the risk of a decline in their physical ability and their mental health. Receiving treatment in their own home is, in some cases, preferable to hospital admission, particularly when they have well stablished care arrangements in place.

"Patients and their families have expressed how grateful they have been to receive this enhanced level of care without having to have a stay in hospital.”

Dr Scott Davidson, deputy medical director for acute services within NHS Greater Glasgow and Clyde, said: “Creating additional bed capacity is a key challenge facing the health service, so we welcome initiatives such as Hospital at Home, where we see the benefits as two-fold. Older patients avoid the risks associated with hospital admissions such as a decline in physical ability and hospital infections but receive the same high-quality treatment at home. Operationally, we can use the additional bed space up for other patients, which is extremely important just now as we see higher demand on bed capacity than ever before.”

Suzanne Adams, lead nurse for the service said: “Normally patients would need to be in a hospital bed to get access to hospital level care, however, research suggests on many occasions if the same treatment can be provided at home, then the outcomes for the patient will be better. This is particularly true of older patients, where there may already be a level of community care in place. It’s about complementing that with acute level input so that the patient can recover at home.”