Neonatal and paediatric hospital at home – Guiding principles for service development summary: August 2026

This is part one of Healthcare Improvement Scotland’s guiding principles for service development for neonatal and paediatric hospital at home services. An extended version of this document will be available in the spring of 2027 and will include learning from services across Scotland.

Key points

• Hospital at home is a service that provides acute, hospital-level care by healthcare professionals in a home context, for a condition that would otherwise require acute hospital inpatient care.
• Hospital at home for neonatal and paediatric patients has differences from adult services but key principles remain. Some services in Scotland are still developing and defining their scope. Thus, the definition and features are subject to change as they evolve.
• We conducted a literature search in January 2026 on the effects of hospitalisation on neonatal and paediatric patients, and their families. The evidence suggests that hospitalisation can be stressful for babies, unwell children, and their parents, siblings and grandparents. Stressors include the hospital environment, family separation and disruption to routines, amongst others.
• We conducted a separate search on the effects of hospital at home for neonatal and paediatric patients, and their families. The available evidence suggests that hospital at home is a safe and effective alternative to hospital care for babies and children with certain conditions. There is also evidence of positive impacts on patient and family experience.
• Neonatal and paediatric hospital at home is an initiative which aligns with several policies and standards. These include Scottish Government’s Operational Improvement Plan (2025), the Health and Social Care Service Renewal Framework (2025) and the United Nations Convention on the Rights of the Child (Incorporation) Scotland Act (2024).
• Healthcare Improvement Scotland supports a national improvement programme which is supporting various health boards across Scotland to implement neonatal and paediatric hospital at home services. The programme’s learning system also provides resources, learning and networking opportunities.
• There are more resources available to professionals involved in the design and delivery of hospital at home services. Sources include the UK Hospital at Home Society, the World Hospital at Home Community and the Paediatric Hospital at Home Network.