Hospital at Home Programme – December 2024 update
Hospital at Home
The Hospital at Home (H@H) programme is a short-term, targeted intervention providing acute level hospital care in an individual’s own home or home setting.
This programme:
- has high satisfaction and patient preference across a range of measures
- reduces pressure on unscheduled acute care in hospitals by avoiding admissions and accelerating discharge
- has consistent evidence of lower costs compared to inpatient care
What we do
Optimise and expand H@H services:
Support NHS boards/HSCPs to optimise and expand their existing older people/acute adult H@H services.
Develop new H@H services:
Support remote and rural areas across Scotland to implement new older people/acute adult H@H services
National Learning System:
Enable older people/acute adult H@H services to share and learn from each other
National Infrastructure:
Develop national infrastructure to enable sustainable older people/acute H@H services
Results so far
13% increase in patients managed by hospital at home services
10,578 patients were managed by H@H services from October to December 2023
11,985 patients were managed by H@H services from April to December 2024
H@H services prevented over 11,900 people spending time in hospital during April to December 2024, relieving pressure form A&E and the Scottish Ambulance Service
Delivering patient centred care
“The H@H service is tremendous with the healthcare that it provides. I would rate it 10 out of 10”
Patient supported by Falkirk’s Hospital at Home service
It is a fantastic service […] I cannot praise the nurses enough and the whole concept of H@H”
Patient supported by Midlothian’s Hospital at Home service
What we achieved
Working with 13 NHS boards across Scotland
We are working with services across 13 NHS boards to create new services, improve the resilience of existing services and evaluate new ways of working
Growing capacity to be bigger than Western General Hospital
In December 2024, there was the equivalent of 555 beds with an occupancy rate of 80%. This is similar to the size of Western General Hospital and larger than University Hospital Wishaw
Service updates
NHS Argyll and Bute implemented a new pathway with general practice and the Scottish Ambulance Service. This means residents in care homes can be admitted directly to H@H.
NHS Forth Valley expanded their team to include heart failure and respiratory expertise.
NHS Lothian are innovating by starting training on point of care ultrasound. Initial staff training has started with an agreement developed for wider staff training and supervision.
Spotlight on
Point of care testing (POCT) allows H@H staff to conduct routine tests using blood samples in the patient’s home, with the aim to speed up clinical decision making and prevent repeat visits.
The national H@H team are creating a short guide which includes:
- experimental data from services using POCT equipment
- a case study from NHS Lanarkshire showing POCT enabled earlier decision making in 54% of admissions
- information on available devices, and
- advice on selecting equipment
This guide will inform teams about the devices in use, how they can use them, and will help them to reflect on whether POCT is suitable for their needs.
Sharing Learning
Upcoming H@H network sessions:
- 11 March 2025 – Senior Decision makers
- 8April 2025 – Clinical Assessors
- 15 May 2025 – Operational Staff
Supporting service
“It was a really valuable experience to visit another service and share ideas for further development and improvement. Seeing that we are facing similar challenges was also very reassuring”
Consultant Geriatrician from H@H, Aberdeen City
Information sources
- Rapid Response – Admission avoidance hospital at home for older people with frailty, Healthcare Improvement Scotland, February 2022
- Monthly improvement data each H@H services submits to Healthcare Improvement Scotland since March 2021.
- PHS Scotland, Acute hospital activity and NHS beds information (annual), Year ending 31 March 2024.
- Care Opinion