Tag: Hospital at Home

Addressing Delayed Discharge

£100 million Scottish Government funding to improve patient flow

£100 million funding in the 2025-26 Budget to tackle delayed discharge will make Hospital at Home the ‘biggest hospital in the country’, if approved by Parliament.

The service, which offers a safe alternative to admission to an acute hospital, will grow to 2,000 beds by December 2026, alleviating pressure on health and social care settings.

The money will also ensure all A&E departments in Scotland have frailty units directly linked to community care settings, with an increased focus on collaborative working to identify ways to improve patient experience.

It is part of an overall £200 million package to clear the majority of new outpatient and treatment time patient waits and renew the NHS.

Social Care Minister Maree Todd visited Queen Margaret Hospital in Dunfermline to outline a package of measures to reduce delayed discharge and to learn about other services that can be replicated across Scotland, such as Discharge to Assess that has been successful in Fife.

Ms Todd said: “Reducing delayed discharges is a key priority for the Scottish Government and the Budget we published last week will throw the weight of the government behind NHS improvement.

“More than 96% of all hospital discharges happen without delay but we are working with local health partners and local government to find solutions for those that don’t and address the variation we are seeing across Scotland. Our Budget for 2025-26, if approved by Parliament, will provide £200 million to help clear waiting list backlogs, improve capacity and remove blockages that keep some patients in hospital longer than necessary.

“Once someone has been assessed as well enough to be discharged from hospital, the best place for them to be is at home, supported by a bespoke care package. This can be delivered by services for older people such as Hospital at Home, and evidence shows that those benefitting from it are more likely to avoid hospital or care home stays for up to six months after an acute illness.

“We want to expand that service to make it the ‘biggest hospital in Scotland’, providing the very best care, in the comfort of a patient’s own home or home-like setting.

“We have a plan to renew our NHS and the Budget’s record funding for the health service will ensure that 150,000 extra patients are treated, deliver additional support for GPs, and invest in new hospitals at Belford and Monklands.

“We want to improve our NHS, but to do that Parliament must approve our Budget Bill to unlock investment to drive long-term and lasting improvements – and the healthier population that we all want to see. The NHS needs Parliament to unite behind this Budget.”

Hospital at Home funding

Providing older people with a safe alternative to hospital

The number of patients using Hospital at Home in Scotland rose by almost a quarter last year, it has been revealed, as funding allocations for NHS boards were announced.

A total of 13 local healthcare providers have been allocated a share of £3.6 million for Hospital at Home for older people to help ease pressure on frontline acute services.

Hospital at Home offers a safe alternative to admission to an acute hospital, with almost 15,000 older patients using the service in 2023/24 and this funding will support the continuation and development of existing programmes.

NHS Borders has been allocated £600,000, with a further 12 healthcare partners also receiving a share of the allocation.

Confirmation of the awards comes as a new report from Healthcare Improvement Scotland highlights the impact that the Hospital at Home service for older people has had in 2023-24. The findings show:

  • 14,467 patients used Hospital at Home in 2023, up from 11,686 in the previous year
  • total bed numbers increased by 58%, ahead of the Scottish Government’s 50% target
  • an estimated £14.9 million was saved in traditional hospital admission costs
  • a further estimated £36.3 million was saved in post-hospital care due to a reduction in re-admissions

Health Secretary Neil Gray said: “I am very pleased to see the progress that local health providers are making on delivering Hospital at Home services and the positive impact it is having, particularly on elderly patients.

“Hospital at Home allows patients to receive acute treatment in an environment that they feel comfortable and familiar with.

“There are more Hospital at Home beds for older people available and an increasing number of patients are choosing to use the service.

“Hospital at Home gives people greater independence during their recovery. Evidence shows that those benefitting from the service are more likely to avoid hospital or care home stays for up to six months after an acute illness.

“It is also one of a range of measures that we have put in place to tackle delayed discharge numbers and free up beds within our hospitals.”

Belinda Robertson, Associate Director of Improvement, Healthcare Improvement Scotland said:  “We know that patients benefit from receiving safe, patient-centred care in the comfort of their own home whilst continuing to benefit from the support they are used to from families, friends and carers.

“Our latest annual report for Hospital at Home across Scotland shows that more and more NHS boards and Health and Social Care Partnerships are providing acute hospital care to people in their own homes.

“Four new services for people living in and around Dumfries, Galashiels, Lerwick and Oban have been established in the last year, and Hospital at Home services across the country have prevented over 14,467 people spending time in hospital.  

“We would like to commend the Hospital at Home services for the fantastic work they’ve done to establish and grow their services. In the year ahead, we look forward to continuing to support NHS boards and Partnerships to further develop the services they provide, and to share learning across all Hospital at Home services.”

Hospital at Home for Older People

£3.6 million investment as capacity increases by 57% to exceed targets

The Scottish Government is continuing to invest in Hospital at Home for Older People with £3.6 million allocated for 2024/25, bringing total funding allocation for the initiative to over £15 million since 2020.

Recent statistics released by Healthcare Improvement Scotland (HIS) show that last year the Hospital at Home service for Older People, which provides a safe, alternative to being admitted to an acute hospital, exceeded targets in several key areas between April 2023 and March 2024, including:

  • total bed numbers have increased by over 57%, ahead of the Scottish Government’s 50% target
  • 14,467 patients used Hospital at Home, up from 11,686 in the previous 12-month period
  • the Hospital at Home service is now the eighth biggest “hospital” for older people emergency inpatients, alongside Forth Valley Royal Hospital in Stirling.

Health Secretary Neil Gray said: “These figures from HIS show that Hospital at Home is becoming an increasingly popular care alternative for elderly patients to receive acute treatment in a place they feel comfortable and familiar with.

“There are more Hospital at Home beds available and an increasing number of patients choosing to use the service.

“Hospital at Home gives people greater independence during their recovery process. Evidence shows that those benefitting from the service are more likely to avoid hospital or care home stays for up to six months after an acute illness.

“It is also one of a range of measures that we have put in place to tackle delayed discharge numbers and free up beds within our hospitals.”

Belinda Robertson, Associate Director of Improvement, Healthcare Improvement Scotland said: “This announcement of additional funding will continue to improve access to Hospital at Home services and make them more sustainable to the benefit of patients across Scotland.

“It’s heartening to see that Hospital at Home services prevented over 14,400 people spending time in hospital over the past year.

“Moreover, with our support we’ve witnessed more NHS boards and Health and Social Care Partnerships embracing Hospital at Home by establishing and developing services.

“We look forward to continuing to help services develop and share learning in the year ahead.”

Hospital at Home: Home is where the heart is for doctor Latana Munang

A West Lothian doctor is leading the way in helping to build services across Scotland that allow people to be treated at home rather than hospital.

And with a strong sense of family firmly at the heart of Dr Latana Munang’s ethos, her role at Healthcare Improvement Scotland as National Clinical Lead for Hospital at Home, has given her a job with purpose.

Healthcare Improvement Scotland is supporting the development of Hospital at Home services which reduce hospital admissions for elderly patients by providing acute care in the comfort and familiarity of their own home. Latana brings her wealth of clinical experience to the role, supporting Hospital at Home services across the country to be established and to grow. Hospital at Home services now cover nearly every NHS board and health and social care partnership in Scotland.

Latana was born in Malaysia and came to the UK on a sixth form scholarship before gaining a place at Edinburgh University to study medicine. She spent a year in Singapore as part of her registrar training before returning to Scotland where she has remained ever since.

The mum-of-two began working at St John’s Hospital in Livingston in 2011 and has remained there since. She is currently a consultant working in general medicine and medicine of the elderly.

Latana said: “Growing up in Malaysia the family structure in Asian communities was very strong. When my granny became ill she moved in with us to be cared for and that was the norm.

“Differences in society and different pressures mean that’s not possible everywhere but I do think most people are happiest being at home with family when they are ill, if it’s an option, and I really enjoy being involved in how we can make that happen.”

Ten years ago Latana was a key figure in setting up Hospital at Home in West Lothian and she remains as committed today as then to “push the boundaries in providing the best possible care for the frail and elderly”.

Latest figures show the Hospital at Home programme has seen an increase of 68% in the number of patients. The amount of areas where Hospital at Home is an option for patients has also more than doubled.

Latana said: “Sometimes people are admitted to hospital as they feel there’s no other safe alternative, but actually for older and frail patients if it’s possible to stay in the security and familiarity of home that can be best for them.

“With Hospital at Home we have a visit at the beginning to see what needs to be organised for each patient. In many cases we are able to cut out unnecessary procedures that would have been done routinely in hospital when we consider how much more complicated it would be to do from home, as we sometimes realise they’re not needed. 

“Hospital at Home is a true generalist service where on occasion we’ve had nurses change a lightbulb to prevent someone falling or check for out of date food in patient’s homes.

“Seeing people in their own homes gives us a different perspective and empowers them to feel their wishes and choices are being fully respected.”

For Latana and her husband Phil Buchan, whom she met at university, and their two children Leo (11) and Zola (9) home is Linlithgow. Latana said: “It’s a great place to live, it’s really family friendly with a strong sense of community.

“Spending time in other countries has made me appreciate the NHS and I’m lucky to be in a role that I feel so passionate about.”

More investment in Hospital at Home

A further £3.6 million has been allocated to Hospital at Home to support more than 150 extra virtual beds.

Hospital at Home can provide a safe, patient centred alternative to an acute hospital admission. It provides a better outcome for the patient, who receives treatment in the safety and comfort of their own home, as well as reducing pressure on hospital sites.

The investment for 2023-24, which will take the total funding in the service to more than £10.7million since 2020, will increase patients managed through Hospital at Home by 50% – an additional 156 beds. 

Funding will be available to existing services, and areas yet to develop Hospital at Home, with improvement support provided by Healthcare Improvement Scotland. 

Health Secretary Michael Matheson said: “Hospital at Home has already proved to be very successful and most importantly, beneficial to patients and the wider system. That’s why we have allocated a further £3.6 million so more people can be managed at home rather than in hospital.

“Patients have spoken very positively about the service and it also reduces pressure on A&E and the Scottish Ambulance Service by avoiding admissions and accelerating discharge. Hospital beds will always be available to people who need them, but this is a better alternative for many.”

Belinda Robertson, Associate Director of Improvement, Healthcare Improvement Scotland said: “We’re delighted the Scottish Government will continue to fund the development of Hospital At Home services. An increasing number of patients are experiencing the benefits of receiving acute hospital care at home.

“More and more NHS boards and Health and Social Care Partnerships are embracing Hospital At Home by establishing and developing services. We will continue to support NHS boards and Partnerships to further develop the services they provide, and share learning across all Hospital At Home services.”

Since 2020 the Scottish Government has made available more than £8 million to support the development of Hospital at Home. 

Expansion to Hospital at Home

£3.6 million to expand services

A further £3.6 million is being made available to support the expansion of Hospital at Home services, with the aim of doubling current capacity by the end of 2022.

The purpose of the service is to reduce hospital admissions for elderly patients by providing treatments in the comfort and familiarity of their own home.

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.

Evidence shows that those benefitting from the service are more likely to avoid hospital or care home stays for up to six months after a period of acute illness. For older patients, it means being able to stay at home longer without losing their independence and this has contributed to overall improvements in patient satisfaction. It also helps alleviate pressure on hospital beds.

The Scottish Government’s total investment in these services is now £8.1 million since 2020.

As well as Hospital at Home, the Outpatient Parenteral Antimicrobial Treatment scheme and Respiratory Community Response Teams now offer more than 600 virtual beds to treat patients for conditions that would traditionally need hospitalisation, an increase of more than a third from 440 virtual beds at the start of January 2022.

Health Secretary Humza Yousaf announced the further funding on a visit to NHS Forth Valley’s Hospital at Home service. He said: “Hospital at Home is one of the many ways we are providing more care in the community and reducing pressure on hospitals. 

“From the success of the scheme so far, we can see that there is a real benefit to treating people at home where possible.

“We know that frail patients tend to occupy hospital beds for a longer period of time and that is why we are expanding the scheme. In reducing the number of prolonged hospital stays, we will free up more hospital beds.

“With additional funding, all health boards can apply for money to either develop or expand their services with the aim of doubling the capacity of Hospital at Home by the end of the this year.”

Dr Sarah Henderson, Consultant Geriatrician for NHS Forth Valley’s Hospital at Home Team, said: “Developing this important service has enabled us to provide the same high standard of clinical care and treatment patients would receive in hospital without the need for them to leave their own home.

“We know from feedback how much local patients have valued being able to stay in familiar, comfortable surroundings without the anxiety and disruption often associated with an admission to hospital. This is also less stressful for family and friends who know that their loved one is getting all the medical care and attention   they require at home.”

Helen Sammels from Alloa has been supported twice by the Hospital at Home team when she required treatment for a respiratory condition.

She said: “I am sure I got better, quicker by being able to stay at home. It really made a difference being in my own surroundings, but I still got the care, services and tests I required. The Hospital at Home team were great, and I feel really grateful for all the treatment and support they provided.

“I also have a little dog and I didn’t want to leave her so being able to stay at home with her was very important to me and fortunately with the support of the Hospital at Home team I was able to do this.”

Support for NHS during ‘most difficult winter’

New remote monitoring tools to support people with Covid to stay safely at home, and free up hospital beds are among a range of steps being put in place to support the health and care workforce and maximise capacity.

Measures include £500,000 to fund 25,000 remote monitoring kits, including additional pulse oximeters, and a dedicated team which will support the early identification of patients who would benefit from antivirals treatments and get these started as soon as possible. This will free up beds in acute hospitals. 

COVID admissions are rising at a rate 45% faster than they did last winter, and this combined with existing winter pressures is creating significant demand on hospitals. A large spike in staff absence relating to COVID is also significantly impacting NHS service provision.

In addition to the investment in remote monitoring, the Scottish Government will also expand existing programmes, including Hospital at Home, Outpatient Parenteral Antimicrobial Therapy (OPAT) services for managing infections and Community Respiratory pathways.  These services allow patients to be treated in their own home and to receive the relevant treatment without admission to hospital.

Health Secretary Humza Yousaf said: “The next few weeks will probably be amongst the most difficult our NHS has ever faced in its 73 year existence. We are facing pressure on a number of fronts.

“Modelling suggests that infections and associated staff absences due to the coronavirus could peak by mid-January. Treating more people who previously may have been admitted to hospital at home with anti-virals and suitable support is essential to free up capacity in our hospitals.

“We know Discharge Without Delay has made a significant impact in some parts of the country and rolling it out to all health boards will make a major difference. Local contingency plans are in place to focus on the redeployment of available clinical and support services staff to essential services. 

“All of this  builds on work already underway as part of our £300 million investment in health and care services as part of winter preparations, to help maximise capacity, support the wellbeing of our fantastic health and care staff, support flow through the system and improve outcomes.”