How Hospital-at-Home teams are freeing-up beds across London

Published: 6 Jan 2023

The Hospital at Home teams at Wandsworth and Merton are providing intensive hospital-grade care to help patients with serious conditions at home.

The scheme is part of an ongoing initiative launched in December 2021 to support early discharges from hospital.

So far the scheme has accepted 310 patients saving an estimated total of 2,134 bed days.

For patients like Agatha Anyiwo, from Wandsworth, this scheme has proven to be of huge benefit to her in her daily life.

Agatha said: “Hospital at Home was a lifesaver for me at a time when I was severely in pain and experiencing mental challenges.

“The help in providing me with the right medication and home equipment relieved my distress and pain.”

Estimates suggest that the initiative will save 200 hospital bed days each month over the winter months that are more challenging for the NHS.

66 per cent of the patients have been classified as “severely frail” according to Central London Community Healthcare Trust, with 88 per cent of them having four or more chronic conditions such as heart failure, asthma, COPD, and pneumonia.

Locality Executive Director for Merton and Wandsworth at NHS, Mark Creelman said: “People have been shown to get better faster when in the place they call home, rather than if they’d stayed in hospital – sleeping in their own bed with their families and friends around them.

“It also helps support our local hospitals as people are supported to go home earlier or avoid going in altogether.

“This is a great example of partnership working between the Hospital at Home team, St George’s NHS Trust, GPs and specialists in the community for the benefit of our patients.”

Initially the team was first made up of medical professionals including doctors, nurses and pharmacists to make decisions involving the patients under their care.

However, the team has expanded to involve the input of other medical professionals such as physiotherapists and occupational therapists who are involved in the care of patients.

Consultant Geriatrician at St George’s Trust Dr Joanna Preston said: “The Hospital at Home team have provided a viable and safe alternative to admission by expanding their skillset to provide what would traditionally only have been available in hospital.

“This has led to more people being able to access high-quality healthcare where it will benefit them most.

“The team has received really positive feedback and delivered high-quality care with good outcomes.”

Remaining in hospital beds for prolonged periods of time can cause frail patients to experience negative side effects from remaining in a hospital bed for lengthy periods of time.

A spokesperson for NHS Central London Healthcare Trust said “Remaining in a hospital bed for prolonged periods of time can cause frail patients to lose muscle tone and fitness because they are no longer doing routine activities such as bathing, getting dressed, and making meals.

“It can also lead to an increased risk of falling, sleep deprivation, catching infections and sometimes mental deconditioning.

“Getting care at home can be better for frail patients, as it allows them to get the hospital-level care they need at home safely and conveniently, and closer to family support networks.”

One GP from Merton claims that the service enables her to work to support patients who may otherwise be at risk of being admitted to hospital without it.

Merton based GP, Sayanthan Ganesaratnam said: “As a GP, I work collaboratively with the Hospital at Home team to support patients who are at risk of being admitted to hospital and need step-up care.

“This is beneficial to patients as, rather than going into hospital for potentially lengthy stays, they can stay at home, receive excellent care, and be monitored closely in familiar surroundings.

“And should a patient start to feel unwell, there are systems in place to quickly alert a clinician, reducing the possibility of an emergency re-admission.”

The scheme has been well received by patients, carers and NHS staff as it enables them to support more patients according to one doctor.

Divisional Medical Director at Central London Community Healthcare NHS Trust, Dr John Rochford said: “This innovative way of working means that we are able to support more patients to get better in their own homes, optimising their wellbeing and helping them to avoid unnecessary and lengthy admissions to hospital, which can have a detrimental impact on their health.

“Patients fare better in familiar surroundings, when they can sleep in their own bed, eat the food they like and have friends, family and pets around them whenever they wish.

“The service is already showing a significant impact, with many patients and their families embracing this new way of receiving care.”

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