‘Hospitals at home’ plan to save NHS
More than half a million patients a year will be treated in “hospitals at home” in an attempt to relieve pressure on A&E departments.
Under the plans, elderly and frail patients who fall will be treated by video link, with ministers saying that a fifth of emergency admissions could be avoided with the right care.
Health officials said the “virtual wards” would be backed up by £14 billion in extra spending on health and care services over the next two years, as the NHS tackles record backlogs, with seven million people on waiting lists.
Rishi Sunak said the Urgent & Emergency Care Recovery Plan, to be published on Monday, showed that the NHS was one of his “top priorities”.
Plans for an expansion in community response teams will mean more elderly patients can be assessed and treated on the spot, instead of being brought to hospital, under schemes that aim to provide a response within two hours.
Trials that sent out a paramedic and community nurse to examine patients who suffered a fall found they could halve the proportion being taken to A&E – with some schemes using video links so that ambulances could liaise with hospital consultants from a patient’s home.
“Virtual wards” will provide round-the-clock monitoring for up to 50,000 people a month, with patients given wearable devices that track vital signs such as temperature, heart rate, and oxygen levels and alert medical teams to any changes.
Patients will also be reviewed on a daily basis by medics using video technology, or via visits to monitor and check progress. These schemes are already being used to support some frail elderly patients and those with acute respiratory infections and cardiac conditions.
The expansion will mean 10,000 such "virtual beds" are created by next winter.
The Prime Minister said: “The most vulnerable and elderly in our society in particular should have access to rapid treatment that’s tailored to their needs.
“That’s why we’re expanding care available to people at home to reduce unnecessary trips to hospital, help at-risk patients receive faster treatment and free up capacity in A&E.” He added that the funding for the scheme would “ensure people get the level of treatment they deserve”.
Mr Sunak has come under pressure over his handling of the NHS in recent weeks, with calls for ministers to step up efforts to help it stay afloat during a severe winter crisis that has been compounded by nurse and ambulance driver strikes.
Steve Barclay, the Health and Social Care Secretary, said: “Up to 20 per cent of hospital admissions are avoidable with the right care in place. By expanding the care provided in the community, the most vulnerable, frail and elderly patients can be better supported to continue living independently or recover ... in the comfort of their own homes.”
It follows warnings from senior officials that hospitals have entered a state of “gridlock”, with wards full of patients who would be better treated elsewhere, fuelling long waits in A&E.
Latest monthly data show the average wait for an ambulance for heart attack and stroke victims reached 93 minutes in December – more than twice the figure of 43 minutes for the previous month.
Meanwhile, 55,000 faced trolley waits of at least 12 hours in A&E, while 500,000 patients were admitted as an emergency case.
Experts say the crisis is exacerbated by the number of patients stuck in hospital for lack of care at home, or an absence of help to prevent a deterioration. About 13,000 hospital beds – one in seven – are filled by patients who are medically well, but need help to be sent home, or discharged to care homes.
Amanda Pritchard, the NHS chief executive, said: “Boosting care in the community and treating more people at home is key to recovery – it is better for patients and their families, as well as easing pressure on NHS services.”
The rollout builds on initiatives being tested in different parts of the country.
In Warwickshire, paramedics sent to patients’ homes can arrange video calls with hospital consultants to work out the best action. The scheme introduced by South Warwickshire University NHS Foundation Trust led to a 16 per cent reduction in the number of over-75s taken to hospital by ambulance.
A pilot scheme introduced in London last October, which sends a community nurse out with paramedics, found
they were able to cut the number of patients taken to A&E from 70 per cent to 35 per cent.