Home-based hospital care is increasingly regarded as a key solution to the NHS’s capacity problem, with Prime Minister Gordon Brown committing to provide free one-to-one care for all cancer patients as a central plank of their election manifesto.
In an announcement today, Brown unveiled plans to provide more NHS and social care to people in their own homes with new guarantees for cancer patients and elderly people.
Today’s report Hospital care at home reveals that by extending home-based healthcare in the following four services to a wider group of patients could represent savings in England of:
•£180 – £210m for long-term and other selected ambulatory care sensitive (ACS) conditions, such as chronic obstructive pulmonary disease (COPD)
•£217m – £837m for enhanced supported discharge
•£46m – £73m for specialised cancer services (specifically, enabling chemotherapy at home)
•£160m for end-of-life care
•£540m – £1.2bn for the four services combined.
The costs of providing care in the home were estimated, based on models already being utilised by Healthcare at Home customers and using assumptions from NHS Birmingham East and North (NHS BEN), where the above services are currently being piloted.
Andrew Donald, Chief Operating Officer at NHS Birmingham East and North says,
“The NHS knows it has to deliver services in a radically different way if we are to meet demands for improved quality in straightened economic circumstances. Creating NHS services that fit the personal circumstances of everyone in east and north Birmingham – but particularly those from disadvantaged communities – is our joint objective.
“Many people – some who stay in hospital too long, others who need not be treated in hospital at all – will benefit from our programme. Nationally, 76% of people say they would prefer to die at home but only 18% of the 500,000 who die each year do so at home. The creation of a the world’s first 24 hour, seven-day a week service for those people approaching the end of their lives who do not need, or wish, to go in and out of hospitals, demonstrates how we can improve safety, the quality of clinical outcomes and quality of people’s experience while saving cash.”
Charles Walsh, Chairman of Healthcare at Home Ltd says, “For ever-increasing numbers of patients, hospital continues to be the default option for getting treatment. We should be asking ourselves, are they in hospital for the right reason? This report gives a conservative estimate of the many thousands of patients who could benefit from being treated at home, at a lesser cost to the NHS and at greater convenience and satisfaction to the patient.”
Tom Moloney, Chief Executive of Dr Foster, says “Treating more people at home tests the established system that puts the hospital at the centre of healthcare delivery and not the patient. Potential savings of over £1 billion cannot be swept under the carpet. This report challenges the NHS; in fact, this report says very clearly that treating people in their homes, where they want to be treated, saves money and aids recovery. “
In spite of government initiatives to reverse the trend, the current health system is still facing an increase in hospital demand. Last year, 8 million patients were cared for in English hospitals, 12.5% of whom were admitted with ACS conditions. Avoidable emergency admissions are also on the rise, with 491,000 patients admitted through A&E for ACS conditions, at a cost to the NHS of £1bn.
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NOTES TO EDITORS
•Four services were selected for the analysis where home-based healthcare models already exist in NHS Birmingham East and North as an alternative to hospital care:
– Care for people with selected long-term and ambulatory care sensitive (ACS) conditions
– Enhanced supported discharge
– Specialised cancer services (chemotherapy at home)
– End-of-life care
•NHS Birmingham East and North and Healthcare at Home have created a strategic alliance to reduce admissions to hospital and the length of time patients stay in hospital by providing more personalised care to patients in their own homes. It therefore directly supports the Trust’s long-term objectives to “work in partnership to tackle inequalities and improve health and well-being.”
•Healthcare at Home Ltd is the UK’s leading provider of hi-tech, home-based healthcare. It also delivers innovative on-site services throughout the NHS and independent sector.
Established in 1992, the company has grown rapidly and now employs almost 1,000 staff, approximately half of whom are specially-trained clinicians.
Operating from locations throughout the UK, Healthcare at Home Ltd provides nationwide services, delivered locally to over 100,000 patients each year. A broad range of care options is offered across many disease areas to patients of almost every NHS trust in the country. While the NHS is the biggest customer of Healthcare at Home Ltd, private medical insurers, pharmaceutical companies, charities and self-funding patients also employ its services.
For more information, please visit www.hah.co.uk
•Dr Foster Intelligence is the UK’s market-leading provider of information, analysis and targeted communications to health and social care organisations. An independent organisation, Dr Foster Intelligence was launched in 2006 as a joint venture between Dr Foster Holdings LLP and the NHS Information Centre for health and social care. Dr Foster Intelligence aims to set a new standard in information for health and social care providers and their users and is legally required to follow a code of conduct that prohibits political bias and requires it to act in the public interest. The Dr Foster Ethics Committee is an independent body empowered to adjudicate on complaints and oversee the code of conduct.
For more information, please visit www.drfoster.co.uk.