Pre-hospital care
Hospital at Home schemes
Hospital at Home schemes are able to provide admissions avoidance in chronic obstructive pulmonary disease (COPD) and are offered in a variety of ways. This is commonly through a respiratory specialist team or through the community based urgent care team. Development and enhancement of these services may facilitate a reduction in admissions for COPD. Some project sites uncovered problems with referral into these schemes. GPs, ambulance services, community matrons and other community based teams may not know of the availability of the hospital at home service, or may not be aware of the referral criteria and often the referral mechanism and this represents a barrier to patients accessing the service. Addressing this problem can reduce the number of avoidable admissions for exacerbation of COPD.
Patients who frequently attend secondary care / High impact user group
Several project teams identified a cohort of patients who attend the Emergency Department (ED) or who are admitted to hospital three or more times per year. A small group of patients can account for a large amount of health care resource with repeated and sometimes unnecessary hospital admissions. The health and social care needs of this user group are ill-defined but are clearly unmet, resulting in a reliance on emergency and secondary care medicine. Early findings from the project sites suggest some of the reasons why this cohort of patients choose to access hospital based services and particularly the ED may be:
- lack of access to primary care services
- convenience
- inadequate end of life care
Specialist case management with this cohort of patients in an endeavour to change behaviour and prevent avoidable admissions is one solution that is being tested.
More information
For more information about transforming acute care, please contact:
Catherine Thompson
National Improvement Lead
Lung Improvement Programme
NHS Improvement
Mobile: 0782 514 2815
Email: catherine.thompson@improvement.nhs.uk