29 January 2023

‘Hospital at home’ plans cannot alone fix NHS pressure, ministers warned

29 January 2023

A plan to create tens of thousands of “hospital at home” beds will only succeed if serious action is taken to fix the severe pressure on the NHS, the Government has been warned.

It comes as the Department of Health announced plans for tens of thousands of elderly and vulnerable people to receive tailored support at home each month, as part of a strategy to shift some NHS care out of hard-pressed hospitals.

Ministers will also publish an urgent and emergency care plan on Monday, amid warnings about the unsustainable pressure on healthcare staff.

The Government said that the plan builds on the virtual wards already in place in the NHS, which see patients treated from home while monitored by medics either through daily visits or through video calls.

About 3,000 “hospital at home” beds are due to be created before next winter, with hopes that about 50,000 people a month could eventually be cared for from home each month.

Officials said that the plan would standardise and scale up current services to treat falls and frailty, with more services in place for next winter.

Without investment in staff, this plan won’t make a difference

The plan received a cautious welcome, but ministers were warned that the new measures would not by themselves fix the current crisis.

Saffron Cordery, interim chief executive at NHS Providers, called it a “timely announcement” but warned that the plans were “not enough in themselves”.

“We desperately need action to tackle the vast workforce shortages, staff exhaustion and burnout, and the inability to free up capacity by discharging medically fit patients in a safe and timely way.”

Patricia Marquis, RCN director for England, also said it was the right aspiration.

“But this plan relies on ramping up community services – services which in the case of nursing have been decimated in recent years,” she warned.

“There is a dire workforce shortage across nursing and it is biting particularly hard in community services, with the number of district nurses falling significantly in the last decade amid soaring demand and care needs becoming increasingly complex.

“Without investment in staff, this plan won’t make a difference.”

Recent weeks have been dominated by reports that hospitals are struggling to cope amid severe pressures on staff, with walkouts by nurses set to continue as a dispute over pay and conditions goes on.

The latest data shows that ambulance handover delays outside hospitals in England have dropped to their lowest level this winter, but one in five patients are still waiting at least half an hour to be transferred to A&E teams.

Cabinet minister Michael Gove was pressed on the idea on Sky News on Sunday, where it was put to him that the Government had been forced into it due to the lack of hospital beds.

“There are people who are in hospital who need care, who can be cared for effectively at home,” he said.

“When the Prime Minister organised a health summit a few weeks ago, one of the striking things that came out of that, which many of us knew beforehand, was that if you can have the right bespoke package of care, then someone can be more comfortable and easily as well cared for as in hospital.”

Announcing the plan, Health Secretary Steve Barclay said that the plan would help ease pressure on stretched A&E services.

“The health and care service is facing significant pressures and while there is no quick fix, we can take immediate action to reduce long waits for urgent and emergency care,” he said.

He suggested that “up to 20% 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 at home.”

NHS chief executive Amanda Pritchard said that the health service had faced a “twindemic” of flu and Covid-19.

“Our extensive planning ahead of winter has helped to boost capacity – from extra 111 and 999 call handlers, to new falls services and more beds – and we now aim to build on that progress to help speed up care and improve the experiences of patients.”

The plan will see urgent community response teams scaled up, with hopes that it will increase the number of referrals and patients seen by healthcare staff within two hours.

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