It’s been one year since the first patients were admitted onto a Surrey-based frailty virtual ward, Hospital at Home, to receive acute hospital care in their own home. Since its launch, more than 400 patients have benefitted from the service, which this month (January) doubled the number of people it can care for.
The Royal Surrey NHS Foundation Trust home-based virtual ward cares for eligible patients living with frailty, who often prefer to stay in their home where they recover more quickly than on a traditional hospital ward.
Once admitted, like on a traditional ward, patients receive daily care from a multidisciplinary team of nurses, allied healthcare professionals, doctors and consultant geriatricians. Their care includes at least one in-person visit each day from a member of their core medical team as well as virtual appointments and catch ups as needed.
Every aspect of care is provided for the person in their own home, including point-of-care blood tests, acute medical interventions, equipment, care and rehabilitation. The multidisciplinary team uses a national system, known as the Comprehensive Geriatric Assessment, to capture what matters most to the older person and their wishes, involving them in decision making about their future care.
James Adams, Royal Surrey Consultant Geriatrician on the Hospital at Home ward, said:
“Older people living with frailty are often telling us they do not want to be taken to the acute hospital when they get sick. We also know that hospital isn’t always the best environment for them as they can suffer from deconditioning and acute confusion when in an unusual bustling, regularly chaotic acute hospital environment. They often recover more quickly at home and are less likely to suffer from the physical and mental health decline caused by inactivity that frequently affects patients living with frailty on hospital wards.
“So we have brought the hospital to their door step, offering an alternative to a traditional ward and improving their experience of care and outcomes at the same time.”
An individualised care plan
Patients are admitted to the ward on a case-by-case basis where both the geriatrician and the patient or, where relevant, their carer agree that hospital care in the home is the best course of treatment. James said:
“The Comprehensive Geriatric Assessment we use means we are able to provide a bespoke plan tailored to each patient’s individual needs. We also speak with all people involved in the patients care to make sure that home is where they want to be and where they will be cared for best.”
Increasing patient beds
At its December 2022 launch, the service offered six patient beds at any one time, expanding to 16 beds by the end of 2023. This month (January 2024), it increased the number of patients it can care for at any one time to around 30.
As well as providing more options for patients living with frailty, the service has helped the Trust care for a greater total number of patients. Throughout 2023, it freed up 2,082 beds across the Trust-based frailty wards, based on a calculation of freeing up one bed for one day.
“I was extremely happy to be visited by the team”
Feedback from patients and their loved ones has been positive, with one patient saying:
“I was extremely happy to be visited by the team. I was very tired and worried and felt quite helpless before, trying to get appointments at the health centre, hours waiting in A&E and panicking not knowing how to get support. This has now totally changed. I feel very supported and understood. Everyone on the team has taken a lot of time and care to listen, support and find solutions.”