NHS leaders have failed to recognise the value of nurse-led services provided in patients’ homes and must do more to develop this type of service as part of its vision for the future, a group of experts has claimed.
More emphasis should be placed on this way of delivering care to reduce pressure on hospitals and drive up quality of care, according to the experts who are from across the NHS, third sector and private organisations.
“There is now a growing evidence base to suggest [there should be more] hospital-type services delivered…directly in a person’s usual place of residence”
The group launched an inquiry into the benefits of “clinical homecare” – defined as integrated care, treatment and support in the home – which is largely led and developed by nurses, after they claimed NHS England failed to give it the “prominence it deserved” in its Five-Year Forward View last year.
The inquiry concluded that this type of service could lead to faster recovery, improved quality of life and fewer hospital readmissions, as well as reduced numbers and length of inpatient visits.
In its report, called Building the case for clinical care in the home at scale, the group laid out five areas for service development in the future.
These were cancer care, long-term condition management, end of life care, timely discharge services and “virtual wards” – which see multidisciplinary teams found in hospitals provide care in the community instead, usually led by nurses.
In organisations across the country some of these services are already being delivered, said the report, but if developed and rolled out fully, it claimed clinical homecare could produce the 3% annual savings by 2020 that NHS England called for in its five-year plan.
“Clinical homecare should be an integral way of delivering new care models [in the Five Year Forward View]”
Christine Outram, who chaired the expert group and is also chair of The Christie NHS Foundation Trust, said: “The plethora of NHS strategies, frameworks and plans that commissioners and providers use to deliver services seem to agree on at least one thing: much acute care needs to move away from hospital buildings and be provided closer to home.”
“There is now a growing evidence base to suggest that in many cases this should be taken one step further, with hospital-type services delivered, under the guidance of hospital trusts, directly in a person’s usual place of residence,” she added in her introduction to the report.
James Featherstone, chief operating officer at private provider Healthcare at Home, which funded the inquiry, said: “This report started out with the aim of elevating the debate that clinical homecare as a solution would deliver on the key ‘value criteria’ laid out in the Five-Year Forward View.”
“We felt that it was an obvious omission [in the Five-Year Forward View] considering the value that the various models of clinical homecare can deliver,” he said.
“I think we have achieved this and strongly believe that clinical homecare should be an integral way of delivering new care models,” he added.
The expert group also included representatives from other organisations including Macmillan Cancer Support, King’s College Hospital, NHS Confederation, and pharmaceutical company Alexion UK.