Hospital @ Home: Bringing hospital-level care to patients’ doorsteps
A new report has highlighted the success of Central London Community Healthcare NHS Trust’s (CLCH) Hospital @ Home (H@H) services, showing how delivering acute care in patients’ homes is transforming outcomes for some of the most vulnerable people in the community.
Hospital @ Home is a model of care that provides hospital-level treatment to patients in their own homes. Unlike traditional ‘virtual wards’ that often rely heavily on remote monitoring, H@H services combine in-person clinical care with community-based expertise to treat high-acuity patients - particularly frail older adults - outside of hospital settings. The service is staffed by a multidisciplinary team including doctors, nurses, paramedics, healthcare assistants, pharmacists, physiotherapists and occupational therapists.
CLCH delivers H@H services across several areas including Barnet (North Central London), Wandsworth & Merton (South West London), and South and West Hertfordshire. These services are run in partnership with local hospitals and Integrated Care Boards (ICBs), tailored to local needs.
The report, delivered by PPL, aimed to drive improvement in existing services, inform the development of new services and build evidence of the value of H@H.
Key findings from the report include:
1. Improved patient outcomes
H@H services are successfully treating high-acuity patients who would otherwise be admitted to hospital. In South and West Hertfordshire, 100% of patients audited were deemed to be among the most serious in terms of the severity of their condition, and 85% of patients across CLCH’s services were discharged to their usual place of residence - on par or better than national averages.
2. Reduced readmissions
Patients stepped down from hospital into H@H care in South and West Hertfordshire had a 27% lower 90-day readmission rate compared to those who were not onboarded, suggesting that H@H care is not only safe but also more effective in preventing repeat hospital visits.
3. High-intensity, personalised care
CLCH’s H@H services deliver more face-to-face contacts per patient than the national average (5.5 vs. 4.8), with higher clinical staffing levels. This hands-on approach is particularly valued by clinicians treating frail patients who need more than remote monitoring.
4. Cost-effective care
Despite the intensity of care, H@H services cost significantly less than hospital stays. For example, the Wandsworth & Merton service costs approximately £165 per patient bed day, compared to £350 - £657 for hospital care (excluding additional overheads)
5. Strong stakeholder confidence
Clinicians across acute and community settings reported growing trust in H@H services. As one acute clinician noted, “CLCH are well-positioned to deliver the kind of high-intensity care that stops patients being admitted to hospital at all – they have the skills.”
Erin Gallagher, Frailty Nurse Consultant for the H@H service in South and West Herts said: “This report provides compelling evidence of the positive impact Hospital @ Home services are having on patients, clinicians, and the wider health system.
“It demonstrates that through collaboration with partners at ICBs and clinical and management staff across the organisations, H@H is providing positive outcomes and being seen as a vital part of the care pathway for some patients.
“It’s also enabling more opportunities for clinical staff, like me, to further their careers in senior clinical roles in a community setting, bringing opportunities and career progression to the community setting that were not available before."
