Lanarkshire’s Hospital at Home team is courting interest from the furthest reaches of the globe – including an earthquake-stricken region of Chile.

The specialist emergency team, which has recently expanded in Lanarkshire and provides hospital-level care in older people’s own homes, has been subject to growing national and international attention. This includes liaising with healthcare professionals from Switzerland and Japan – who are working to find new and innovative ways of caring for their ageing populations.

Now senior members of Hospital at Home are currently in talks with a similar service in Chile – rolled out after the earthquake of February 2010 which claimed over 500 lives and devastated vital infrastructure, including many hospitals.

A report following the disaster showed all Government-run hospitals surveyed lost varying degrees of functional capacity, including loss of communications, electricity and water.

The earthquake, ranked as the sixth largest ever to be recorded, was felt strongly in six Chilean regions with damage particularly pronounced in Chile’s largest urban area, Concepción. Geriatric Nurse Specialist, Carolina Gomez Puchi, who is carrying out a vital research from the University of Concepción, has been in talks with the Lanarkshire-based team.

Speaking from Chile, Ms Puchi explained: “In 2010, as part of a strategy to support the loss of hospital beds experienced in central and southern Chile during the earthquake, a number of new hospital in the home programs were set up.

“As of last year there were about 24 Chilean public hospitals which have a program of home hospitalisation.”

In Chile doctors, nurses, physiotherapists and auxiliary nursing staff work together to provide complex hospital care in homes for adults suffering from conditions such as pneumonia and urinary tract infections. Research, however, is still very new with no standards, protocols or guidelines issued for implementing the service.

As part of her studies and research, Ms Puchi contacted the Lanarkshire Hospital at Home after finding an online presentation about the team, by Hospital at Home lead and Consultant Geriatrician, Dr Graham Ellis.

Evidence shows that Lanarkshire’s Hospital at Home provides safe, effective person-centred care, equivalent to the acute hospital, in the patient’s own home. After being piloted in some areas of North Lanarkshire, where the rise of over 75 hospital admissions in the area was reduced, the team have recently been expanded to South Lanarkshire.

Trudi Marshall, Nurse Consultant for Older People and member of the Hospital at Home is in talks with Ms Puchi.

Trudi explained: “We’re offering insight into aspects like staff development, the patient and carer’s experience and our evaluation measures.”

In, Lanarkshire, the service is made up of a range of healthcare professionals including NHS Lanarkshire consultants and nurses, occupational therapists and physiotherapists.

They work with social work resources in both North and South Lanarkshire Councils who provide additional community support to patients, when required.

Additionally, the Scottish Ambulance Service is a key partner in the Hospital at Home team – which also works closely with unpaid carers and their representatives.
Claire Ritchie, of Hospital at Home, who has also been liaising, added: “In Chile they are interested to broaden out the scope of the care their teams provide. We’re delighted to do anything we can to assist – and also learn from their experience.”

Ms Puchi added: “Finding out about the experiences of the Hospital at Home team in Lanarkshire has been hugely helpful as there are some very similar challenges with an ageing population.”

The growing international attention comes at a crucial time. A new Act requires health boards and local authorities to integrate their adult health and social care services.  

A key aim of integration is to provide person-centred planning and delivery, so that people get the right advice, support and care in the right place and at the right time.

Janice Hewitt, Chief Accountable Officer of North Lanarkshire Health and Social Care Partnership, said: “The approach adopted by the Hospital at Home team is key to improving outcomes for older people by avoiding, where possible, hospital admission. 

“It is one of many of partnership initiatives aimed at supporting more older people at home.”

Harry Stevenson, Chief Officer of South Lanarkshire Health and Social Care Partnership, added: “Services like Hospital at Home demonstrate that we are fully focussed on making a real difference to the lives of people in the area. The international attention the service is now receiving underlines that.”

Similar challenges:

The shape of Scottish society and the health and care needs of our communities are changing. People are living longer, healthier lives and as the needs of our society change, so too must the nature and
form of our public services.

In the next 10 years, the number of Scots aged over 75 will increase by over 25%. In the same period, it’s also estimated that nearly two-thirds of people will have developed a long-term condition by the age of 65.

Research shows that most older people would prefer to remain in their own homes, with support if they are unable to look after themselves.

Ms Puchi explained similar challenges are being experienced elsewhere.“The current health situation in Latin America and the Caribbean is characterised by a progressive increase in the burden of chronic diseases secondary to a marked aging of the population.

“There is a high cost of treatment with hospital beds that have generated the need to reorganise the health systems and services in order to meet the demand for care.

“In this context developed forms of care in alternative health to the traditional such as hospital in the home, which seeks to provide selected patients in their own homes, levels of diagnosis, care and treatments similar to those given in the hospital.”

 
• For more information on Hospital at Home and how the team works with unpaid carers and existing resources in the community visit: http://www.nhslanarkshire.org.uk/Services/hospital-at-home/Pages/default.aspx
• For more information on the integration on health and social care in Lanarkshire visit: http://www.nhslanarkshire.org.uk/About/HSCP/Pages/FAQs.aspx