Health Secretary commends the NHS Western Isles ‘Hospital at Home’ Service 

Health Secretary, Humza Yousaf, has praised NHS Western Isles for the extensive range of services being provided through the local ‘Hospital at Home’ service. Through the patient-centred service, NHS Western Isles now delivers intravenous antibiotic therapy at home to the highest proportion of patients, of all Scottish Health Boards. 

Over recent months, the service has established itself as a virtual ward attached to Western Isles Hospital in Stornoway, with many patients now receiving treatment at home that would have traditionally required hospital admission.  

NHS Western Isles recently showcased the success of the service at the NHS Scotland Event in Aberdeen and has shared progress with the Chief Operating Officer for NHS Scotland, John Burns, during a recent visit to Stornoway, and today with the Health Secretary, Humza Yousaf. 

Mr Yousaf said: “Hospital at Home is one of the many ways we are providing more care in the community and reducing pressure on hospitals.  From the success of the scheme so far, we can see that there is a real benefit to treating people at home where possible. It has been invaluable to hear from staff on the ground, and learn how the scheme has been expanded and developed to meet the needs of patients.  It is our aim to double virtual bed capacity across Scotland by the end of the year.” 

The feedback has been consistently excellent highlighting the ‘can do’ attitude of staff and willingness to find solutions throughout the pandemic and beyond. 

NHS Western Isles Hospital at Home Coordinator, Gail Black, explained: “The service was initially implemented in the early part of the pandemic as a short-term solution to help reduce demand on Western Isles Hospital. Over the following 24 months it has established itself as a dedicated service providing hospital level care in the comfort of the patient’s own home.” 

The Hospital at Home service now provides outreach care for the whole of Lewis and Harris. The core duties of the service are to provide hospital level care at home. This is for conditions which would usually require inpatient care such as infections requiring intravenous antibiotics, oxygen therapy for various acute and chronic lung conditions, intravenous diuretics for heart failure, subcutaneous (drip) fluids for patients who may be at risk of dehydration, and all forms of monitoring of acute illness (pulse, blood pressure, ECG, oxygen and blood analysis). 

Intravenous antibiotic therapy is established as one of the biggest groups of patients in the service and patients are also able to self administer their antibiotics intravenously if appropriately trained, further increasing their freedom to live life as normally as possible during their stay in the service. 

Hospital at Home patients remain under the care of the hospital consultant and are visited or contacted daily by the Hospital at Home nurse in most cases. They are all provided with equipment to allow them to self monitor their condition and have 24-hour access to a clinician seven days a week for any problems that may arise. On any given day there is just one nurse on duty supported by a co-ordinator Monday to Friday. This small team however has a ‘ward’ of six beds, but on occasion, when demand dictates and capacity is available, this has increased to 12 beds. 

During the pandemic, Hospital at Home became the hub for NHS Western Isles provision of home monitoring equipment for patients with COVID and supported GP Practices with the provision of equipment and registering patients on the national portal. They have also co-ordinated COVID drug treatment for the whole of the Western Isles, providing over 200 assessments to date with intravenous drug delivery being provided in both hospital and home settings. 

The wide range of interventions now covered by the service shows clinicians’ willingness to find solutions to problems. 

Most recently, two other services have been absorbed into the Hospital at Home ward. They provide intravenous bone sparing therapy to patients who have had a hip fracture, ensuring that they receive this treatment in a timely manner in the comfort of their own home while recovering from surgery. Finally, the new Colon Capsule Endoscopy service launched this month is using a home delivery model in Lewis and Harris to test this concept as a first for NHS Scotland. This allows patients to remain in the comfort of their own home throughout the preparation and delivery of the capsule, a real patient centred approach to service design. 

NHS Western Isles Chief Executive, Gordon Jamieson, said: “This service has gone above and beyond our initial expectations and the extensive range of interventions now being provided in people’s own homes is commendable and testament to the hard work and dedication of all the staff involved. 

“The success of the project is something we wish to build upon and there is much more that we would like to see developed. Uist and Barra will both need to benefit from the lessons learned to date and there are plans to ensure equity of provision. There is also further work to ensure that more complex intravenous regimes can be accommodated at home, further releasing capacity in our pressured hospital settings.” 

Gail Black added: “It's been such a pleasure and privilege to work within this team to develop something I think we can be justly proud of. The ability to allow patients to carry on their daily lives caring for family, running businesses and maintaining their functional wellbeing, whist being an ‘inpatient' is lovely to see. The feedback has been amazing and whilst we know there is always more to learn we are committed to maintaining the high standards that patients have come to expect during an inpatient stay.”