Patients treated at home in bid to cut stays in hospital
Plan even includes heart failure and gangrene
TENS of thousands of people suffering from serious illness will be treated at home under emergency NHS plans.
People with conditions including angina, cellulitis, heart failure, gangrene, pneumonia asthma, lung disease, epilepsy and gastroenteritis will get care at home or in the community to free up hospital capacity.
Medical staff will take blood samples, do heart checks and administer intravenous treatments. Carers and parents are also set to play a greater role in looking after patients, some of whom will be monitored by app.
The NHS is lining up 90,000 people a year for so-called Interface Care, where patients spend either fewer or no nights in hospital.
While the move has been planned for some time, it has now been accelerated by the Scottish Government amid soaring Omicron cases as part of a massive bid to free up beds and cut the risk of hospital-acquired infections, including Covid.
However, medics say the service must be properly staffed.
A Scottish Government spokesman said: ‘Providing care as close to home as possible is a key component of the NHS Recovery Plan, as well as ensuring patients get the right care in the right place. We have engaged with every health board in Scotland to consider what opportunities the Interface Care programme can offer them according to local priorities.
‘An additional £6 million provided to health boards will help accelerate development of pathways to maximise hospital capacity – which is an essential focus given increased concern around the Omicron variant.’
The programme has already launched in NHS Greater Glasgow and Clyde and NHS Tayside, with rollout across Scotland ‘planned through the winter’.
Eligible patients also include those suffering from chronic obstructive pulmonary disease, dental conditions, diabetes complications, ear, nose and throat infections, high blood pressure, flu, anaemia, nutritional deficiencies, perforated or bleeding ulcers, and kidney infection.
Draft guidance says the programme ‘will focus on safely reducing admission rates or shortening lengths of stay to improve patient experience and minimise hospital-related complications’.
With heart failure, for example, ‘nurses can see patients in community at homes’ as well as clinics, to give oral therapy or ‘ultimately IV [intravenous] diuretics’.
It also describes a ‘focus on selfcare through an app’ to measure fluid retention, blood pressure and heart rate.
It adds: ‘Patient is in charge: picked up remotely as data checked on daily basis – phone call if needed and visit is last resort.’
The document also says: ‘Education, communication and support for carers, families and parents can help prevent admission or attendance.’
Norman Provan, of the Royal College of Nursing Scotland, said: ‘The Scottish Government is right to be looking at measures which can reduce delayed discharge and ensure that patients receive treatment closer to home.
‘However, like any service, it will need to be staffed safely. With nearly 5,000 nursing and midwifery vacancies in the NHS and an increasing number of staff having to isolate due to Covid, there is pressure on all health and social care services. Additional funding will not keep people out of hospital if there are insufficient staff.’
Dr Lewis Morrison, chair of BMA Scotland, said: ‘Primary care and hospitals are both under severe pressures and likely to be for a considerable time to come. Providing healthcare nearer to home, where appropriate, safe and properly staffed, can free up capacity elsewhere in the system.
‘However, patients and families must have confidence that they will receive the same or better care at home.’
Scottish Conservative health spokesman Dr Sandesh Gulhane said: ‘Any scheme to try to ease pressure on capacity is welcome, but the devil will be in the detail. Clear and consistent communication will be crucial.’
‘Phone call if needed and visit is last resort’