An 89-year-old World War II veteran has become the first Nottingham person to return home as part of Hospital at Home, a pioneering initiative by Nottingham University Hospitals (NUH) NHS Trust aiming to ease the pressure on hospital beds.
Caird was admitted to Queen’s Medical Centre after having a fall and developing hypothermia.
Nursed back to health, he was medically fit to be discharged but without Hospital at Home would have had to have remained in hospital until a care package was secured.
Under Hospital at Home, Caird will now receive two one-hour care visits a day from familiar NUH staff, easing the anxiety that many patients feel on returning home.
Hospital at Home is one of a raft of initiatives commissioned and funded by NUH. One patient going home under the scheme can free up four to five beds in the patient journey to help relieve the pressure on the Emergency Department.
“Patients are desperate to go home,” said Bev Brady, Lead Nurse in Clinical Care. “We know people recover better when they are in their own environment and this allows them to do so while remaining under our care.”
Hospital at Home has been in the planning stage for several months; Berman Ward 2 at City Hospital became a “transition ward” last month, for patients who need reduced clinical care but are not yet ready to go home.
“We bridge the gap for patients who are medically fit but can’t go home because no care package is in place,” said Bev. “We can take them home while that care package is sourced, which obviously frees up a bed a lot quicker.
“Our staff will deliver care in the patient’s own home for up to 14 days until the care package is put in place. And we will mirror what the package of community care is expected to be.”
Healthcare Assistant (HCA) Lisa Cunningham prepared Caird to leave after his month-long hospital stay. Sitting on his bed, fully dressed and waiting to go, Caird’s face broke into a wide smile when Lisa stopped and said hello.
He wiggled his feet in his spotty red non-slip-soled socks “Do you like them? Would you like a pair?”
He chatted about his time in the Education Department at the RAF, wistfully explaining that poor eyesight stopped him from becoming a pilot.
“Sometimes, a chap would swing by and say ‘I’ve had a cancellation, do you fancy going up?’ and I’d say ‘boy do I ever!! And then he’d do the loop-the-loop and the sky would become green for a few seconds before switching back to blue.”
Caird praised the staff and the care he’d received during his stay at NUH but said he was looking forward to getting home and watching TV.
“Without Hospital at Home, Caird would be still on an acute ward, waiting for a package of care,” said Lisa. “While further down the line, someone else is waiting for a bed to be freed-up so they can be admitted.
“He’s been in for 32 days and, as much as he wants to go home, he will be feeling quite anxious about it. And so having a familiar face is really important, it really helps ease that anxiety.”
“I know him,” said Lisa. “I know what he likes, and I’ve been on the ward with him, and I’ve built up a rapport with him. I’ll be taking him home today and I’ll be delivering his care for the next 14 days. That’s really important – especially for older people.”
Hospital at Home has the potential to make a real impact across the Trust.
“It eases the pressure on the acute wards staff – and it eases the pressure on the ED,” added Bev.
“Potentially, you have created, or freed up, several beds in the chain by Caird going home; you’ve got a patient in ED who can go onto an assessment ward; you’ve got a patient on an assessment ward who can go on to a base ward, and then you have a patient who can come here, and then patients that can go home.
“You consider that – and take it right back to that patient in ED, we can really impact on patient flow, and save an elderly patient spending hours in ED waiting for a bed.”
Rachael Ellis, whose 95-year-old father Stanley made the news after a long wait on a trolley in the ED at Queen’s Medical Centre, welcomed the initiative.
Mr Solomons – who trained at the top-secret Bletchley Park and ran a listening post in Hong Kong during the Cold War – is now back in his care home, and modest about his military past, saying “I’ve had a singularly patchy life”.
“He was in his 80s before he told us he’d trained at Bletchley Park,” said Rachael. “When everyone else suddenly started talking about it – he must’ve thought it was finally ok to tell us!”
“I do appreciate these initiatives,” said Rachael. “I think Hospital at Home is a great idea, and if it is safe, the more healthcare that can be provided in someone’s own home or community has to be the way to go – it’s very person-centred. And it will help free up hospital beds.
“If this had been in place a few weeks ago, and had there been beds available, I have no doubt that my father would not have endured such a long wait.
“I thought the NUH staff were brilliant and I have no complaints about the care that they were offering.”
Back at Berman 2 and Caird made his way out with Lisa, wheeled down the corridor lined with staff waving goodbye and wishing him well. Grinning from ear to ear, he told Lisa: “I feel like a celebrity!”
Lisa and Bev are aware that patients and their relatives can sometimes be concerned about being sent home.
“We’ve tried to plan for absolutely everything but there are going to be things that crop up that we will have to work through and deal with,” said Bev. “We can’t know what we don’t know.
“That’s why we are starting slow, with just one or two patients, so we can tweak things if we need to in the first week or so.”
Lisa Kelly, Chief Operating Officer at NUH, said: “We know families can be concerned that they are unable to properly look after their loved one at home or are concerned that their loved one ‘isn’t ready’ or is ‘not back to how they were before’. We want to reassure people that hospital, community and social care teams are here to support them and their loved ones to return home including supporting any ongoing care needs, so please ask us questions and be part of the planning process to get your loved ones home.
“We are calling on patients and their families to help us get them home as soon as possible once they no longer need the care provided in hospital. We know that for recovery – both physically and psychologically – being out of hospital is best for patients, where they have their support networks and usual routines”.
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