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Found 186 results
  1. Event
    until
    This joint webinar, hosted by the Digital Care Hub and Homecare Association, will be an insightful session on the safe use of AI in homecare. This discussion is tailored for adult social care providers in England, and will include: Provider Insights: Hear from industry experts and social care providers on the latest trends and challenges. Innovative AI Applications: Discover exciting examples of AI transforming homecare. Ethical and Safety Considerations: Learn about the key ethical and safety aspects to consider. Practical Tips: Get top tips for implementing AI effectively in your practice. This session is designed for adult social care providers in England and are aimed at people who make decisions about the use of technology in care services. Register
  2. Event
    until
    The King's Fund is pleased to invite you to their moving care closer to home event in October. For years there has been an ambition to move care closer to home – now it’s time to make it a reality. This timely event, now in its second year, moves beyond local implementation to ask a critical question: what will it take to scale community-based care across the entire health and care system? It will bring together policy leaders, operational managers, innovators and practitioners to tackle the entrenched challenges, such as workforce, funding and infrastructure, and to spotlight the real-world innovations already changing care delivery. This in-person event is a perfect opportunity for you to connect with key stakeholders from across the system and clarify the role you can play in making care closer to home a reality. Register
  3. Content Article
    This article explores how remote patient monitoring (RPM) is transforming patient safety by enabling continuous, real-time tracking of health data outside clinical settings. It provides a comprehensive overview of RPM technologies, their clinical benefits, implementation challenges and best practices. It highlights the growing importance of RPM in proactive care models and its role in reducing hospital readmissions, improving medication adherence and supporting vulnerable patient populations. How is remote patient monitoring changing patient safety? A Mass General Brigham study of 10,803 participants found that RPM reduced mean blood pressure from 150/83 to 145/83, which significantly lowers cardiovascular disease risk.[1] RPM technologies provide clinicians with real-time data streams; this allows for quick interventions when patient conditions change. The continuous monitoring bridges dangerous gaps between appointments where medical complications developed undetected. Beyond crisis prevention, RPM enhances medication safety through adherence tracking and creates comprehensive longitudinal health records revealing subtle trends conventional episodic care might miss. The benefits reach vulnerable groups—elderly, rural and mobility-limited patients—who now get regular supervision free of transportation constraints, creating safety nets once inaccessible under conventional care models. Real-time monitoring: a lifeline for early intervention and patient safety RPM provides regular data collection that serves as a buffer against avoidable harm by detecting minute physiological changes that indicate clinical deterioration. RPM significantly bolsters patient safety by enabling early detection of health deteriorations, thereby facilitating timely interventions. A study published in NPJ Digital Medicine analysed 29 studies across 16 countries and found that RPM interventions led to a reduction in hospital readmissions and emergency department visits.[2] Specifically, the study highlighted that RPM demonstrated positive outcomes in patient safety and adherence, and improved patients' mobility and functional statuses. This early warning feature considerably improves patient safety by enabling timely clinical interventions before symptoms worsen. A known patient with serious congestive heart failure can also be given diuretic adjustments remotely, avoiding hospitalisation. RPM also decreases the risks associated with medications by enabling physicians to identify missed doses and adverse reactions. Long-term data further strengthens safety by showing patterns—like low oxygen levels at night in chronic obstructive pulmonary disease (COPD) patients—that single tests might miss. Personalised interventions are supported by this fine-grained understanding, especially for high-risk populations such as patients living in rural areas that have improved access to attentive monitoring. By combining speed and accuracy, RPM transforms patient safety to an actionable, data-driven and efficient procedure rather than a fixed objective. Key technologies driving remote patient monitoring: enabling safer, data-driven care Remote patient monitoring depends on a complex ecosystem of linked technology that extends clinical supervision outside of facility boundaries. Wearable devices form the basic foundation of this system—with regulatory-approved sensors capturing vital metrics continuously. RPM is transforming healthcare by shifting from reactive to proactive safety strategies. These digital systems continuously track vital signs, medication compliance and physiological parameters outside traditional clinical settings. This enables early detection of deterioration before serious complications arise. Advanced cardiac monitors identify arrhythmias with 98% accuracy and smart glucose sensors provide real-time glycaemic information via subcutaneous readings. Connected devices for tracking urinary patterns help physicians diagnose various types of incontinence without requiring in-person assessments, improving dignity and convenience for patients with mobility challenges. Smart inhalers with embedded sensors record medication usage patterns and technique, enabling precise interventions for respiratory conditions. Mobile applications are a link between patients and clinical teams—with simple dashboards that show health trends and medication adherence. These platforms usually combine clinical protocols, secure messaging systems and alerts based on preset thresholds. Backend analytics platforms transform raw physiological data into clinically relevant insights through sophisticated algorithms. These systems analyse longitudinal data against established baselines to detect minor abnormalities that precede clinical deterioration. According to studies, these predictive capacities can detect sepsis 6–12 hours earlier than traditional approaches, considerably increasing survival rates.[3] Secure, Health Insurance Portability and Accountability Act (HIPAA) compliant electronic health record (EHR) integration—using end-to-end encryption and strict authentication—creates comprehensive patient profiles, enabling better-informed treatment decisions. Implementing remote patient monitoring: main challenges RPM has numerous benefits in healthcare, but putting it into practice involves challenges that need thoughtful solutions. Digital literacy gaps create accessibility barriers, particularly among elderly populations where only 64% report comfort with technology-based healthcare tools according to the Journal of the American Geriatrics Society survey of 3,450 seniors.[4] Privacy concerns are significant as continuous monitoring generates sensitive health data that requires strong security. To maintain patient trust while meeting regulatory standards, healthcare centres must use end-to-end encryption, unambiguous consent mechanisms and transparent data governance frameworks. Another problem is clinical workflow integration; RPM systems that function without the use of EHR platforms result in documentation silos. Customised integration pathways that embed remote monitoring data within regular clinical interfaces are required for successful RPM implementation. When clinicians get an overwhelming number of notifications, the intended safety benefits are undermined. Effective systems use tiered alert processes with tailored thresholds that are based on patient baselines rather than population norms. These graduated notification systems ensure that important notifications receive necessary attention while preventing frequent low-risk alerts. As healthcare organisations face these issues, good implementation frameworks that include technical assistance, privacy safeguards and workflow optimisation are relevant to fulfilling RPM's full potential. Best practices for patient-centered remote monitoring Effective RPM is beyond technological equipment; it requires an effective structure that can only come from consistent planning and review. Healthcare organisations should establish dedicated implementation teams comprising clinicians, IT staff and patient advocates to gather diverse viewpoints and boost adoption of RPM. This cross-functional strategy improves RPM acceptance and sustainability while lowering possible resistance. Healthcare administrators should train providers thoroughly on both technical use of medical devices and data interpretation. A 2023 NEJM Catalyst study of 76 healthcare centres showed that centres with robust training of healthcare professionals had 43% higher RPM use after a year compared to those with minimal training.[5] Healthcare professionals should also be trained to focus equally on patient support through easy enrolment, clear instructions in multiple languages and in-person device training. Dedicated tech support channels should be created for RPM users in order to prevent frustration whenever there is a network glitch. Clear clinical protocols defining intervention thresholds, escalation pathways and response timeframes should be made to transform data into actionable intelligence. Rigorous quality assurance measures—including regular connectivity testing, data validation audits and patient usability assessments—safeguard programme integrity. Periodic review cycles examining alert frequency, response times and intervention outcomes help refine system parameters for maximum clinical utility. The most effective RPM programmes integrate patient feedback mechanisms allowing continuous refinement of interfaces, alert frequencies, and educational materials based on real-world experience. Conclusion RPM is improving healthcare from reactive to preventive care. As technology advances, these systems will become standard practice. Future developments will include smaller sensors, longer battery life and better connectivity—making monitoring easier for patients while improving data quality. Better predictive analytics will help physicians identify health problems earlier with greater accuracy. Beyond helping patients, RPM is changing organisational safety culture by expanding care beyond hospitals. This shift represents a major advancement—creating continuous monitoring systems that protect patients throughout their healthcare journey and redefining patient safety for modern medicine. References 1. Mass General Brigham. Mass General Brigham Remote Healthcare Delivery Program Improves Blood Pressure and Cholesterol Level, 9 November 2022. 2. Ying Tan S, et al. A systematic review of the impacts of remote patient monitoring (RPM) interventions on safety, adherence, quality-of-life and cost-related outcomes. NPJ Digital Medicine 2024; 7: 192. 3. King J, et al. Early Recognition and Initial Management of Sepsis in Adult Patients. Ann Arbor (MI): Michigan Medicine University of Michigan, 2023. 4. American Geriatrics Society 2024 Annual Scientific Meeting. Journal of the American Geriatrics Society 2024; 72: III-VI. 5. Barrett JB, et al. Reduced Hospital Readmissions Through Personalized Care: Implementation of a Patient, Risk-Focused Hospital-Wide Discharge Care Center. NEJM Catal Innov Care Deliv 2025;6(6). DOI: 10.1056/CAT.24.0420. Further reading on the hub Putting patients at the heart of digital health Digital diagnosis—what the doctor ordered? Electronic patient record systems: Putting patient safety at the heart of implementation How do we harness technology responsibly to safeguard and improve patient care?
  4. Content Article
    The transition of older adults from the emergency department (ED) to home remains a potential area of preventable harm. Through a human-centred design process, the authors developed a patient-centred intervention aimed at improving communication and coordination between ED staff and patients. The intervention included a new electronic health record (EHR)-based template for physicians to enter discharge instructions, a redesigned after-visit-summary (AVS), enhanced nurse training for patient teach-back, and EHR-embedded tips for nurses at the time of follow-up call. The research objective was to evaluate this patient-centred ED discharge process redesign from multiple perspectives. The authors used A SEIPS 3.0 model to evaluate the intervention, in particular work system barriers and facilitators in the three subprocesses of the redesigned ED discharge process: physician writing discharge instructions, nurse/patient communication at discharge, and nurse/patient communication at follow-up call. The authors used multiple methods to collect quantitative and qualitative data from the perspectives of patients, and ED physicians and nurses. Overall, the redesigned patient-centred discharge process was perceived positively by ED physicians and advanced practice providers, ED nurses, and patients. All three groups identified work system facilitators regarding the intervention, in particular the usability of the AVS. Work system barriers pointed to areas for future improvement of the intervention, such as adding prepopulated information to the AVS. Using a human-centred design process, the authors improved ED discharge for older adults. The SEIPS-based research and evaluation fit with the learning health system concept as it provides input for future work system and patient safety improvement.
  5. Event
    As part of Care Forward, a national movement focused on making care better for over a million people across the country, Healthcare Excellence Canada with supporting organisations are launching new offerings that provide participants with funding, resources and coaching to drive impact on four key priorities: expanding care access, helping more people age where they call home, advancing person-centred long-term care and strengthening the health workforce. Join this webinar series to explore these offerings and how you can get involved: Right Care Challenge supports health and social care organizations to launch or enhance initiatives that ensure patients receive the right care, at the right time, in the right place—all while helping reduce avoidable emergency department visits.   Enhancing Integrated Care supports primary and community care organisations to strengthen integrated team-based care models, including virtual care, making access easier and reducing pressure on emergency departments. Paramedics and Social Prescribing helps paramedic teams use social prescribing to connect clients with local community services, improving overall health and wellbeing. Primary Care Access Improvement helps team-based primary care organisations  create efficiencies and optimise team functioning, so patients receive timely care, regardless of urgency or demand.   Nursing Home Without Walls supports jurisdictions across the country to bring nursing home support and services to older adults in their own homes, helping them age safely and comfortably where they already live. Sparking Change in Appropriate Use of Antipsychotics Awards Program provides long-term care homes across Canada with support to use person-centered approaches to reduce potentially inappropriate antipsychotic use. Register
  6. Content Article
    The Patients Association and the Royal College of Physicians (RCP) have published a joint report setting out a bold new vision for reforming outpatient services in the NHS over the next decade. Outpatient care (planned specialist care delivered without an overnight hospital stay) is one of the most commonly used NHS services, with over 135 million appointments in 2023/24 alone. Yet for many patients, the experience is marked by long waits, fragmented communication, and a lack of coordination between services. Drawing on extensive engagement with patients, clinicians and NHS England, Prescription for outpatients: reimagining planned specialist care outlines five key ambitions to reshape the outpatient model: provide timely care by the right person, in the right setting, empower patients through personalised care and self-management, improve communication across professionals and with patients, use innovative models of care to avoid unnecessary appointments, harness data and technology to reduce inequalities and prioritise need. The report also proposes eight transformational shifts to how care is delivered, supported by five key enablers including digital infrastructure, workforce investment, and improved commissioning models. Collectively, these changes aim to ensure outpatient services are more efficient, equitable and centred around patients' needs.
  7. Content Article
    When they get into the system, people living with mental health issues are typically prescribed medication. The most common prescriptions are for antidepressants, anti-anxiety medications, stimulants for ADHD, and antipsychotics for conditions like schizophrenia and bipolar disorder. These are dangerous drugs if not taken properly, with potentially serious side effects. So taking them on time, in the right dosage, is vitally important. According to the Pharmaceutical Press: “Adhering to (or compliance with) the recommendations on how to take all these medicines is essential if they are to work successfully and with minimal side effects”. But those at home living with mental health issues are the ones most likely to fail to remember to take their meds, or to deliberately overdose. So there need to be systems in place to monitor and report on this most vulnerable group. What could those systems look like, and what are the most effective mechanisms for ensuring adherence and safety?
  8. Content Article
    Hospital at home and virtual wards provide safe alternatives to hospital care in the community. There is considerable variation in how they are operationalised at a local level. In general, their common feature is to provide healthcare in people’s homes through a multidisciplinary clinical team. Care is delivered both remotely and face to face. They aim to help avoid admission as well as facilitate rapid discharge. The models vary in terms of who leads the service; the hours of operation; the staffing model; the conditions they support; the length of support; how technology is used; and how patients and professionals access the service. In March 2025, NIHR Evidence held a webinar showcasing research on two home-based alternatives to hospital care from three evidence reviews: admission avoidance hospital at home and virtual wards for people with frailty. The webinar addressed: the key elements of hospital at home and virtual wards their impact on outcomes their impact on service costs factors that contribute to their success.
  9. Content Article
    This study from Spain investigated the factors influencing medication errors made by informal caregivers while providing care at home.    It found that errors made by informal caregivers occur more frequently than expected, and recognising these errors remains a challenge. Training is essential for creating safer care environments by increasing awareness of error sources and the risks associated with medication. Recipients’ direct relatives should receive appropriate training, considering differences between male and female caregivers. Associations and companies within the care economy sector should prioritise the creation of safer home care environments as a key objective.
  10. Content Article
    Wrist-based wearables in the US have been FDA approved for atrial fibrillation (AF) detection. However, the health behaviour impact of false AF alerts from wearables on older patients at high risk for AF are not known. In this work, the authors analysed data from the Pulsewatch (NCT03761394) study, which randomised patients with history of stroke or transient ischemic attack to wear a patch monitor and a smartwatch linked to a smartphone running the Pulsewatch application vs to only the cardiac patch monitor over 14 days. At baseline and 14 days, participants completed validated instruments to assess for anxiety, patient activation, perceived mental and physical health, chronic symptom management self-efficacy, and medicine adherence. The authors used linear regression to examine associations between false AF alerts with change in patient-reported outcomes. Receipt of false AF alerts was related to a dose-dependent decline in self-perceived physical health and levels of disease self-management. The authors developed a novel convolutional denoising autoencoder (CDA) to remove motion and noise artifacts in photoplethysmography (PPG) segments to optimize AF detection, which substantially reduced the number of false alerts. A promising approach to avoid negative impact of false alerts is to employ artificial intelligence driven algorithms to improve accuracy.
  11. News Article
    Two women who police allege practised as unregistered midwives have been charged with manslaughter after a baby died after a home birth on the New South Wales mid north coast. The women, aged 41 and 51, appeared in Coffs Harbour local court on Wednesday in relation to the newborn boy’s death in 2022. Emergency services were called to a home in Karangi, north-west of Coffs Harbour, when the baby was unresponsive after the home birth on 11 September 2022, NSW police said in a statement. Paramedics treated the baby before he was airlifted to Coffs Harbour base hospital where he died. Police allege the younger woman was an unregistered midwife at the time of the birth while the older woman held no medical qualifications and had been practising unregistered home-birth midwifery. Read full story Source: The Guardian, 13 March 2025
  12. Content Article
    In early 2022, following his wishes, my husband was discharged from hospital for end of life care at home to be provided by his family (his wife, three adult children and son-in-law) and nurses from our local hospice. We were completely unprepared for the challenges and disruption that lay ahead for us all.  Challenges during discharge The first challenge we encountered was receiving conflicting, confusing information from different staff members regarding my husband’s prognosis and future treatment and care. His consultant and their team were optimistic, speaking of further tests and a possible response to treatment in 3 weeks’ time. It was in that meeting, and on that basis, that we supported discharge and discussed arrangements. But the senior specialist nurse caring for him was alarmed by what we had been told. Immediately after the meeting they took us aside to tell us that, in their view, my husband had only days left to live. Although unsettled by this conflicting information, we preferred to believe in the more optimistic prognosis. On that understanding, we began to make preparations. At this point we knew: My husband would be taken home by ambulance the next day. A hospital bed and other equipment would be delivered to our home the next morning. We would receive a supply of medication on leaving the hospital. Hospice nurses would visit us twice a day to assist, starting the next day. Apart from needing a family member to wait at home in the morning to receive the bed, we thought we would be able to spend his last day in hospital quietly by his bedside. What actually happened couldn’t have been more disorderly or more disturbing. In practice, in addition to receiving the conflicting prognoses, this is what we experienced before discharge: My husband’s discharge was delayed by more than 48 hours, as hospital staff had great difficulty coordinating everything required for his move home. There were significant requirements we had not been told about, such as the need for an oxygen supply at home, which had to be located at a distance from a gas supply. The coordination difficulties meant that one of us waited alone at home for two full days, to receive the hospital bed and other equipment. This family member was therefore unable to be with my husband for an extended period at a critical time. On the second day of the delay, in direct contradiction of their advice the previous day, the ward sister advised us to take an immediate patient transport appointment even though it would mean going home before the hospital bed had arrived, and without any confirmation of when, or if, one would arrive. As the day went on, this nurse’s exhortations to leave without a bed in place at home were repeated and increasingly aggressive, and included the threat that there would, as a result, be no guarantee that hospice nurses could support us when we did eventually get home. We experienced this as bullying, coercive behaviour that greatly confused and disturbed us at a time when we most needed clarity, consistency and sensitivity. Delivery of the hospital bed was not straightforward. Access had not been checked beforehand, and when the bed arrived it was found that the layout of the house made it impossible to move it into a bedroom. With some difficulty, it was placed in the living room. The other equipment included an oxygen supply. This was not straightforward either. The bed had been placed near a gas fire. It had to be moved to a safe distance from the gas supply, which required taking furniture out of the room, difficult for the one family member at home handling this situation. Ward staff had contacted our local hospice on our behalf. We asked to have direct contact with the hospice ourselves so we could confirm arrangements. The ward sister (the one whose behaviour we had experienced as coercive) advised us not to contact them. We complied with this and so we left the hospital with no information about what the hospice nurses knew of my husband’s condition and no direct confirmation of their visits. This felt very insecure and contributed to our stress. We felt thrust into the unknown when we were at our most vulnerable by a system that didn’t want us. While we worked our way through all the problems, my husband’s condition was deteriorating, and he was suffering. He had a high temperature, great pain and nausea. But once the discharge decision was taken, nursing staff stopped taking his observations, stopped providing him with any medication to relieve symptoms and stopped washing him and providing meals. We had to insist that he be provided with some ongoing care and medication, and although he did receive the latter we had to overcome considerable resistance. These problems compounded one another and created chaotic, confusing circumstances. All family members at the hospital were spending their time running around, trying to get assistance and accurate information about what was happening and when from the various departments involved in the discharge of a patient in palliative care, all the while trying to be present for my husband and trying to ensure his comfort. We’d been very wrong indeed to have thought that we could spend the period before discharge gathered round his bedside, gently reminiscing. Challenges at home Once home, we faced further difficulties: There was a great deal to learn: how to operate the hospital bed; how to store and use the oxygen supply safely; how and when to administer the medication supply; how to turn my husband, and deal with incontinence; and how and when to try to feed him or give fluids. We all (including the hospice nurses) struggled to understand the medication which had been provided. We’d received 15 different drugs. They were to be administered according to widely varying schedules and had different means of administration (subcutaneous, injection, oral rinse, sublingual, oral). The explanations provided were delivered rapidly while we were standing in a congested corridor inches from my husband who was being removed by the ambulance staff, when he needed me and was calling to me. We had no opportunity to confirm our understanding of the different medications or to check the contents of the bag before we left the hospital. At home, we found several errors to the medication supply. There was a supply of chemotherapy medication that wasn’t prescribed. There was no supply of other medication that was prescribed. Most critically, we hadn’t received any pain relief medication in a form that we could administer, as my husband’s condition had deteriorated significantly during the delay to his discharge and he became unable to swallow. As a result, just a few hours before he died, at the advice of the hospice nurses who were waiting to receive a syringe driver for intravenous morphine administration, I was compelled to drive from pharmacy to pharmacy searching for pain relief medication that we could administer. I deeply regret that time away from my husband’s bedside. The hospice nurses arrived at our home a few hours after we did. We spent a significant period of time briefing them on their first visit. They needed details of my husband’s medical history, condition, and medication. This also took time away from his bedside. We found there were errors to the information recorded in the discharge summary we’d received on his departure from hospital. One was to his condition, which was assessed and recorded as ‘moderately frail’ (it had been erroneously auto-populated with admission data and should have been ‘terminally ill’). This information bewildered and misled us (causing some family members to delay visiting him, believing he was fitter than he was, for example) and created difficulties for the hospice nurses. They had prepared to assist someone ‘moderately frail’ and it took them time to adjust and get the necessary equipment and pain relief. Consequently my husband didn’t receive intravenous morphine until one hour before he died. As a result of these and many other issues, 34 hours after arriving home, my husband died having endured terrible pain and distress in chaotic and undignified conditions, which was devastating for his family to witness. Learning from experience If we had been aware of what we were undertaking, seeing how quickly my husband was deteriorating during the delay and understanding how little time we had left, we would have encouraged him to remain in hospital and explained to him why going home wasn’t a good idea. We wouldn’t have supported the decision to discharge him home. The delayed discharge and the short time that remained to us meant that all the problems we experienced were concentrated, and much harder to deal with as a result. This detracted from the very precious few hours that we had left together. Even the period immediately after his death was affected. We’d had no time to find out what happens once someone has died, and were devastated to learn, at 1 am, that we needed to identify undertakers as a matter of some urgency. Given the delay to my husband’s discharge and his deterioration, we should have asked for his suitability for discharge to be reassessed. As part of that reassessment, we should also have insisted on a review of his medication, particularly his pain relief medication. He left with a supply of medication that was based on an assessment of his condition made three days before his discharge. But even when everything goes smoothly and there are none of the problems described above, taking someone home for end of life care is still a major undertaking. The following could be useful for anyone preparing to do that. Key things needed to help families prepare to take someone home for end of life care 1. A handbook, providing: A checklist of what should happen and in what order, once the decision to discharge a patient has been made. Contact information for all hospital departments involved in discharging a patient for end of life care at home, including an indication of who’s responsible for what. The advice to find, if possible, a more distant relative, a friend or a neighbour willing to be at your home to receive the hospital bed and other items on your behalf. Instructions for use of all of the equipment provided, e.g. the hospital bed and the safe storage and use of the oxygen supply. Instructions for how to care for a bed bound patient in palliative care, e.g. how to turn them, wash them, deal with incontinence, how to feed them and provide liquids, and the best position for them to be in to facilitate breathing and their general comfort. Contact information and details of available support in the community, including, for example, pharmacy opening hours. A checklist of what items are needed to make the patient as comfortable as possible once home. Instructions for what needs to be done in the hours following death. 2. Contact with the hospice before discharge A meeting or phone call in which the patient’s medical history, condition and medication is shared. Information about what to expect e.g. visit frequency, timing and length; what the nurses will do/not do; how to manage in between visits and what support is available then, especially at night or otherwise out of hours. The hospice contact details, including emergency numbers. 3. A private meeting, in the hours prior to discharge, between the primary caregiver and a nurse familiar with the patient’s care and condition, enabling: A discussion of the patient’s ongoing care. An explanation of the discharge summary (and checking accuracy). A review of, and instructions for, the medication supply, including which medication should be prioritised in the event that not all can be administered. Confirmation that pain relief medication is provided in a form that can be administered as a patient in palliative care is likely to become unable to swallow. All of the above needs time. With time, the transition home is more likely to be successful. But if time is short, and particularly if problems arise, there can be concentrated chaos and confusion, likely to detract from the patient’s last hours and interfere with their care, as we found. For these reasons, in our experience, it isn’t viable or advisable to take a patient home from hospital for end of life care when they are deteriorating and it seems likely that only hours or days remain. If my husband had remained in hospital he would have received undisrupted care and medication (albeit in our case only with our insistence). All members of his family would have been able to be at his bedside throughout. He would have died in less pain, in more comfort and security, and with his dignity intact. And his family would have been much less traumatised by the experience. We live with enduring shame and sorrow for his suffering. What makes it worse is that much of it could have been avoided. Motivated by a desire to reduce the possibility of others suffering as we had done, in 2022 we submitted 20 complaints to the hospital concerned. Following a largely unsatisfactory response, we made a submission to the Parliamentary and Health Service Ombudsman. Our efforts over 16 months to bring about improvement are documented here. Related reading on the hub: HSIB: Variations in the delivery of palliative care services to adults Patients who experience harm provide stories, but who will really engage with their insights and opinions? Top picks: Eight resources about hospice and palliative care
  13. Content Article
    Examples of how two NHS trusts have designed a virtual ward using the system-wide digital healthcare platform, Luscii. The team at Maidstone and Tunbridge Wells NHS Trust (MTW) in collaboration with the Home Treatment Service (HTS) have designed a virtual ward to cater for frailty patients, allowing them to provide acute-level care without the need for hospital admission. MTW’s innovative approach means patients are empowered to live fuller and freer lives with access to hospital care from the comfort of their own homes. Maidstone and Tunbridge Wells NHS Trust_ Frailty Case Study.pdf Nurses at London North West University Healthcare NHS Trust (LNWH) have created a virtual ward caring for hundreds of heart failure patients. The new virtual heart failure ward is a fascinating case study of the power and potential for technology to optimise the use of critical resources and improve care outcomes. The Future of Care - Inside LNWH's Virtual Heart Failure Ward (1).pdf
  14. News Article
    t-home tests for men worried about prostate cancer can give inconsistent and inaccurate results, BBC News has found. The tests, which resemble a Covid lateral flow strip, turn positive if a high level of a protein called PSA is detected in a drop of blood. Of five rapid tests analysed by the BBC, one did not work, three were negative or all-clear, but one returned a false positive result - all from the same blood sample. Prostate Cancer UK said it had significant concerns about the sale of the tests given their "questionable accuracy" and the absence of a doctor to interpret the results. There is no national prostate cancer screening programme in the UK, unlike for breast, bowel and cervical cancer. Instead, the onus is on men to request a blood test from their GP once they are over 50 years old, external, or from 45 for higher risk groups. That NHS test, which is processed in a laboratory, measures the level of PSA released by the prostate, a small gland involved in the production of semen. A high PSA level does not mean you have cancer but is a warning sign which can then lead to further scans and tests to rule out the disease. Dozens of companies now sell self-testing kits designed to measure PSA levels. The UK medicines regulator, the MHRA, says in its guidance that over-the-counter PSA kits are "not a reliable indicator of prostate cancer" and must not "claim to detect cancer". "As your experience shows, these rapid tests appear to have questionable accuracy," says Amy Rylance, assistant director of health improvement at Prostate Cancer UK. "That's a big problem because they can falsely reassure people who really do have elevated levels of PSA and should seek further testing, or they can cause undue worry among people who are absolutely fine." Read full story Source: BBC News, 5 March 2025
  15. News Article
    An AI tool is being rolled out across the NHS that can predict a patient’s risk of falling with 97% accuracy, preventing up to 2,000 falls and hospital admissions each day. The predictive tool, developed by Cera, is being used in more than two million patient home care visits a month, monitoring vital health signs such as blood pressure, heart rate and temperature, to predict signs of deterioration in advance so it can then alert healthcare staff. It is in use across more than two-thirds of NHS integrated care systems and helps to provide care at home by flagging up to 5,000 high-risk alerts a day, reducing hospitalisations by up to 70%. Dr Vin Diwakar, national director of transformation at NHS England, said: “This new tool now being used across the country shows how the NHS is harnessing the latest technology, including AI, to not only improve the care patients receive but also to boost efficiency across the NHS by cutting unnecessary admissions and freeing up beds ahead of next winter, helping hospitals to mitigate typical seasonal pressures. “We know falls are the leading cause of hospital admissions in older people, causing untold suffering, affecting millions each year and costing the NHS around £2 billion, so this new software has the potential to be a real game-changer in the way we can predict, prevent and treat people in the community. “This AI tool is a perfect example of how the NHS can use the latest tech to keep more patients safe at home and out of hospital, two cornerstones of the upcoming 10-year Health Plan that will see shifts from analogue to digital, and from hospital to community care.” The software will also be used to detect the symptoms of winter illnesses like Covid, flu, RSV, and norovirus, allowing NHS and care teams to intervene before hospital care is needed. Read full story Source: Digital Health, 5 March 2025
  16. News Article
    A mum-of-four has praised a hospital-at-home service – hailing it as a “life changing miracle” for her family. Maria Hicklin, whose two young sons Roman, aged seven, and Ricco, aged two, have both battled respiratory conditions, knows firsthand the benefits of the Paediatric Virtual Ward delivered at Sandwell and West Birmingham NHS Trust. The service has treated over 2,000 children with 143 of these being via direct access to the virtual ward, effectively saving 3,800 bed days and making a cost saving of over £1.7 million. Maria, from Oldbury, explained how it has helped her two boys: “The virtual ward service has transformed our experience and saved us money. We’ve had minimal hospital admissions and the medical team provides home visits, monitoring equipment, and offers continuous support. “They’ve even helped build my confidence in administering medication. The team comes out within an hour if we need help, and they know the boys by name. Roman and Ricco are now comfortable and less anxious about their medical conditions. “It’s a stark change from previous winters. Every cold and flu season, we were constantly rushing to A&E. It was destroying our family. “Roman is also autistic, and this made hospital visits even more traumatic. He wouldn’t eat hospital food, and the constant needles and medical procedures were overwhelming for him.” NHS England introduced virtual wards to allow patients to get hospital-level care at home safely and in familiar surroundings, helping speed up their recovery while freeing up hospital beds for patients that need them most. Dr Maria Atkinson, Consultant Paediatrician, said: “Our virtual ward allows us to provide acute medical care directly in patients’ homes, reducing the stress of hospital admissions and keeping families together during challenging medical periods. “Roman has had a particularly challenging medical journey, having first contracted COVID-19 and then developed severe asthma and pneumonia, leading to repeated hospital visits. His younger brother Ricco suffers from viral-induced wheeziness, which added to the family’s medical challenges. “This isn’t just about saving money. We’re providing personalised, compassionate care that keeps children in their home environment through admission avoidance, and by facilitating a reduced length of hospital stay this can support the entire family.” Read full story Source: NHS Sandwell and West Birmingham, 6 February 2025
  17. Content Article
    England is likely to need between 23,000 and 39,000 more hospital beds by 2030/31. Providing hospital care in people’s homes could be a practical alternative to building more NHS facilities, helping to reduce risks and improve efficiency. There have been high expectations of remote monitoring as a key element of NHS England’s virtual ward (otherwise known as “Hospital at Home”) programme. But its use on virtual wards caring for people with frailty has been low compared with other virtual wards. The reasons why remote tech monitoring hasn’t had such high uptake on frailty wards aren’t clear – so THIS Institute set out to find out. This study looks at the views and experiences of people involved in virtual wards – for example as health professionals, managers, policymakers, or evaluators. The project was guided by a patient and public involvement group. What the study found There were four main challenges with using remote monitoring in virtual wards for frailty care: Healthcare professionals weren’t sure about the benefits of remote monitoring for people with frailty. Some people said that that remote monitoring would require significant changes in how patients, carers, and staff worked. The right tools and technology weren’t always available, and products needed to be improved to give frail patients and virtual wards better support. Virtual wards differed greatly in operation and use of remote monitoring, making comparison difficult. Standardisation efforts were sometimes viewed as unhelpful, and the balance between standardisation and local flexibility wasn’t always right. Although using remote monitoring has been a major goal of the NHS virtual wards programme, this study highlights several of the key challenges in making it work for frail patients. If technology is going to work, the solutions will need to be co-designed with input from patients, carers, and staff who care for patients with frailty across different health and social care sectors.
  18. Content Article
    All Together Better Sunderland is an alliance of local health and social care services working as an integrated ‘out of hospital’ system. By working in a much more joined up way, it supports Sunderland residents with long-term illness, health problems, mental health issues and disabilities. The service enables them to access care as close to home as possible and live healthy, independent lives. The alliance wanted to find a digital solution which would enable hundreds of elderly and vulnerable people in self-isolation to receive healthcare support with the use of home care technology.
  19. News Article
    The UK spends £11.7bn on people’s health in the last year of their life, largely on hospital care even though most would rather die at home or in a hospice. The stark disparity is “robbing many tens of thousands of dying people of the chance to remain where they want to be in the final chapter of their life”, according to Marie Curie. A report from the charity has revealed that, in all, Britain spends £22bn a year on health care, social care and welfare benefits for people who will be dead within 12 months. Of the £11.7bn spent on health needs, £9.6bn (81%) goes to hospitals and out of that, more than two-thirds, £6.6bn, is used to provide emergency care such as in A&E. The findings come as MPs consider how to introduce assisted dying for people with a terminal condition who have less than six months to live. The Labour MP Kim Leadbeater’s private member’s bill has prompted widespread agreement that end of life care needs a dramatic expansion. “Through inadequate community care for people in the final year of life, we are currently robbing many tens of thousands of dying people of the chance to remain where they want to be in the final chapter of their life. It is inexcusable and it cannot be ignored any longer,” said Dr Sam Royston, Marie Curie’s executive director of research and policy. “No one wants to be calling an ambulance in the middle of the night because they can’t get the support they need at home, or facing long stays in hospital when they don’t want or need to be there, but that is the shocking reality for far too many dying people.” Read full story Source: The Guardian, 5 February 2025
  20. Event
    Hospital at home and virtual wards use technology to monitor someone’s condition and provide remote as well as face-to-face care. These services aim to help avoid hospital admissions and facilitate early discharge. In this webinar, researchers and a clinician will present evidence from 3 reviews on hospital at home and virtual wards. Presentations will be followed by a Q&A session. The webinar will help participants understand: what are the key elements of hospital at home and virtual wards what is their impact on outcomes? what is their impact on service costs? what factors contribute to their success? Register
  21. Content Article
    Healthcare at home has become an increasingly popular alternative to hospital-based treatment, offering patients the comfort and convenience of receiving care in familiar surroundings. However, while the home care model presents clear benefits, it also brings about unique challenges—especially when patients or their family members are tasked with operating complex medical devices. These devices, such as ventilators, haemodialysis machines, and infusion pumps, have traditionally been used in acute care settings, where healthcare professionals provide continuous oversight. With such devices increasingly being used in the home, the need for appropriate selection, management, and use of those technologies is becoming more critical. One of the most significant concerns associated with home healthcare is the potential for preventable harm due to improper use or malfunction of medical devices. As highlighted in ECRI’s annual Top 10 list of healthcare hazards, improper setup and management of these technologies, particularly by lay users, can result in delayed or inaccurate care, with serious consequences for patient health. This year, ECRI has expanded the discussion of this issue to explore in greater detail the risks associated with home use of complex medical devices.
  22. News Article
    The drive to cut NHS waiting lists is being hampered by bed-blockers who now cost taxpayers more than £2billion a year, a study reveals. More than 12,000 hospital beds every day are occupied by patients who no longer have a medical need to remain but are unable to leave. The huge scale of the crisis - equivalent to closing 26 entire hospitals - is forcing managers to cancel operations and fuelling ambulance delays as there are so few beds for new admissions. A total of 15.7million bed days have been lost to bed-blocking over the past three-and-a-half years, according to new analysis of NHS figures. This averages 12,008 beds per day over the study period but the problem has significantly worsened during this time - soaring 59% from an average of 8,039 per day in April 2021 to 12,772 in April 2024. Many of those stuck on wards are waiting for a place in a care home or for a package of care to be arranged in their own home. Charities warn the longer elderly people remain in hospital the more they deteriorate and the greater they risk they will never regain independence. Read full story Source: The Daily Mail, 31 December 2024
  23. Event
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    Sign up for this free, half-day policy event in Westminster to explore what it would take to successfully move care ‘from hospital to home’ and what we can learn from the experience of other health systems. Chaired by Isabel Hardman of The Spectator, the sessions will look at this through the lens of primary care, social care, and how health systems can rely less on hospitals. Register
  24. News Article
    Patients in the West Midlands, including some of those suffering heart attacks, are being asked to get themselves to hospital amid worsening pressures on ambulance services this winter. The West Midlands Ambulance Service has advised its 999 call handlers to ask patients if they can make their own way to the hospital when services are under high demand. According to reports in The Sunday Times a memo was sent to staff explaining the change was needed due to delays in patients getting an ambulance. The memo said category three and four patients – those who have fallen or are vomiting – will be told: “The ambulance service is under significant pressure, and we don’t have an ambulance available to respond to you. It may be a number of hours before one is available.” “Is there any way you can arrange to safely make your own way to a hospital emergency department?” All ambulance services have adjusted their guidance for call handlers, according to the reports. West Midlands Ambulance Service confirmed that in some cases it is asking people if they can make their own way to hospital, and if they can’t, help will be arranged. Read full story Source: The Independent, 8 December 2024
  25. News Article
    About 300 hospice inpatient beds are currently closed or out of use in England, hospice leaders have warned. They say a lack of funding and staff are the primary reasons why some of England's 170 hospices have had to close beds permanently or take them out of use. Hospice UK, which represents the sector, is now calling for an urgent package of government funding to prevent further cuts. The Department of Health said it was looking at how to financially support hospices to ensure they are sustainable. Annette Alcock, Hospice UK's director of programmes, said the way that hospices are funded and commissioned by the NHS is "acting as a huge cap on what they can do", while also blaming "underlying pressures like staff shortages". She added: "If the government can act in both the short and long term to resolve these problems, these figures are clear evidence that hospices can do a lot more for patients, and a lot more for the NHS. "That's true out in the community too, where most of hospice care is actually delivered. "With better funding and commissioning, hospices could provide so much more care where people most want it - at home." Read full story Source: BBC News, 4 December 2024
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