Hospital at Home

People need time to rest and recover after illness or injury. But spending longer in bed than necessary can lead to muscle loss, reduced confidence and a slower recovery.

Hospital care is vital for people who need specialist treatment. However, research shows that many people recover more quickly and maintain their independence for longer when they can receive care and support at home.

Some people no longer need acute hospital treatment but still require ongoing monitoring, therapy or nursing care. Hospital at Home provides this support in a safe and effective way. It helps people leave hospital sooner and continue their recovery where they feel most comfortable.

Advances in healthcare mean we can now deliver many treatments at home that would previously have required a hospital stay. For many people, getting back to their own bed as soon as it is clinically safe helps them stay active, maintain their strength and confidence, and return to everyday life sooner.

Key facts 

Spending long periods away from home can affect a person's confidence and independence. When appropriate, receiving care at home can help maintain their usual routines and reduce some of the risks associated with longer hospital stays.

Research shows that:

• frail patients who are living independently and admitted to hospital are less likely to recover their mobility and more likely to need to move to a nursing home after being discharged
• just 1 week in hospital can lead to 10% less muscle strength and 25% reduced circulation. It can also lead to a decline in dignity, confidence and independence
• for patients over 80, 10 days of bed rest can lead to 10 years of muscle ageing and deconditioning in hospital leads to delayed discharge in nearly half of older patients
• half of frail, older patients will have cognitive decline between admission and discharge
• half of older people can become incontinent within 48 hours of admission

Hospital at Home allows you to receive hospital level care in your own home or care home as an alternative to being in hospital. Our service is available 7 days a week.

The virtual wards (set up during the pandemic) are now part of our wider Hospital at Home Service. Hospital at Home wards can safely manage people who are acutely unwell. They can also manage people who need palliative care or who are coming to the end of their life. 

The team uses a range of diagnostics, in-person treatments and therapy, as well as remote monitoring depending on what you need. The service is consultant led. It has doctors, nurses, therapists, pharmacists, healthcare assistants, a team of collection and delivery drivers, and is supported by administrators. This means it can care for a broad spectrum of patients with a range of needs.

Hospital at Home wards 

As a patient on a Hospital at Home ward, you stay in the comfort of your own home or care home. Our healthcare staff will check your condition until you are better, both in person and remotely. Regular monitoring means we will pick it up early if you become more unwell. If this happens, we will make sure you can access extra care quickly and in a planned way. This might involve us sending out an enhanced practitioner. They will be able to assess you and decide the next steps of your care.

You will be loaned the device(s) you need to check your condition at home. The digital equipment enables patients to send instant messages to the Hospital at Home team. It also uses patient to clinician video conferencing for direct conversations. You will be able to self-monitor your blood pressure, pulse, respiratory rate, and temperature. These are automatically sent to the team through the monitoring platform, to enable them to make informed decisions about your treatment plan. If your readings get worse, the team may contact you. They will give you support and advice on what to do next.

The team will explain how to use the device(s), how to send in your readings, and how they will get in touch. They will tell you what to do if you feel unwell. They will also tell you when you have recovered. This will mean you can stop monitoring.

When you have recovered, the team will arrange to collect the equipment from you. They will also make sure you are referred to other services to support your ongoing care.

If you live alone, ask a friend, family member, or neighbour to check up on you. Volunteer Cornwall can offer help through their care support volunteer network. Call Volunteer Cornwall on 01872 265 305.

Hospital at Home offers a self-managed service for patients who need long-term condition support after an acute event, or as recognised by their GP, community matron or specialist services. This is where patients are supported to understand their condition better. It empowers them to manage this to reduce a crisis.

People across Cornwall and the Isles of Scilly now have more choice about how and where they receive palliative and end of life care. A range of enhanced services are helping more people stay at home or close to home, with support for both patients and their families.

A new Hospital at Home ward provides palliative and end of life care in people's own homes. This helps them to stay in familiar surroundings with the people who matter most. The Trust has also strengthened its urgent community response service. This now operates 7 days a week.

A new community support service for people in the last 12 months of life is up and running. Provided by the voluntary sector, it is focussed on compassionate and personalised conversations to capture what matters most to families and loved ones, as well as what their wishes might be.

The service also offers a range of non-clinical support through the Cornwall's Community Gateway and Community Hubs Network. This includes things like help with grocery shopping and moving furniture around to accommodate specialist beds at home. Teams can signpost families to other groups like bereavement support too.

Together with a developing 24-hour support phone line, these improvements will help more people receive compassionate, dignified care in the place they choose. This work aligns to the 10 Year Health Plan and our aim to care for more people at home or as close to home as possible.

If you are under the care of Hospital at Home and your symptoms quickly get worse, use this information to assess yourself.

Ring your Hospital at Home team or 111 as soon as possible if you:

• gradually feel more unwell or more breathless
• have difficulty breathing when you stand up or move around
• feel very weak, achy, or tired
• are shaking or shivering
• have lost your appetite
• sense that something is wrong
• you are unable to care for yourself, for example you are unable to wash or dress yourself, or make a meal or snack

Call the Hospital at Home team on 01726 873 400. They are available from 8am to 8pm, 7 days a week. Outside of these hours, call 111 or visit the NHS 111 website.

Go to the emergency department immediately or call 999 if:

• you are so breathless that you are unable to say short sentences when resting
• your breathing suddenly gets worse
• you cough up blood
• you feel cold and sweaty with pale or blotchy skin
• you develop a rash that looks like small bruises or bleeding under the skin and does not fade when you roll a glass over it
• you collapse or faint
• you feel agitated, confused, or very drowsy
• you have stopped peeing or are peeing much less than usual

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If you are recovering, you should:

• notice a gradual improvement in how you feel
• you will be mobile for example will be able to climb the stairs (if this is normal for you)
• you will not be confused
• you'll be eating and drinking as normal