Hospital at Home

In response to the lack of evidence to guide investment in hospital at home services and concern about optimising healthcare for a growing older population with complex health needs, we conducted a UK wide NIHR funded randomised trial that compared hospital at home with hospital admission for a select group of older people.

The hospital at home service we tested was led by a geriatrician (a doctor who treats older people) who worked with a multi-disciplinary team of NHS staff to provide healthcare in the home.

Over 1,000 older people participated in the trial. We found that for a select group of older people referred for a hospital admission due to being medically unwell and who were physiologically stable, hospital at home did not lead to higher deaths after six months or one year compared with hospital based care.

People receiving hospital at home care:

• were less likely to be admitted to long-term residential care
• were less likely to experience an episode of delirium after one month
• were more likely to be transferred to hospital after one month
• had higher levels of satisfaction for hospital at home.

In our randomised trial, we found that hospital at home was cost-effective when compared with a hospital admission.

Admission avoidance hospital at home has the potential to strengthen the provision of healthcare for a select older population. The evidence from this randomised trial informed a new policy on a hospital at home model with NHS England, by September 2023 the NHS had rolled out 10,000 virtual wards.

The research, published in Age and Ageing in 2023, was awarded the 2023 Dhole-Eddlestone Memorial Prize for the most deserving published work of medical research relating to the needs of older people. 

The most deserving published work of medical research appertaining to the needs of aged people.

Dhole-Eddlestone Memorial Prize, 2023