Resource Topic: Partnerships

During winter last year, a 1,500-bed acute Trust faced significant challenges with capacity. Historically, the Trust invested in additional intermediate care beds to improve patient flow during peak periods, but demand still often exceeded capacity, leading to delays in discharge and reduced efficiency.

To address these challenges, the Trust aimed to streamline the transition of patients from hospital wards to the Adult Social Care Short-Term Intervention Team to reduce the need for additional beds and expedite patient discharge. The goal was to optimise existing resources and maximise efficiency without increasing overall costs.

To identify a potential solution, HomeLink Healthcare carried out a comprehensive feasibility assessment at the hospital, meeting with Trust and community teams to understand their perspectives on patient flow and capacity. This insight helped us focus on the specific interventions that would have the most positive impact on services.

Building on the findings of the feasibility study, HomeLink and the Trust worked closely together to co-design and implement a bespoke bridging service between the hospital and the Adult Social Care team to improve patient flow and facilitate timely discharge. By reallocating the Trust’s existing funds more effectively, we helped the Trust achieve increased productivity and efficiency without requiring additional budgets for extra beds.

Mobilisation of the new service took just 12 weeks, led by a dedicated HomeLink project manager overseeing key workstreams, including clinical governance and IT integration. The service operates seven days a week with patient visits supported by HomeLink’s  24/7 on-call clinical team. Within weeks, the partnership achieved the target of 150 visits per week and expanded to include an additional hospital, adapting seamlessly to the Trust’s evolving needs.

Impact

• Improved patient flow and capacity: Within the first six months, the service has enabled 129 patients to spend an average of 10 days fewer in hospital, releasing 1,042 bed days. On the busiest days, we freed up to 11 beds daily, providing critical operational relief.
• Cost-effectiveness: By reallocating existing budgets, the Trust avoided additional expenditure on extra beds. Every pound invested in HomeLink’s service delivered better value, improving efficiency and reducing pressure on acute beds.
• Better patient outcomes: Patients reported, on average, a 16% overall improvement in health outcomes (measured through EQ-5D-5L) between their first home visit and discharge. This included an 8% improvement in mobility and self-care, a 12% increase in their ability to perform usual activities, and reductions of 15% in pain and discomfort and 5% in anxiety and depression, leading to greater independence and reduced long-term reliance on healthcare services.
• High patient satisfaction: 99% of our patients said they would highly recommend us to their friends and family, and 99% said they would be happy to be treated by HomeLink at home again.

What our patients say

“This service is brilliant. Without it I would have been in hospital for weeks blocking a much needed bed and unable to do anything. All of the staff who came to provide treatment were very professional, efficient, respectful and interacted with my wife and I exactly at the right level. Thank you.” – Patient feedback 

“I want to thank you all for the care and support you have given me these last few weeks. Nothing has been too much trouble. Your devotion to your jobs were there to see in all of you. With my eternal gratitude. Bless you all.” – Patient feedback

Work with us 

Find out more about the process of commissioning HomeLink Healthcare to set up a hospital at home service.

Get in touch

To discuss how HomeLink Healthcare could help your organisation or to request a free feasibility assessment, call us on (020) 3137 5370 or contact us.

The partnership between The London Clinic and HomeLink Healthcare has delivered meaningful improvements to the oncology patient journey, particularly in reducing waiting times, increasing operational efficiency, and enhancing clinical flexibility. By introducing a ‘pre chemotherapy bloods at home’ service, The London Clinic has been able to transform a traditionally time-intensive pathway into a more streamlined, patient-centred experience.

Reduction in Patient Waiting Times and Fewer Journeys for Patients

With the introduction of HomeLink Healthcare’s at-home blood collection service, the waiting time for treatment has been reduced by an average of 83% for patients who have their bloods taken in advance.

This substantial improvement that not only enhances patient satisfaction but also reduces the physical and emotional burden associated with long hospital visits—particularly important for oncology patients undergoing intensive treatment.

Efficiency Gains for The London Clinic as well as for Patients

The benefits extend beyond those directly using the at-home service. By shifting a proportion of taking bloods into the community, HomeLink Healthcare has alleviated pressure on The London Clinic’s in-house phlebotomy services.

As a result, patients who continue to have their bloods taken at the clinic have also experienced up to 40% shorter waiting times from appointment to treatment. This demonstrates how redistributing workload can create system-wide efficiencies, improving the experience for all patients, not just those using the new service.

Supporting Chemotherapy Preparation

An often-overlooked benefit is the additional time this model provides to pharmacy teams. With blood results available earlier, pharmacists have more time to prepare chemotherapy medications. This reduces time pressure, supports accuracy, and enhances overall treatment safety.

Increased Flexibility and Clinical Safety

HomeLink Healthcare’s service offers a standard 48-hour turnaround for blood testing, with the flexibility to adjust to 24-hour or 72-hour windows depending on clinical need. This adaptability provides several key advantages:

• Early identification of abnormal (deranged) blood results, allowing clinicians more time to assess and respond appropriately.
• Opportunities for repeat testing, particularly in cases where initial samples are inconclusive or unsuccessful (e.g., difficult venous access).
• Improved contingency planning, ensuring that patients are not delayed on the day of treatment due to avoidable issues.

A More Patient-Centred Model of Care

The collaboration between The London Clinic and HomeLink Healthcare represents a shift toward a more proactive and patient-centric model. By moving essential but routine elements of care—such as blood testing—into the home, which has improved patient flow, and created a more responsive and resilient oncology service.

Matthew Clark, Head of Operations: Cancer Care at The London Clinic commented: “The introduction of at-home blood collection through HomeLink Healthcare has delivered measurable and meaningful benefits for The London Clinic. With significant reductions in waiting times, improved operational efficiency, and enhanced clinical flexibility, this partnership demonstrates how innovative service models can elevate both patient experience and healthcare delivery.”

If you think your organisation would benefit from a partnership like this please call us on (020) 3137 5370 or fill in the form below.

Thanks to a partnership with HomeLink Healthcare, The James Paget University Hospital NHS Foundation Trust has freed up nearly 20,000 bed days since they started working together four years ago. The service, known as Paget at Home, creates an additional ward of capacity every day, by providing treatment and care at home to patients who would otherwise have remained in hospital. The operational headroom created contributes to productivity benefits while the bed days are costing less than half the equivalent in-hospital care.

The situation

Like almost all acute hospitals The James Paget was experiencing extreme capacity issues when they first commissioned our services back in March 2020. Fast forward to the end of 2023 and hospital bed capacity was 88%. This compared favourably to an average across all NHS hospitals of 90%, thanks in part to Paget at Home.

The solution

Paget at Home started as an Early Supported Discharge service which included clinical care at home and Bridging Packages of Care. It has developed over four years to cover a range of pathways including supporting the Virtual Ward, IV Therapy, Discharge to Assess and Reablement.

How does it work?

An on-site team pro-actively identify patients who are medically optimised or no longer meet the criteria to reside and enable same-day transfer / discharge home. Home based wrap-around care is provided by a HomeLink Healthcare multi-disciplinary team. The on-site team do the heavy lifting managing the on-going care, co-ordinating with consultants, referrers and community providers, minimising the impact on hospital staff.  The service is supported by a 24/7 on-call service.

As a clinician-led organisation, a commitment to quality care is at the heart of everything we do. For each new pathway HomeLink Healthcare carry out a feasibility assessment using hospital data. Clinical governance is co-produced, and pathways are rapidly prototyped, evaluated and rolled out, using technology as an enabler where appropriate. A comprehensive suite of KPIs is implemented, and real-time data allows the team to identify best practice quickly and apply corrective actions as necessary.

Services are commissioned using the NHS SBS Patient Discharge and Mental Health Step Down Beds Services Framework Agreement. Using the Framework means that the time to contract is shortened significantly compared to a full tender. This saves significant time and money and enables us to fully mobilise new services through a ‘test and learn’ phase to full ramp in 4-12 weeks.

The results

Increased capacity and improved patient flow: Over the last four years Paget at Home has supported over 1,000 patients and released over 20,000 bed days, saving an average of 20 bed days every day. This is the equivalent of almost a whole hospital ward. With a capacity of around 500 in-patient beds, these 20 ‘at home beds’ effectively increase hospital capacity by four percent.

Better patient outcomes: Patients reported, on average, a 21 percent improvement in clinical outcomes (EQ-5D-5L) by the end of their treatment. 99 percent also said they would recommend HomeLink/Paget at Home to Friends and Family. By supporting patients across a largely rural area our service also address inequalities in access to care.

Cost effective: In 2022, James Paget calculated the average cost per hospital bed to be £450. The cost of our Hospital at Home services are currently under £200 per bed day. Even without factoring a cost increase, this is a 55 percent cost saving.

Implications for the future

Patients: Paget at Home and other HomeLink Healthcare Hospital at Home models ensure that patients spend much less time in hospital which reduces the risk of infections, deconditioning and depression. By being discharged as soon as they are medically optimised or medically fit, and starting rehabilitation immediately, they also have much better outcomes. Patients much prefer being treated in the comfort of their own homes and, as a result of all these factors, they are much more likely to return to their pre-hospital level of independence. Patients are less likely to be re-admitted into hospital and will need reduced ongoing care.

Patient flow: Patients needing complex treatments or multi-disciplinary care often remain in hospital for far longer than they need to. A recent study found that the average length of stay in hospital was 34.8% longer in 2022/23 compared to 2019/20*. HomeLink Healthcare’s feasibility assessments often reveal around a ward worth of patients across the hospital that could complete their recovery at home, with the right Hospital at Home provision in place.

If every hospital in the country could create an additional 4% capacity, as The James Paget has done, this could be used to reduce the occupancy levels from 90% to 86% (85% is widely considered the risk threshold).

Sustainable additional capacity: If hospitals are to tackle increasing demand on Urgent and Emergency Departments, growing elective waiting lists and pressure on GPs they either need to increase hospital capacity (requiring more staff and additional wards) or treat more people at home.

As HomeLink Healthcare bring our own multi-disciplinary staff team, this avoids the recruitment challenges associated with resourcing additional capacity. This additional capacity, along with lower occupancy rates enables existing healthcare staff to focus on core delivery and allows time to plan for new patients and longer-term care.

Cost-savings: When occupancy levels are optimised** the cost of hospital at home services are significantly lower than the equivalent in-patient care. Improved patient outcomes mean smaller ongoing care packages, which are easier to source and lower in cost. The costs of building new hospital wards are also avoided.

Key stats (March 2020 – Feb 2024)

• Over 1,000 patients have been treated at home
• Patients spend on average 20 days fewer in hospital.
• Patients reported an average 21% improvement in clinical outcomes
• The service costs 45% compared to in-patient care
• 99% of patients would highly recommend the service
• 100% of client contacts said they would recommend us
• SBS Framework allows new pathways to be mobilised in as little as 4 weeks

About HomeLink Healthcare

HomeLink Healthcare have been delivering Hospital at Home services since 2016 and provide a solution for the future. We deliver system benefits for ICBs, Trusts and the Community. Our services improve patient outcomes, improve patient flow, reduce waiting lists and save costs. In our recent survey 100% of client contacts said they would recommend us.

HomeLink Healthcare is a named supplier on the NHS SBS Patient Discharge and Mental Health Step Down Beds Services Framework Agreement. By using the framework, you can contract with us directly and we can get a new service up and running in around 12 weeks.

To discuss how HomeLink Healthcare could help your organisation, or to request a free Feasibility Assessment please get in touch.

Call 020 3137 5310 or email info@homelinkhealthcare.co.uk

 

* Newton / CCH report – Finding a way home, November 2023

** HomeLink Healthcare virtual wards have a 97% occupancy rate compared to 70% across the NHS (Jan 2024)