Partnership with HomeLink saves 20,000 bed days at James Paget Hospital

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.

"Pro-active lead, excellent engagement with Trust colleagues and escalating concerns"
- James Paget Client Survey

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.

"Excellent team and service, so happy I can be treated in my own home"
- Patient

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.

Better patient outcomes

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)

NHS Shared Business Services (NHS SBS) framework agreement renewal enables direct commissioning of Hospital at Home services

We are pleased to announce we have been reappointed as a supplier on NHS Shared Business Services (NHS SBS) Patient Discharge and Mental Health Step Down Beds Services Framework Agreement. NHS partners can procure services with HomeLink Healthcare directly via the framework agreement.

 

New NHS SBS Framework Agreement

About the framework agreement

This NHS SBS framework agreement has been developed to reduce the demand on NHS Trusts by supporting with their adult patient discharge pathways. The framework agreement aims to:

  • facilitate transfer of patients from hospital beds to a more appropriate level of care
  • supply additional bed capacity within the NHS urgent care system infrastructure by relieving bed pressures within the local health economy
  • discharge patients meeting specific clinical criteria into an appropriate care setting, reducing instances of re-admission to hospital
  • allow patients to have personalised on-to-one support maintaining continuity of care
  • provide a dedicated pathway to hospital discharge management services.

HomeLink Healthcare is a supplier on the following Lots:

  • Lot 1: Discharge to Assess Services: facilitates patient discharge not only from emergency departments but also from the wider acute hospital and community care settings.
  • Lot 3: Virtual Ward Support Services: supplies a “secondary care” service within a patients care setting for up to 6 weeks. Patients are transferred to the Virtual Ward Support Service following referral from the Trusts’ clinical discharge teams on acceptance by service leads.

“Free to access, our ‘Patient Discharge and Mental Health Step Down Beds Services framework agreement is designed to support the transition of patients from hospital, reducing instances of pressure on acute hospital beds, Social Services and re-admissions. In turn, this enables health and care providers to free up capacity to deal with other patients. improve quality of care and health outcomes.” Elaine Alsop, Head of Category – Health, at NHS SBS.

Avoid delays and contract with us directly

NHS partners can use the NHS SBS Patient Discharge and Mental Health Step Down Beds Services framework agreement to directly award contracts to HomeLink Healthcare, saving time and money on the procurement process.

New services can be mobilised in 8-12 weeks. Act now to get a new service up and running within three months and at full capacity within around four months.

  1. Develop specification, business case, contracting options and supplier engagement: now!
  2. Contracting: one week
  3. Service mobilisation: twelve weeks
  4. Go live!
  5. Ramp up to full capacity: six weeks

Work with us

HomeLink Healthcare has been delivering Hospital at Home services since 2016. As a supplier to NHS SBS’s new framework agreement and its previous iteration which ran for four years from March 2019,  it has been used to procure a wide variety of pathways from a large number of organisations including Trusts and the Community Services.

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

Get in touch

To speak to a member of our team about our services, call us on (020) 3137 5370 or contact us. You can tell us about your situation, and we can tell you more about our experience of supporting our NHS partners and how we might be able to help you.

 

Release in-patient bed capacity this winter with Hospital at Home services

The case for Hospital at Home services is compelling. Seasonal resilience funding is often seen as a one-off. Why not use it to work with an experienced provider which has a track record of delivering results for the NHS and for patients. HomeLink Healthcare can also help with business planning now. This will speed up the process of delivery once funding is released.  

According to the Delivery Plan for Urgent and Emergency Services the winter crisis of 2022 saw hospitals fuller than pre-pandemic levels, with 19 out of every 20 beds occupied and 7.2 million patients on waiting lists. In January 2023, nearly 14,000 beds were occupied by patients who were fit to be discharged.  

This winter is expected to see similar challenges. With bed occupancy rates over 90%, hospitals are increasingly looking towards Hospital at Home services to free up beds ahead of winter. 

The case for Hospital at Home services is compelling

"Boosting care in the community and treating more people at home is key to recovery – it is better for patients and their families, as well as easing pressure on NHS services."
- Amanda Pritchard, NHS Chief Executive

NHS England sees Hospital at Home and Virtual Wards as a key solution to improving patient flow through A&E and reducing elective recovery waiting lists. According to statistics patients are five times less likely to acquire an infection and eight times less likely to experience functional decline on a Virtual Ward compared to an acute setting. Twenty-three per cent of these patients also achieve a more independent social care outcome. 

HomeLink Healthcare provides Hospital at Home services through a number of pathways including Early Supported Discharge, Discharge to Assess, Virtual Wards, Reablement, Rehabilitation, Anticipatory Care, and Bridging Packages of Care. 

Seasonal resilience funding can relieve the pressures and build a case for future roll-out 

As Hospital at Home services become more established, and increasing numbers of patients are seen at home, savings can be made through introducing fewer hospital beds and outsourcing less elective care procedures to the private sector.  

Setting up a Hospital at Home service doesn’t need to be difficult

A Hospital at Home service requires expert knowledge; integration with existing governance structures; staffing; and in the case of Virtual Wards, technology. We understand that this can be quite daunting, particularly at a time of such immense pressure.  

That is where HomeLink Healthcare comes in.  

  • EXPERTISE IN HOSPITAL AT HOME: We are 100% focused on delivering Hospital at Home services and have been since 2016. We have numerous clients and we deliver services in four of the seven NHS England regions. 
  • COMMITMENT TO QUALITY: We are clinician-run and everything we do is patient-centric. Our clients see us as ‘NHS like’ and in our most recent client survey we received 100% client satisfaction. 
  • NO NEED TO RECRUIT: We bring with us a multi-disciplinary team of compassionate, patient-focused nurses, therapists and healthcare support workers. 
  • TECH, OR NO TECH, NO PROBLEM: If you’re interested in a Virtual Ward, we can provide our own technology partner, or work with your existing technology supplier. 
  • FAST, EFFECTIVE MOBILISATION OF SERVICES: Services can be procured directly using the NHS Shared Business Services Patient Discharge and Mental Health Step Down Beds Services Framework. We use a PRINCE 2 project management approach, supported by a dedicated project manager and can get brand new services up and running within 12 weeks.  
  • WE WORK IN PARTNERSHIP: We bring our expertise and tried and tested ways of working and at the same time treat each relationship on a case-by-case basis. We have been shortlisted for three HSJ Partnership awards.  
  • REAL-TIME DATA: Advanced KPI reporting enables clients to see what is happening in real-time and share best practice. Data includes patients, visits, outcome measures and patient experience metrics 

We can help you to increase hospital discharges in time for winter

HomeLink Healthcare can get a brand new service up and running within 12 weeks. This means that if you act now, you can have new pathways in place by winter 2023/24.  

No funding yet? Don’t let that stop you from contacting us!

We know that funding for winter is on its way but that you might not know how much you will receive. To avoid unnecessary delay, and to make things easier for you during the procurement phase, our staff can carry out a no-obligation feasibility assessment now. The outputs from this can also be used to help pull together a business case. After funding levels have been agreed, we can adjust the numbers accordingly.  

View our case studies:

  • Last year we implemented new Bridging Packages of Care and Reablement pathways in Buckinghamshire. Discussions started in the summer before funding was in place, and the service commenced on 1 December 2022. The service saved 951 bed days its first 18 weeks. Read more here 
  • A patient in Norfolk gets home in time for Christmas thanks to the Virtual Ward. Read more here  
  • Hospital at Home services in Norfolk and Waveney save the equivalent of two hospital wards every day. Read more here.  

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 speak to a member of our team about our services, call us on (020) 3137 5370 or contact us. You can tell us about your situation, and we can tell you more about our experience of supporting our NHS partners and how we might be able to help you. 

 

Collaboration with four NHS organisations frees up two hospital wards every day

HomeLink Healthcare has been working across Norfolk & Waveney ICS alongside multiple NHS organisations to respond to exceptional capacity challenges.

"HomeLink gave us the ability to quickly respond to demand, flex up and down, and were invaluable in enabling us to meet varying complexity of needs”
- NHS Trust Chief Operating Officer

The partnership began in 2019 with Norfolk and Norwich University Hospital (NNUH). Today we also work with James Paget University Hospital, The Queen Elizabeth Hospital King’s Lynn, and Norfolk & Waveney ICB.

Hospital at Home services are delivered through a number of pathways: Virtual Wards, Reablement, Early Supported Discharge, and Discharge to Assess. Some pathways include patient monitoring. We also provide Bridging
Packages of Care.

This testbed for pan-ICS work in collaboration with an independent sector provider has been very successful. Services are rated excellent by patients, provide measurable system benefits and improved patient outcomes. Services are also delivered at 45% of the equivalent in-patient cost.

The scope and scale of the collaboration continues to expand across the ICS. Findings have been shared and used to inform models of care and to support delivery of NHS strategy and plans.

Setting the scene

"HomeLink Healthcare has an ongoing flexible collaborative approach; high-quality service provision with robust governance and transparent data and reporting”
- NHS Trust feedback

The Norfolk & Waveney Integrated Care System (ICS) covers a largely rural area in the East of England.

The widely dispersed population and long travel times, on mainly country roads, creates challenges in providing consistent community and home-based care.

In addition, the relatively isolated location makes it hard to attract and retain sufficient numbers of community nurses, physiotherapists and healthcare assistants.

Gaps in access to community care led to delays in discharging patients from hospital, with the inevitable impact on emergency admissions and electives.

In 2019 it was decided to engage with a specialist Hospital at Home service provider, HomeLink Healthcare, to provide pathways for patients who had no need to remain in hospital.

In common with many systems, NNUH faced a longstanding need to create additional acute capacity that became more severe in 2020.

The benefits of the new services were closely monitored.

Key achievements

• A unique pan-ICS collaboration with the independent sector

• The partnership has saved 45,000 bed days (Jan 19 – Apr 23)

• Services were delivered at 45% of the in-patient cost (James Paget University Hospital, Jan 21- Aug 22)

• 17% improvement in self-reported clinical outcome measures (EQ-5D-5L Jan 19 – Feb 23)

• Today the service frees up the equivalent of two hospital wards every day (56 hospital beds)

• Over 99% of patients would highly recommend us (patients scoring us 8+ out of 10)

• Findings have been shared across the ICS and with NHS England

• The partnership was shortlisted for an HSJ partnership award in 2023

The collaborative approach

Initially, a ‘test and learn’ pilot was conducted at NNUH with the financial, patient and system benefits evaluation leading to conversations across the other acute hospitals, community providers, and Norfolk & Waveney ICS.

A Virtual Ward was developed at NNUH in 2019 and findings were used to improve subsequent service development.

Since 2020, we have worked with a team from the Trusts and ICB to design and create additional Hospital at Home services including treating patients with more complex needs. We have also provided short term wrap-around support to frail patients, to reduce hospital attendance, and to support independence. Taking a safety-first approach, we ensure that governance is paramount and that KPIs are built into the system.

Services were rapidly prototyped, evaluated and rolled out, using technology as an enabler where appropriate. A comprehensive suite of KPIs was implemented and real-time data allows the system to identify best practice quickly and apply this across the ICS.

HomeLink Healthcare provided a flexible regional workforce with a good understanding of the local geography. We worked with our NHS colleagues as one team and acted as a force multiplier in a hard-to-recruit region. The result was that capacity was always maintained and inequality in access to care was reduced.

Patients rate the service as ‘excellent’, and outcomes have been impressive. We use the EQ-5D-5L ‘self-reported clinical outcome measurement‘. We saw an average improvement of 17% between January 2019 and May 2023. Patients also demonstrated a positive improvement in the following five domains: mobility; self-care; usual activities; pain/discomfort; and anxiety and depression. We use an ongoing flexible ‘test and learn’ approach which ensures robust governance and continual service improvement. Operations manuals were co-designed specifically for each service and reduced service duplication saves the NHS time and money. New services can now be mobilised within as little as four weeks.

System benefits & the future

As four NHS organisations and an independent provider, we were combined early adopters of Hospital at Home services. We have worked from the start to share benefits across the ICS. The collaboration has shown how pan-ICS contracting results in better value for the NHS and an excellent patient experience and outcomes.

The scope and scale of the collaboration continues to expand across the ICS. Findings have been shared with NHS England, and Virtual Ward models align with and support NHS strategy and plans.

Get in touch 

To speak to a member of our team about our services, call us on (020) 3137 5370 or contact us. You can tell us about your situation, and we can tell you more about our experience and how we might be able to help you. 

HomeLink Healthcare feature twice in IHPN Community Services Report ‘What does good look like?’.

We are proud to have two case studies featured in the Independent Healthcare Providers Network (IHPN) Community Health Services report ‘What does good look like?’. The report includes an overview of community health services in England, along with sixteen case studies from IHPN member organisations.

 

The report explains how moving more services into the community, and out of hospital, is core to the NHS Long Term Plan. It says that it has never been more important to see community healthcare services as the essential building block to a modern, responsive health service. The report showcases how community health service providers, including HomeLink Healthcare, are bringing much needed capacity to the NHS and delivering innovation as well as improved productivity and patient outcomes. The case studies depicted in the report show ‘what good looks like’ and ‘the art of the possible’.

 

The case studies about addressing capacity issues in Buckinghamshire Health Trust and Norfolk and Waveney ICB are featured as below.

 

You can read the full report here IHPN Community Health Services report 2023.

Find out more about HomeLink Healthcare’s Hospital at Home services.

Get in touch 

To speak to a member of our team about our services or to book a free feasibility assessment, call us on (020) 3137 5370 or contact us.  

NHS England and IHPN visit HomeLink Healthcare service

Sam Sherrington, Deputy Director for Community Nursing at NHS England, Dawn Hodgkins and Danielle Henry from The Independent Healthcare Providers Network came to visit us at St. Mary’s Hospital in Paddington to see how HomeLink Healthcare services work in practice.

“What we have seen here today in HomeLink is a very dynamic, solutions focused way in which we are trying to address problems around discharge”. – Sam Sherrington, NHS England

Here is a short video with Sam and Dawn reflecting on the importance of the service and some of the great things they’d observed from the HomeLink Healthcare service – the partnership between independent sector and the NHS, the innovation and quality of service, and the care, dedication and expertise of the clinicians – nurses, therapists and more – working to deliver for patients.

 

Find out more about HomeLink Healthcare’s Hospital at Home services.

Get in touch 

To speak to a member of our team about our services or to book a free feasibility assessment, call us on (020) 3137 5370 or contact us.  

Case study: Partnership with Buckinghamshire Healthcare NHS Trust

For some time, delays in discharging patients from Amersham Hospital in Buckinghamshire meant the hospital’s in-patient bed base was at capacity, with beds occupied by patients medically fit for discharge. This led to problems with patient flow and reduced availability of ‘step down’ care in the hospitals. It also created a continuous back log of patients for the NHS Trust’s intermediate care teams, thus delaying patients return to home.

Buckinghamshire Health NHS Trust (BHT) commissioned HomeLink Healthcare to provide Early Supported Discharge, Rehabilitation and Bridging Package of Care to support with delayed discharges.

"I’ve worked with a lot of providers and HomeLink Healthcare are a very professional organisation. Every member of my team have said how respectful and courteous your staff are. It has been a pleasure to work with a partner who does exactly what they say they will”
- Jenny Ricketts, Director of Community Transformation

During the initial stages of our discussions in Summer 2022, funding was not yet in place and the type and amount of support the hospital were looking for had not yet been defined.

HomeLink Healthcare carried out a free Point of Prevalence survey, walking the ward and consulting with the ward nursing team to estimate the percentage of patients we could transfer into our care. We discussed and reviewed the potential solutions with BHT and in partnership created a bespoke service that would best impact patient flow and support BHT’s intermediate care teams.

We agreed on an Early Supported Discharge and Rehabilitation pathways, both of which included the option for Bridging Package of Care and made a formal service proposal. Six weeks later we started mobilisation against a fixed price and set of agreed outcomes.

Typically, the mobilisation process for brand new services takes eight to 12 weeks. In this instance it took nine weeks.

HomeLink Healthcare uses PRINCE 2 project management approach, led by a dedicated Project Manager. This focuses on working in partnership to move initiatives through predefined stages across seven workstreams: service and pathway design; clinical governance; information governance; IT; contract and finance; communications; and workforce.

An average of nine hospital bed days saved per patient

An initial kick-off meeting with the full HomeLink Healthcare and BHT team set out the parameters and timescales of the project. This was followed by individual meetings between HomeLink and BHTs workstream leads. Weekly checks were held between the two project leads.

The first patient was referred to us on 1st December 2022 and as with all new services, we went through a four-week, post go-live intensive programme of checks and support. We always start small to ensure the service is delivering as planned in a safe and effective manner. ‘HyperCare’ ensures that the service is delivering to schedule and on track to meet all outcome-based measures.

When the service launched, we aimed to complete 20 visits in the first week and ramp up to full capacity over the following weeks. Over the first six weeks we overperformed, completing 115% of the required visits.

This service saved 951 bed days in the first 18 weeks.

After 18 weeks we had saved 951 bed day, an average of 53 bed days per week. Getting people out of hospital sooner than they would ordinarily have been able to has had a significant improvement on patient flow in both Amersham Hospital and Olympic Lodge (a step down facility).

"The staff have been brilliant, I am going to miss everyone!”
- Patient feedback

Peggy, age 94, was referred to us on 1st December following a fall. We started care on the same day which meant that Peggy could leave hospital four days earlier than she would have been able to had she had to wait for her social care package.

 

 

 

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 speak to a member of our team about our services, call us on (020) 3137 5370 or contact us. You can tell us about your situation, and we can tell you more about our experience of supporting our NHS partners and how we might be able to help you. 

Virtual wards: tech matters, but so do people

Emily Wells CNIO NNUHEmily Wells is the first Chief Nursing Information Officer to be appointed by Norfolk and Norwich University Hospitals NHS Foundation Trust and was the Digital Health CNIO of the Year in 2021. Here, she outlines her thoughts on how to develop a successful virtual ward, drawing on her Trust’s experience of working on new care pathways with HomeLink Healthcare.

NHS England recently issued a letter to give health and care services early sight of its thinking about the coming winter. One of its recommendations is to increase capacity by the equivalent of 7,000 beds, some of which will be on virtual wards.

The letter has renewed debate about the use of virtual wards, and whether they can be safe and effective. Norfolk and Norwich University Hospitals NHS Foundation Trust has considerable experience of setting up and operating this new model of care, during the Covid-19 pandemic and beyond.

Our experience is that they can release valuable bed days: by the end of September, more than 1,530 patients had been through the NNUH virtual ward, releasing more than 11,000 bed days. Just as importantly, they can deliver benefits to patients.

Patients can return home days or even weeks earlier, to recover in the comfort of their own surroundings, sleeping in their own bed, eating their own food, and being in the company of their family, friends and pets.

However, that only applies as long as they also feel safe and cared for. That means virtual wards need good planning and governance. They need to be supported by the right technology. And they may need something that is often overlooked, which is skilled staff to provide at home care. On the Norfolk and Norwich virtual ward, this is provided by HomeLink Healthcare.

Responding to the need for home IV therapy and new services for Covid-19

"There have been other benefits to working with a private provider. It’s not just that we would have struggled to recruit the staff required. HomeLink Healthcare understands the NHS and is committed to partnership working."

Our experience of working with this specialist provider of hospital at home services started in 2018. An audit had shown that there were many patients in hospital on IV therapy, who could have been treated at home if there had been a service available.

I worked closely with HomeLink Healthcare to define a pathway for these patients. We worked on the referral criteria and the governance to make sure the service was safe, and then we tested it and rolled it out in the first months of 2019.

Then, I moved into my current role, and in March 2020, Covid-19 arrived. In the first year of the pandemic, we were looking at how remote monitoring technology could support the Trust.

So, when the national ask came through to set up a virtual ward, we were able to respond at pace; initially to support Covid-19 patients who could be safely treated at home but quickly expanding to incorporate additional pathways.

We loaned patients devices that they could use for daily phone or video calls with staff and provided them with devices to measure temperature, pulse, blood pressure and oxygen saturation levels.

The virtual ward was very well received. Patients said that they found the technology easy to use and valued being in control of their routines. So, as we reset after the pandemic, we continue to expand the concept.

Today, the Virtual Ward looks after many patients who would ordinarily require a hospital bed. We have developed a ‘waiting for treatment’ pathway for patients who would otherwise have to remain in hospital. We can accept oncology and palliative care patients.

In fact, we have around 15 active pathways, and we are still exploring new uses for the concept. For example, we are looking to create a ‘front door’ service for patients who might otherwise be admitted after attending the Emergency Department. We know that if patients are admitted, they can deteriorate, so the idea is to turn them around and get them home again – while making sure that they still get the monitoring and treatment they need.

Successful virtual wards need the right tech – and the right hands-on care

"HomeLink Healthcare also has great reporting tools, so we know what is being delivered and what impact it is having."

In all of these cases, we are looking after patients who would ordinarily require a hospital bed and be inpatients. That means our virtual ward is part of the hospital. Patients are not discharged onto the ward; they remain under the care of a consultant and our virtual ward team.

We use Current Health to monitor the observations collected by the remote monitoring devices. We see the readings on a dashboard and have a ward round and do everything that we would do for them in hospital. And where patients need hands-on care, we use HomeLink Healthcare to provide it.

HomeLink Healthcare delivers IV therapy and a specialist wound care service known as VAC therapy. Its staff can carry out blood tests and observations. The technology gives us visibility of our patients, and if they show a sign of deterioration, we can ask HomeLink Healthcare to visit that patient – which might save us an admission to check on an alert.

Of course, we also work closely with our community provider, Norfolk Community Healthcare NHS Trust and existing services, such as the Aylsham Medical Day Unit, which provides a day-case medication, IV therapy, and other treatment service on-site.

Right at the start of our NNUH at Home development, we co-created an operational manual that was focused on safety. That really matters in our model, because if the consultants who remain responsible for patients are not confident that they will be safely and effectively cared for, they will not refer to it.

HomeLink Healthcare also has great reporting tools, so we know what is being delivered and what impact it is having. That business approach to things is very helpful, because it gives us visibility of where patients are being seen and what care they are receiving.

Supporting the NHS this winter, and working for patients

As we head into the winter, we will continue to develop our virtual ward and work within the Norfolk and Waveney Integrated Care System to join up a larger model of care across the system.

We started behind other health systems in terms of digital maturity, but these new services are performing exceptionally well; something that has been recognised by senior officials from NHS England and representative bodies.

That’s because we were able to focus on the governance, and finding the right model, supported by the right technology, and the right home care.

We know that virtual wards can deliver additional capacity to the NHS, but we also know that they can deliver a great service for patients. Most people would prefer to recover in their own homes, as long as they feel safe and well cared for; and virtual wards can deliver on both.

This article is also published in the following journals:

Building Better Healthcare Virtual Wards

HT World Virtual Wards

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 speak to a member of our team about our services, call us on (020) 3137 5370 or contact us. You can tell us about your situation, and we can tell you more about our experience of supporting our NHS partners and how we might be able to help you. 

Chief Clinical Officer presented at RCNi virtual wards webinar in February

Jane Tobin, Chief Clinical Officer, HomeLink Healthcare

On 1st February Chief Clinical Officer, Jane Tobin, was one of the keynote speakers at the RCNi Virtual Ward webinar.

Jane presented to hundreds of nurses about the nurses role in the set up and delivery of a virtual ward.

The patient need is at the heart of the HomeLink Healthcare virtual ward. Jane discussed the nurses role in the setup of a virtual ward including co-design, development of clinical leadership and governance, pathway design and KPI development. She also talked about how the nurse is at the heart of the delivery of a virtual ward, covering off the different roles in-hospital and within the home. Embedded in the presentation is a video which shows a nurse delivering patient care on the virtual ward.

The session was very well received with lots of questions and interaction from the attendees.

You can watch the full presentation here: Virtual Wards, Lessons Learned

Jane’s presentation starts at 8 minutes 20 seconds.

Get in touch

To speak to a member of our team about our services, call us on (020) 3137 5370 or contact us. You can tell us about your situation, and we can tell you more about our experience of supporting our NHS partners and how we might be able to help you. 

Capacity challenges overcome with rapid response at Norfolk and Norwich University Hospitals during Covid

Covid-19 home testing service improves capacity, accessibility and patient flow.

From October 2020, HomeLink Healthcare have provided additional capacity to Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUHT), preventing cancellations of elective surgery by offering Covid-19 screening at home. HomeLink Healthcare has delivered a new pre-elective Covid screening pathway for housebound patients, helping NHS hospitals and Trusts avoid financial penalties from surgeries being cancelled and further reducing inequalities in access to care. This case study shows how capacity challenges were overcome, whilst accessibility and patient flow were improved, with rapid responsiveness and time-critical precision.

Their advanced scheduling tools ensured that the clinical staff were deployed efficiently. As a result, patients were ready and available for their scheduled surgery.

NHS capacity, accessibility and patient flow challenges overcome

As part of the third phase of the NHS response to Covid-19, there is a requirement to restore and recover NHS services, whilst overcoming increased demands and capacity constraints. The need for patients to be screened for Covid and then self-isolate 72 hours prior to elective hospital admission is critical to ensuring that elective surgery can go ahead as planned.

Challenges with accessibility to Covid testing risks cancelled electives.

NHS Trusts need to accelerate the return of non-Covid health services, which will help address the growing waiting lists for elective procedures. Therefore, it is imperative to overcome any challenges with capacity, accessibility and flow. Housebound patients are unable to get to Covid testing sites which is where HomeLink Healthcare can help.

Additional capacity provided by a trusted partner to prevent cancellations.

Norfolk and Norwich Hospitals NHS Foundation Trust (NNUHT) asked HomeLink Healthcare to provide urgent additional capacity for Covid home testing, to prevent cancellations in elective surgery. Rapid mobilisation enabled quick, accurate and responsive results. HomeLink Healthcare set up a fully functioning home testing service within 6 days, including training the clinical team to Trust standards.

Recognised as ‘the most esteemed accolade of healthcare service excellence in the UK’, HomeLink Healthcare were finalists for an HSJ Award for their partnership work with the NNUHT making them trusted partners with a proven track record.

Benefits of Covid testing pathway to combat NHS winter pressures:

Cursty Pepper, Emergency and Urgent Care Performance and Recovery Operations Director, reported: Having HomeLink to support us is fantastic as it means we have a trusted and experienced team supporting our elective patient pathway – this provides real peace of mind and their willingness to diversify and respond so quickly really has saved us from having to cancel operations so thank you HomeLink for stepping in and stepping up.

Helps prevent cancellation of elective surgeries

Reduces inequalities in access to care

Maximises community capacity available and improves patient flow

Smart logistics and scheduling tools provide real time data and deployment

Fully integrated with existing systems and services

Reduces risk of financial penalties

Enhanced management as patients have confirmation of a 1 hour time slot

Clinical team trained to Trust standards

Overcoming issues of patient flow for the maximum elective activity possible. HomeLink Healthcare added an additional pathway to the core service delivering Covid testing in the community for housebound patients prior to pre-elective surgery.

To manage logistics and increase availability, HomeLink Healthcare called patients in advance and agreed a one-hour window for testing. This resolved the challenges reported by community teams of the patient not being at home on the agreed day.

To maximise responsiveness, HomeLink Healthcare used real-time data and analytics to provide same day reporting back to the Hospital Trust.

Whole system benefits of HomeLink Healthcare Partnership

Smart logistics and specialist support provided the time-critical level of precision and quality required. The availability of tests across the whole CCG area helped reduce inequalities in access to care. By providing Covid testing at home, HomeLink Healthcare prevented surgeries being cancelled at the last minute. This has a financial impact on the Trust avoiding penalties for not meeting targets in elective cases.

This also increased capacity for the NNUHT team to focus on other important work, in the confidence that this service is being efficiently managed.

Due to the disruption caused by the pandemic, some patients may have been waiting longer than usual to access elective services. Being able to plan and maintain scheduled appointments is imperative to patient’s physical and mental health and wellbeing.

Jonny Lim, HomeLink Healthcare Project Manager, concluded: “We want to support the NHS Trusts, hospitals, and patients during this challenging time. This was a great example of how additional capacity, accessibility and patient flow can be deployed quickly, safely and reliably by our clinical team. It was excellent knowing that life-changing procedures could go ahead as planned and seeing the positive benefit this had on the patient’s lives, as well as the teams involved.

HomeLink Healthcare delivers hospital-based patient services at home, making healthcare systems more flexible, efficient and cost-effective. We provide expert face to face nursing and therapeutic care combined with new technologies to improve patient flow.

HomeLink Healthcare has clinical teams available immediately to assist NHS, CCGs, Community teams and private hospitals.

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