An innovative scheme where hospital patients with lung disease are treated at home, is effective, saves the NHS £1,140 per case, and has extremely high patient satisfaction ratings according to new research presented at the British Thoracic Society’s Winter Meeting today (Wednesday 6th December 2017).
The researchers believe that if the scheme was more widely adopted across the country it could improve care and has the potential to save the NHS £ millions.
At a national level over 12,000 people were admitted to hospital in England during 2013-14 with bronchiectasis, a long-term lung condition which affects around 1 in 1,000 adults in the UK. Bronchiectasis occurs when the airways of the lungs become abnormally widened, leading to a build-up of excess mucus that can make the lungs more vulnerable to infection.
Experts at Dorset County Hospital identified that most of their local patients admitted needed two weeks intravenous antibiotics to eradicate infection, but many didn’t need to be in hospital to receive this treatment.
An Acute Hospital at Home (AHAH) service had previously been created at the Dorchester Hospital – and so, from January 2016, a team was developed to specifically treat bronchiectasis patients at home, where appropriate.
The research included retrospective analysis of 51 patient records to review clinical outcomes including length of hospital stay, infection rates, culture rates and cost implications.
Findings not only revealed a substantial financial benefit – a saving of £1,140 per patient, per admission – but also significantly improved patient satisfaction. Nearly all patients (98%) said they would recommend the service to family and friends (compared to 83% managed on a hospital inpatient ward), as they could enjoy their own home comforts, and could even continue to work, rather than being in hospital.
The research also showed that:
- inpatient hospital stays reduced from an average 9.1 days to 2.5 days, meaning a reduced risk of possible hospital-acquired infection
- the scheme was just as effective as purely hospital-based treatment when measured by the number of patients being readmitted to hospital in the future
Dr Jennifer Graves, respiratory consultant at Dorset County Hospital, and member of the British Thoracic Society, said:
“Our study has revealed a whole range of benefits of treating this group of lung disease patients in the community. By ensuring consultant-level involvement and careful daily monitoring by a highly skilled NHS team, we have been able to free up much needed hospital beds whilst improving care for our patients.
Bronchiectasis patients are prone to recurrent infections and so have previously faced a number of two week stays in hospital throughout a year, purely to receive intravenous medication. Now we can completely treat them at home, or in extreme cases treat them in hospital for the first 48 hours and then let them continue treatment at home once that’s appropriate.
We believe this far more personal care is forward-thinking for a hospital of our size, and is in line with national guidance. It is saving budgets as well as allowing patients to be more active, which aids recovery by helping to keep the chest clear of phlegm, and to avoid infection from other patients.”
The multi-disciplinary team includes medical consultants, microbiologists, nurses and physiotherapists. In addition to daily home visits by the team administering medication,
a respiratory consultant regularly reviews the digital notes on each patient in a ‘virtual ward round’ and will visit the patient at home as required.
For more information prior to the British Thoracic Society Winter Meeting (that is, before Wednesday 6thDecember 2017), please contact:
Rosie Strachan: t: 020 7831 8778 or 07566 223644
Charlotte Sutton: t: 07958 279240
Ed Gyde t: 020 7831 8778 or 07809 574801
During the British Thoracic Society meeting (from Wednesday 6th to Friday 8th December 2017):
Please contact the BTS news media office on t: 020 7798 4801/ 020 7798 4541 or the mobile numbers above.
Note to Editors:
The British Thoracic Society is the UK’s professional body of respiratory specialists. The Society seeks to improve standards of care for people who have respiratory diseases and to support and develop those who provide that care. A registered charity, it has over 3,400 members including doctors, nurses, respiratory physiotherapists, scientists and other professionals with a respiratory interest. For more information, go to www.brit-thoracic.org.uk
The British Thoracic Society Winter Meeting takes place from Wednesday 6th to Friday 8th December 2017 at the Queen Elizabeth II Conference Centre in Westminster, London.