Staff Views of Hospital at Home: A Qualitative Interview Study of 3 Services in South East Scotland

Background

Hospital at Home (H@H) services exist across the UK to provide acute multidisciplinary care in an individual's own home. Evidence suggests this approach is safe for many older patients, and services are expanding to address expected winter challenges. We explored the views of staff working in these services.

Methods

We conducted 23 semi-structured interviews with multidisciplinary staff working across three H@H services in South East Scotland during March 2022. Questions focussed on service strengths and challenges aiming to identify common themes.

Results

There was high job satisfaction amongst staff working in these services. Three challenge themes were identified - raising awareness for referrals, expanding the service efficiently and staff security on home visits (7/23). Existing activities to raise awareness of H@H services included posters within Emergency Departments, offering taster days for non-H@H staff to understand the service, and daily emails to communicate virtual bed capacity to acute inpatient services. The interviews raised challenges around the efficiency of visits and ideas for non-clinical staff to help with activities such as transporting blood samples and driving (11/23). The potential climate impact was also raised by staff, who suggested investment in electric vehicles. Security of H@H staff conducting home visits was also prioritised, with mixed views on the practicality of personal alarm devices.

Conclusion

The rapid growth of H@H services are the centre-piece of a strategy to address stretched hospital bed capacity. Our study suggests staff enthusiasm for H@H while raising important challenges to address during service expansion.