We want to hear your views
Survey coming soon
Our vision is to reshape the care we provide for people in need of rehabilitation or urgent care and make hospital admission less likely.
This means we will be able to:
- provide urgent, hospital-level care at home, as an alternative to hospital admission
- identify people at risk of hospital admission and support them to remain well at home for longer
- help people who are recovering from illness or injury to return home faster, safely
- reduce the demand on emergency departments and acute hospitals, resulting in less ‘corridor care’
- empower patients to take a more active role in their health and rehabilitation.
Why are we talking about this now?
The population of Kent is changing. We need to evolve and adapt our services so we can meet people’s needs both now and in the long term.
- there are 1.8 million people living in Kent at the moment, but this number is expected to rise by a quarter by 2031
- the number of people living with multiple and complex health conditions will rise by around 16 per cent by 2027
- the number of people living with frailty* will increase by around 16 per cent by 2027.
- Demand for frailty services and complex conditions is expected to increase by 30 per cent by 2030.
Apart from the changing population, we have identified several additional behind the need to transform services. They are:
- Research suggests people recover faster and retain their independence if they can be treated at home.
- The majority of people don’t want to go to hospital and would rather be treated at home.
- We know around a third of people currently in hospital do not need acute treatment and could be discharged, if the right support is available.
- We are now able to deliver many more hospital-level treatments in people’s homes than we could ten, or even five years ago.
More urgent treatment for people at home
During the Covid-19 pandemic, we enhanced and improved NHS home treatment in Kent, as a way of keeping people out of hospital, at that time to reduce risk of infection.
Community teams found that people recovered more quickly at home, were happier and less at risk of infection. They were also less likely to decondition further and they regained their independence faster.
We began to expand the types of treatment people could receive at home and we now provide a full urgent response for frail elderly patients who don't want to be taken to hospital, if we can provide an alternative.
You can find out more by watching some of our films.
Find out more about the range of treatments we can offer at home to people who need urgent care:
Beating the ambulance queues
We also started working more closely with partners in the acute sector and with the ambulance trust, helping to avoid hospital admission in the first place by ‘turning around’ frail elderly people in ambulance queues and treating them at home, where appropriate.
Patient choice is considered at all times, if the patient wishes to be treated in hospital they will be transferred.
Read the news:
Better at Home: How our Urgent Community Services transformed Paul’s recovery
Homeward bound
Case study: Wendy, 89, has a hidden condition which causes low sodium levels. When she collapsed at home her daughter called 999, but instead of taking her to hospital, the paramedic team were advised by a remote team of clinicians to leave her at home, where someone would quickly pick up her care. The urgent community response team visited Wendy at home and were able to stabilise her without hospital admission.
We have also introduced a ‘Home First’ service, which supports people in acute settings to go home faster and safely.
Home First: Helping people get home from hospital sooner
Home First helps people at home with personal care, medication and signposting to community services, which could support them to live independently for longer.
Case study: Lesley, 76, had some complications following a knee replacement operation. She no longer needed acute care but had not regained her independence. Instead of being transferred to a community hospital, Lesley was able to return straight home after, with support from Home First.
Support workers came to visit Lesley twice a day to help her with personal care, mealtimes and medications, with a focus on supporting her, to support herself. After 14 days Lesley was discharged from the service and is as independent as she had been before the operation.
Let’s get you home
What’s wrong with staying in a hospital bed?
Many people are staying too long in a hospital bed, losing muscle and strength, when they would recover better at home.
Staying too long in a bed also means people often need more complex support when they do get home, or they need to move into a nursing home, when they might have been able to continue living independently.
Patients receive different care and outcomes depending where they are, which is unfair.
The average length of stay in a community bed varies from hospital to hospital, the shortest is 23 days and the longest is 36 days. For our Home First service, the average time someone needs care for is 21.8 days.
People need time to rest and recover while they are in hospital, or when they are recovering at home following injury or illness.
But staying in bed or sitting still all day for longer than they need to will not help them to recover in the long run. In fact:
- Independently-living frail patients who are admitted to hospital are less likely to recover their mobility and more likely to need to move to a nursing home after discharge.
- Just one week in hospital can lead to 10 per cent less muscle strength, 25 per cent reduced circulation and a decline in dignity, confidence and independence.
- For patients over 80, 10 days of bed rest can lead to 10 years of muscle ageing.
- Deconditioning in hospital leads to delayed discharge in nearly half of older patients
- Half of frail older patients will have cognitive decline between admission and discharge
- Half of older people can become incontinent within 48 hours of admission.
- Even in community hospitals, patients are much more likely to become ‘institutionalised’ and are more susceptible to falls and hospital infections.
What about the hospital buildings?
- Our Kent community hospitals are a mix of pre and post-war sites, with half of our buildings pre-dating the birth of the NHS in 1948.
- Some of our buildings are in poor condition, with outdated layouts which can hamper our ability to deliver effective rehabilitation, for example, gyms are a long way from wards, there is a lack of space around beds and there is not enough communal or outdoor space
- Some are also a poor environment for patients to recover and for staff to work in, for example, they are too hot in the summer and too cold in the winter. They are also not suitable for caring for people with dementia or cognitive impairment
- The projected cost of bringing all our community hospitals up to modern standards is £12 million.
- We’d prefer to invest this money into evidence-driven home-based care.