The Healthcare at Home service for patients with Chronic Obstructive Pulmonary Disease (COPD) is an innovative, clinically effective, high quality service that meets the needs of both the NHS and its patients. Every year over £400 million is spent on hospital and emergency admissions of patients with COPD in England.

The main benefits of the service are:

-Reducing pressure on hospital beds by preventing unnecessary admissions and through early discharge programs, particularly during the winter peak.

-Significant cost savings to the local health economy while increasing patient throughput

-High levels of patient satisfaction

-Demonstrably improved outcomes

Caring for patients with COPD requires a dedicated team of nurses available around the clock, actively case managing each patient. Experience in providing this service on behalf of a number of NHS Trusts has established that on average a nurse will achieve 6 patient contacts each day. Five dedicated nurses can manage a case load of around 40 patients (in their own homes) in this way, potentially saving hundreds of hospital bed days each month.

COPD Case Study

The bulk of the winter problem at Southampton General Hospital was identified as acute respiratory admissions, and in particular, acute exacerbations of COPD. It was found that patients with these exacerbations stayed in hospital for an average of 10 days. The service set up by Healthcare at Home in collaboration with the Trust has saved 2,500 bed days in 12 months and at least £500,000. The project has been independently evaluated by the National Association of Primary Care (NAPC) who stated that as well as reducing admissions and speeding up discharge "it was also associated with improved quality of care, incredibly high patient satisfaction and more comprehensive services."
This initiative has saved the equivalent of 18 acute beds per annum and now operates throughout the whole year. Of the 300 patients who have been through the service since it opened, 80 who would have previously been admitted, went home on the same day, with appropriate care and support in place. The service has received the accolade of being described as the "nirvana" of healthcare - combining cost savings with improving quality of life and services for patients.

Healthcare at Home has extended its COPD "public-private" partnerships with a well established service at Aberdeen Royal Infirmary (which saved 700 bed days in its first winter of operation) and a new service in Portsmouth. A pilot COPD service is also due to commence in East London in early 2003.

Complete details on the development and operation of this service are available on request from Ash Khan, NHS Business Development Manager on 0870 600 1540.