February 9, 2010

UK: NHS told push on home care could save £1bn

. LONDON, England / Financial Times / February 9, 2010 By Nicholas Timmins, Public Policy Editor The National Health Service could potentially save more than £1bn a year and improve the quality of care by treating more people outside hospital and in their own homes, according to a study. Delivering sophisticated care - such as chemotherapy for cancer - at home, providing more intensive support for people with long-term conditions, and supplying intensive short-term support packages when people are discharged, also produce higher patient satisfaction, less risk of infection, fewer emergency admissions and good clinical care, says the study by Dr Foster Intelligence, the healthcare data analyst part-owned by the NHS. The work has been commissioned by Healthcare at Home, a company that provides a range of such services, including chemotherapy. However, it draws on existing schemes in Southampton and Birmingham. The reduced costs the hospitals and primary care trusts have identified have been scaled up, using data from a Birmingham primary care trust that is a leader in providing hospital services at home. The findings cover four areas: chemotherapy; action to reduce unnecessary hospital admissions; end-of-life care; and earlier discharge but with active support after hip surgery. They follow publication of a report by the CBI claiming that delivering more services at home and in the community could save £15bn by 2015 by cutting unnecessary admissions. Hospital admissions have been rising sharply: up 12 per cent during the past five years to about 8m a year. At least one in eight of such admissions, however, is for long-term conditions that could be handled outside hospital, says the study on hospital care at home. The NHS has many pilot schemes aimed at providing more care outside hospital. However, the Audit Commission recently concluded that nationally "there was no shift from hospitals to care closer to home in the community, either in terms of investment or activity". Sir William Wells, a former regional chairman of the NHS and of the old Department of Health's commercial advisory board, said the report "demonstrates that savings from unnecessary hospital activity are achievable - it is up to NHS managers to capture them". To achieve them, however, such programmes needed to be run at scale, so the money and staffing deployed in hospitals could be reduced to release the savings. Given the pressures to come on NHS spending, the service needed to adopt such programmes "boldly and now," he said. [rc] Copyright The Financial Times Limited 2010