NHS to provide more care
at home - Under embargo for 00:01 hrs on Thursday 18 February
Measures to shape
NHS services around individual patients were set out today by
Health Secretary Andy Burnham.
More dialysis at home and chemotherapy in the community will mean
patients can benefit from more convenient services that help
produce better outcomes and can be more efficient.
Focussing on providing care at home can also have a significant
impact for social care. A report out today (Thursday 18 Feb) from
the Audit Commission shows that older people who have the
opportunity to be looked after in their own home if they want to
are happier and there are less costs to the taxpayer. There are
already examples of how being innovative can have significant
outcomes and save money – for example, for the cost of just one
month’s care package, a home can be equipped with sensors and
pagers to help a family look after a relative with dementia.
Other measures include providing more services at home for
children and young people who have acute or long-term conditions
or disability or palliative care needs, and giving more people the
option to die at home if they wish to.
Around 7000 patients across England could benefit from home
dialysis – cutting out the need for regular long visits to
hospital and allowing patients to lead more normal lives.
Providing haemodialysis at home means that patients can tailor
their dialysis sessions around their lifestyle, which can lead to
benefits such as:
- better blood pressure control
- less reliance on
medication
-patients being able to lead a more normal life
and spend less time away from their family
- fewer
admissions to hospital
- greater freedom from dietary
restrictions
As well as benefits to patients, the annual costs of home
haemodialysis could be up to 25% less than providing dialysis in a
hospital or renal centre, and can lead to long term savings once
initial set-up costs are recovered.
Health Secretary Andy Burnham said:
"The time has come for the NHS to make a decisive shift
in providing more care out of hospitals and in the
patient's community and home.
"For too long, services have been organised to fit the
convenience of the system. A great NHS will put the convenience of
the patient first, and move services towards them where it is safe
to do so. But care in the home can also achieve better results and
save money.
"So this is the right move at the right time. Evidence
shows that we can now do far more out of hospital and the NHS
needs to move confidently in this direction. Fears about changing
services should not stand in the way of improving care for
patients. Transforming the NHS from good to great will mean
becoming more people-centred and productive at the same time.
“NHS patients have already seen significant improvements in the
care they receive in hospital, with shorter waits and more choice
over how and where they access treatment. But the NHS needs to do
more to plan services around patients – even taking services into
their home. Dialysis at home is a perfect example, which can mean
patients no longer have to worry about long trips to their nearest
hospital three times a week while also enjoying better clinical outcomes.
“We are already seeing Lord Darzi’s vision to put quality at the
heart of care becoming a reality across the country, but we can go
further. By making NHS services truly people-centred and ensuring
that patients have access to high quality, integrated and
efficient community services, the NHS could save up to £2.7bn a
year – meaning a better service for patients, and a more
productive service for taxpayers.”
Jane Macdonald, President of the British Renal Society and Lead
Nurse for Renal Services at Salford Royal Foundation NHS Trust said:
“The need for long term dialysis undertaken either thrice weekly
or in some cases daily has a significant impact on the lives of
dialysis patients, their families and carers. To be offered the
choice, if clinically appropriate, to undertake dialysis at home
is a major factor in eliminating frequent travel, maximises time
spent with family, and plays an important role in remaining in employment.
“Increased access to home haemodialysis could be achieved through
improved commissioning and local implementation policies, so that
those able to can chose to be treated at home supported by their
specialist kidney care teams.”
Fiona Loud, Chair of the Kidney Alliance said:
“The Kidney Alliance is firmly in favour of offering dialysis
patients the best possible options. We believe that everyone whose
kidneys fail should be offered a choice of therapies, including,
where clinically suitable, dialysis treatment at home. Kidney
failure is difficult and challenging for patients, and to be able
to dialyse at convenient times and more frequently can mean a
great improvement in quality of life and future outcomes.
“By allowing patients to manage their own dialysis treatment,
they can not only be more in control of their condition but can
also feel better emotionally and physically.“
The Department of Health has also published a guide for the NHS
on developing chemotherapy services closer to home. Giving cancer
patients the option of having chemotherapy at or closer to home
where clinically appropriate can benefit patient experience and
contribute to better outcomes. This follows the recent
announcement that all cancer patients will have one to one support
within five years.
Children and young people who have acute or long-term conditions,
or disability or palliative care needs, should be able to spend
less time in hospital and receive care at home or the community
instead. Providing services for children and young people at home
can mean fewer unplanned visits and shorter stays in hospital,
reducing distress for children, young people and their families.
As part of this, we want to move to a situation where families
can expect:
- 24/7 access to advice and support from Community Children’s
Nursing Teams;
- a single lead professional for the family,
who can liaise with the various agencies involved in delivering
NHS care;
- the choice to die in their preferred place for
those children nearing the end of their life; and
- an
integrated package of care in a chosen location.
As a next step, the Department of Health will be publishing the
final version of the National Framework for Children and Young
People’s Continuing Care very shortly. This will help with
assessing the continuing healthcare needs of children and young
people, and with considering the bespoke packages of care that
will be required to meet those needs.
The Health Secretary also confirmed plans to review progress on
End of Life Care by 2013, with the intention of setting out
proposals for a right to choose to die at home in the future.
Marie Curie is already piloting a range of models through their
Delivering Choice programme.
Transforming how the NHS treats patients with long-term
conditions by providing more support in people’s homes and local
community settings means that people are able to better manage
their health and avoid unnecessary hospital visits. Improvements
in the management of long-term conditions have already led to
efficiencies and savings of £2.1bn.
Notes to Editors
1. Improving Choice for Kidney Patients: Home Haemodialysis and
Chemotherapy Services in the Community are available on the DH
website:www.dh.gsi.gov.uk 2. Patients can benefit from both
Haemodialysis and Peritoneal Dialysis at home. 3, Haemodialysis is
when reliable access is established to a patients blood
circulation to pass their blood through a machine, removing
impurities, excess fluid, restoring essential salts and returning
purified blood to the patient. 4. Peritoneal Dialysis is when
reliable access is established to the abdominal cavity, the lining
of which (the peritoneum) acts as a natural dialysis membrane,
through which pure fluid can restore essential salts and
impurities removed, by several 'exchanges of
fluid' into and out of the abdominal cavity per day. For
media queries, please call the Department of Health Newsdesk.
Contacts:
Department of Health
Phone: 020 7210 5221
NDS.DH@coi.gsi.gov.uk