Patient satisfaction with a hospital-in-the-home service

At present, the NHS is facing unprecedented demands on its services, with 11.8 million people over 65 years and 4 million people with long-term illnesses living in the UK (Age UK, 2018). Alongside this, emergency department (ED) staff are witnessing the highest ever bed occupancy rates, which underlie their aim to discharge patients back into the community for further management (Royal College of Surgeons, 2018). A King's Fund report highlighted the need for better alignment of primary, community and acute care to reduce avoidable hospital admissions and length of hospital stay (Imison et al, 2012), and this has been re-enforced in the recently published NHS Long Term Plan (NHS England, 2019a). The ‘hospital-in-the-home’ (HitH) model is one solution that allows patients to return home and receive short-term treatment in a familiar environment. Since its inception in 2014 (Lee and Titchener, 2017), many countries have created their own version of HitH services and reported very positive results in terms of various aspects, including efficacy, safety, cost and patient satisfaction (Caplan et al, 1999; Van Donk et al, 2009; Montalto, 2010; Rodriguez-Cerrillo et al, 2012; Varney et al, 2014). Studies have also highlighted the need for strategic planning and coordinated partnerships to ensure the success of HitH services (Brody et al, 2019). One study noted that the use of HitH resulted in a reduction in hospital readmissions from 7% to 3% (Rodriguez-Cerrillo et al, 2012). Another review of HitH services concluded that HitH care was at least equivalent to hospital-based care and offered greater cost savings (Varney et al, 2014). In terms of satisfaction with the HitH service, the literature reports the positive impact of HitH on patient care and notes the overall efficacy of the HitH programme (Caplan et al, 1999; Montalto, 2010; Montalto et al, 2010; Varney et al, 2014). Patient satisfaction is a goal in its own right and, more importantly, it is an important determinant of patient concordance with advice and treatment. Patient views are considered a legitimate, important measure of care quality and an indirect measure of health outcome (Hardy and West, 1994).