title: Does the National Health Service want hospital-at-home?
abstract: There has been increasing interest in the development of hospital-at-home within the National Health Service (NHS) as a way of shifting resources from secondary to primary care. We describe the development of hospital-at-home schemes in London and draw on data from an evaluation of five such schemes to discuss support for hospital-at-home within the NHS. The study has identified a small but important group of patients who do not want hospital-at-home, as well as resistance to it from some health care professionals and managers, particularly in hospitals. These organizational issues must be taken into account in any evaluation of hospital-at-home, along with issues of quality, outcome and cost. Feasibility studies are needed to identify possible organizational barriers to hospital-at-home and the development work that is required. This service innovation should not be considered in isolation from other services, but rather within the context of a wider debate about the pattern of acute care.
authors.affiliation: Department of Public Policy, London School of Hygiene & Tropical Medicine, England.
authors.forename: N J
authors.initials: NJ
authors.lastname: Fulop
authors.forename: S
authors.initials: S
authors.lastname: Hood
authors.forename: S
authors.initials: S
authors.lastname: Parsons
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration*; D006801:Humans; D008131:London; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom