NHS Community services help reduce hospital visits by caring for more patients at home

Published on Monday 16 November 2020

With the second national lockdown under way, First Community teams are delivering even more specialist care and support to patients in their homes, to help reduce demand on local hospital services.

Since the pandemic began the District Nursing team  have been supporting increased numbers of patients with complex and end-of-life needs in their own homes, to maximise their health and wellbeing whilst lowering the demand for hospital care. 

Some patients on the teams' caseload have a Peripherally Inserted Catheter (PICC) line to help safely administer chemotherapy and or intravenous medication.

In normal circumstances these patients would usually attend hospital to have the PICC line removed at the end of their treatment, but to ease pressure on hospitals during the pandemic the resilient nursing team are now providing this care to patients in the comfort of their own homes.

Julie Hardy, District Nurse, First Community Health and Care said: “It was so rewarding to see the smiles on patients faces knowing that they could still receive the care they needed by a skilled professional without needing to leave their home.  It’s never been more important for our community nursing teams to adapt quickly and care for as many patients as we can at home.”

Lawrence (pictured) was one of the patients who received care at home and said: “Having the nurses come to you saves a lot of time, it's a lot easier and the nurses have been very good. I am vulnerable to Covid-19 because of the cancer, and being able to have the PICC removed at home has given me peace of mind and an element of control as I'm not coming into contact with lots of people at the hospital. The service is something I'd definitely recommend."

Towards the beginning of lockdown the District Nursing team also cared for a palliative care patient with a diagnosis of leukaemia. The patient, who was being cared for at home by her husband and two children, had daily visits from the team to administer medications through a medication pump. During this period the family home became busy and due to the patient’s vulnerability to Covid-19 her family wanted to avoid having too many visitors.

The team were able to significantly reduce their number of visits by teaching the patient’s husband how to administer the medications using the pump himself. This enabled him to care for his wife at home, with our nurses support available if they needed it, and allowed them to be close as a family during the last days of her life, in line with their wishes.

Since May 2020, First Community have also been supporting patients requiring multi-disciplinary rehabilitation for Long Covid conditions such as musculoskeletal problems, fatigue, shortness of breath, severe pulmonary / respiratory problems, decrease in mobility, and upper limb weakness post COVID-19 infection.

A new team of health care professionals was created to work together to support patients with these needs and help them recover at home.

Other examples of working differently to support people at home include the First Community Podiatry service, operating throughout the pandemic to care for vulnerable patients in the community and keeping them out of hospital. The service ensured vulnerable patients with conditions such as diabetes, vascular disease, patients at risk of lower limb amputations and other neuropathy’s had timely referrals into the service so that the best prognosis was achieved. They also saw more vulnerable patients in their homes to help reduce their risk of catching Covid-19 and held virtual appointments where possible. Patients in casts for broken limbs were moved into removable bespoke casts so they could avoid weekly trips to the hospital.

The Caterham Dene Hospital Minor Injury Unit (MIU) has also remained open seven days a week throughout the pandemic to treat injuries such as deep cuts, eye injuries, broken bones, sprains and strains, minor head injury, minor burns and scalds. The MIU are now offering bookable appointments and encourage people to do this by dialling  111,  although patients do not need to make an appointment to be seen by a specialist nurse or paramedic practitioner. The service helps to reduce the pressure on accident and emergency departments to treat many common minor injuries.

Community services are central to the future of the health and care system and First Community continue to strengthen and co-ordinate services to deliver more care closer to home.


Pictured (left to right): Julie Hardy, District Nurse, First Community Health and Care with Lawrence Munt, Patient