Key points

  • An evaluation of hospital use among 526 residents aged 65 or over living in 15 vanguard nursing or residential care homes in Wakefield between February 2016 and March 2017, compared with a local matched control group.
  • The enhanced support they received had three main strands: voluntary sector engagement, a multidisciplinary team and enhanced primary care support.
  • Estimations show that vanguard residents experienced 27% fewer potentially avoidable admissions than the matched control group – the effect was stronger among those who had been resident in a care home for three months or longer.
  • But there was no conclusive evidence that overall emergency admissions or A&E attendances differed between the vanguard residents and those in the matched control group.

In this briefing, the Improvement Analytics Unit – a partnership between the Health Foundation and NHS England – identifies some early signals of changes in hospital use by vanguard care home residents in Wakefield, in order to inform local learning and improvement.

Read the full list of key points.

While researchers did not see a significant difference in overall hospital admissions or A&E attendances, there was a promising observation – there were fewer potentially avoidable emergency admissions among residents receiving enhanced support. This reflects the multidisciplinary teams’ (MDTs) targeted care for residents needing additional support, and training of care home staff on key issues such as falls and pressure sore prevention.

Complex interventions need time to take effect – and this briefing also indicates that the enhanced support initiative possibly did not have an impact on overall hospital use, or that an effect could not be detected, due to the short study period.

It also highlights the importance of good quality data for evaluation – and how further analysis would benefit from access to additional linked data sets, in combination with qualitative research to better understand how MDTs, GP enhanced support and other elements interact with the local context.

You can read more detail about the results and the methods used in the accompanying technical appendix and statistical analysis plan (SAP)

Further reading

Briefing

Emergency admissions to hospital from care homes: how often and what for?

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Improvement Analytics Unit

An innovative partnership between NHS England and the Health Foundation providing robust evaluation of complex changes

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