The impact of providing an enhanced package of care for care home residents in Nottingham City

Findings from the Improvement Analytics Unit

July 2019

IAU briefing cover Nott city

Key points

  • This briefing presents the findings of the evaluation into the effects of providing enhanced support for older people living in residential and nursing care homes in the Nottingham City CCG’s area from September 2014 until April 2017.
  • The rate of emergency admissions into hospital for Nottingham City care home residents was estimated to be 18% lower compared with the control group – and 27% lower relating to conditions which are ‘potentially avoidable’.
  • These lower admissions were driven by residents of residential care homes: for example, compared with the control group, they experienced 34% fewer emergency admissions and 39% fewer potentially avoidable emergency admissions.
  • There was no discernible difference in the number of A&E attendances between the care home residents and the control group, although residents had 20% fewer A&E attendances that did not result in admissions.

This report from the Improvement Analytics Unit – a partnership between the Health Foundation and NHS England – looks at whether enhanced support had an effect on hospital utilisation for new care home residents who moved into one of 39 care homes in Nottingham City, compared with a matched control group.

Read the full list of key points.

The analysis presented in this briefing evaluated the impact of Nottingham City CCG’s existing enhanced package of care up to April 2017, when, as part of the New Care Models programme, a Clinical Pharmacy intervention and Telemedicine facility were established on top of the existing enhanced package of care.

Not only did the IAU observe overall lower rates of emergency admissions, but they found a notable difference when comparing residents from nursing care homes with residents from residential care homes. This indicates that the lower rate of hospital activity is driven by residents of residential care homes.

Assuming that the care home residents and the control group were comparable, the most likely explanation for these findings is that they reflect higher quality of care being delivered to residents of care homes in Nottingham City. This briefing therefore indicates that there is potential to reduce emergency admissions to hospital and A&E attendances for care home residents, and reduce pressure on NHS hospitals.

Further reading


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

Combined learnings from national linked datasets and focused care home evaluations in Rushcliffe, Sutton, Wakefield and Notti...


Improvement Analytics Unit

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

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