The future of community nursing: Hospital in the Home

Br J Community Nurs. 2017 Apr 2;22(4):174-180. doi: 10.12968/bjcn.2017.22.4.174.


With an increasing ageing population who often have multiple long-term conditions, there is a growing need to provide an alternative type of care to the traditional hospital-based model. 'Hospital in the Home' is a model that provides integrated care for patients in their home. The @home service was established in 2013 by Guy's and St Thomas' NHS Foundation Trust. The service provides health care in patients' home, supporting early discharge from hospital as well as preventing avoidable admissions and readmissions saving valuable hospital bed days and reducing length of stay. This article describes the service available with the use of a case study of a 78-year-old lady who was referred by the London Ambulance Service with exacerbation of chronic obstructive pulmonary disease (COPD). This case study highlights the ability to assess, treat and manage an acutely unwell patient with newly diagnosed heart failure in the community without the need for hospitalisation. This type of integrated care model with a multidisciplinary team is a feasible alternative to the traditional models of care in both the acute and community settings.

Keywords: acute care; community; hospital in the home; integrated care.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Bronchodilator Agents / therapeutic use
  • Clergy
  • Community Health Nursing / methods
  • Delivery of Health Care, Integrated*
  • Disease Progression
  • Diuretics / therapeutic use
  • Echocardiography
  • Female
  • Furosemide / therapeutic use
  • Heart Failure / complications
  • Heart Failure / diagnostic imaging
  • Heart Failure / nursing*
  • Home Health Nursing / methods*
  • Humans
  • Nursing Assessment
  • Occupational Therapy / methods
  • Pharmacy Service, Hospital / methods
  • Pneumonia / complications
  • Pneumonia / diagnostic imaging
  • Pneumonia / nursing*
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / nursing*
  • Radiography, Thoracic
  • State Medicine
  • United Kingdom


  • Anti-Bacterial Agents
  • Bronchodilator Agents
  • Diuretics
  • Furosemide