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No place like home: using virtual wards and ‘hospital at home’ services to tackle the pressures on urgent and emergency care

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RCP Cymru Wales has launched a new report calling for investment in ‘hospital at home’ services that provide specialist medical care in the community across Wales.

Lengthy stays in hospitals can increase the risk of hospital-acquired infections, including COVID-19. Keeping older people out of hospital and in their own home has never been more important. Over the next few months, the vision of care closer to home as set out in A healthier Wales must be supported by a significant investment in community resource and staffing, especially in social and intermediate care. These teams can help to reduce hospital admissions, get people home more quickly, and improve the quality of patient care.

This means:

  • better regional collaboration and clinical networking across health boards
  • investment in training more clinicians to work in the community
  • rapid access to the right diagnostics and interventions
  • closer working relationships with therapists, social care and palliative care teams.

Supported by the British Geriatrics Society, this new report comes as the latest RCP membership survey found that almost two-thirds (63%) of respondents in Wales said they had felt overwhelmed at least once while at work in the past 3 weeks. One in six (17%) told us they felt overwhelmed almost every day. This is likely due to high levels of staff absence which is still putting immense strain on exhausted and demoralised staff who are working under the extreme pressure of rising COVID-19 cases coupled with usual winter illnesses. With so many people off work, over half of respondents (52%) in Wales had been asked to cover rota gaps at short notice in the previous 3 weeks, and almost a third (30%) had been asked three times or more, adding yet further stress to their working days.

Dr Olwen Williams, Royal College of Physicians vice president for Wales said:

‘There are some very difficult choices ahead to try and reduce waiting lists and put the NHS back on a sustainable footing. But what is clear is that a lack of workforce across all professions will continue to limit our recovery. Increased investment in the NHS cannot improve patient care if we don’t have the staff to treat patients. This shouldn’t be about doctors taking on more and more patients until people simply burn out.

‘We need to increase the number of medical students and postgraduate trainees to prepare for an ageing population. This year, more than half of advertised consultant posts in Wales were unfilled due to a lack of suitable applicants. These rota gaps meant that an over-stretched NHS came close to breaking during the pandemic.’


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