To ask the Minister of Health to detail any assessment that has been made of the potential to use capacity in the Acute Care at Home service to improve hospital throughput and alleviate pressure on Emergency Departments.

In March 2022, my Department published the Review of Urgent and Emergency Care. Following the recommendations of the review, a regional group was established under the auspices of the Chief Nursing Officer to examine the current challenges regarding Hospital at Home services, particularly how to ensure consistency of approach and outcomes of a high performing model. This group concluded its work in mid-2024 and identified a number of recommendations and priorities for further work.

A Working Group has been established, led by HSC Trusts with support from the Strategic Planning and Performance Group (SPPG) and the Public Health Agency (PHA).

The Working Group will take forward the review’s recommendations to reduce variation in referral criteria and maximise capacity of Hospital at Home Services across Northern Ireland.

To alleviate pressure, Hospital at Home take referrals from Emergency Departments (ED), however, the priority is to prevent patients needing to attend EDs in the first place and so Hospital at Home referrals are prioritised for GPs and NIAS, then ED and then inpatient units.

Focusing Hospital at Home efforts at the pre-hospital pathway is expected to make the most impact on patient experience and the best use of limited resources. Where patients self-present to EDs and they are suitable for Hospital at Home, then referrals can be made to the service.

In regard to age, the priority patient group for Hospital at Home services in Northern Ireland is for older adults with frailty syndromes, significant learning disabilities or chronic neurological conditions, whose acute medical needs can be met in their home environment.

Referral criteria are based on need and benefit from the service, rather than age restrictions or health conditions. However, currently the majority of patients who use the service are over the age of 75 years.

Concerning awareness, GPs, NIAS, community services and hospitals are aware of the Hospital at Home service and are able to refer patients. Currently the vast majority of referrals are made by primary care. It is important that service users receive the form of care that meets their needs and HSC Trusts will discuss a range of care options with individual patients.

Discussions are underway with the Northern HSC Trust to establish a Hospital at Home service. Relevant stakeholders, including primary care, NIAS and Care Homes will be involved in this work to ensure that there is full awareness of the service and how it can benefit patients.

Concerning budgets, while an analysis of costs and benefits formed part of the review work, no assessment has been made to date of the impact on budgets of aligning age and other criteria across all Trusts.