Chief Investigator: Dr Natalie Cox, NIHR Academic Clinical Lecturer Geriatric Medicine, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton

Team: Dr Stephen Lim, Principal Clinical Research Fellow, Academic Geriatric Medicine, Faculty of Medicine, University of Southampton & Honorary Consultant Geriatrician University Hospital Southampton NHS FT

Dr Sara McKelvie, NIHR Clinical Lecturer Primary Care Research, Primary Care Research Centre, Faculty of Medicine, University of Southampton

Dr Carole Fogg, Senior Research Fellow, School of Health Sciences, University of Southampton

Start: 1 October 2024

End: 31 March 2026

Partners: Hampshire and Isle of Wight NHS Healthcare Foundation Trust, Isle of Wight NHS Trust, Portsmouth Hospitals University NHS Trust, University Hospital Southampton NHS Foundation Trust, University of Southampton

Background

In Southern England, there are more older people than in many other parts of the country. Many of them live with several health conditions that can suddenly get worse. When this happens, they often need quick help from healthcare professionals.

Whenever possible, it’s better for people to get this care at home rather than going to hospital. This matches the government’s plan to move more healthcare from hospital to the community.

To support this, urgent care services have been set up across Hampshire and the Isle of Wight. These services aim to treat older people at home when they become unwell. But even with these services in place, many older people still go to hospital emergency departments. Some are sent home within 24 hours, which suggests they might have been safely treated at home instead.

That’s why it’s important to understand how these urgent care services are working. Although they are close to each other, they are all set up differently.

This research will look at the teams and networks of healthcare staff who help older people avoid hospital stays. We will interview people who work in these services and those who receive care from them. We’ll also study data from two local emergency departments to learn more about why some older people go to hospital and are sent home.

By doing this, we hope to better understand how older people move through the urgent care system, and what helps or gets in the way of good care. We’ll also look at whether things like where someone lives, or whether they have a certain problem, affect their chances of going to hospital when it might not be needed.

Our findings will help the NHS organisations design better urgent care services, so more older people can be safely cared for at home rather than in hospital.

What have we found out?

The analysis of the data is ongoing for CAtCH NET:

We have data for UHS emergency department and have a cohort of 25,000 patients representing over 40,000 attendances.

We are currently analyzing the data to understand the characteristics of these patients and factors related to discharge within 24 hours.

We have completed interviews with staff who work within community urgent care services for older people, those who refer to them and those working closely with the emergency departments.

Three main themes encompass the experiences of the participants:

  Complexity in urgent care service provision

  Complexity of work to avoid hospital admission

  Complexity of navigating an array of services and personnel

What will we do with this new knowledge?

We plan to create a report for the ICB and trust stakeholders.

We will be working with HIW to conduct stakeholder meetings to discuss out findings and how they may inform ongoing service re-structuring.

We have been conducting patient advisory groups meetings and have mapped their experiences to the findings of the qualitative data to aid in stakeholder discussions.

We have also highlighted the study to a recent parliamentary call: 10.5258/SOTON/PP0162 10.5258/SOTON/PP0162