New home-based intervention could reduce emergency hospital admissions for older people

The results from the clinical trial, published in The Lancet Healthy Longevity and funded by the National Institute for Health and Care Research (NIHR), evaluated the effect and cost-effectiveness of a new service, consisting of six personalised home-based visits from a support worker, tailored to each person to identify what they need to stay well and independent.

Interventions could include home exercise programmes, nutritional support to improve energy levels, improving mental wellbeing and increasing social connections.

The researchers tested the service with 388 people, who were over the age of 65 and assessed as having "mild frailty," across three areas of the UK (London, Hertfordshire and Yorkshire). Of these participants, 195 people were randomly allocated to receive the service, while 193 received their usual care, with no additional support.

Frailty is when someone is less able to recover after a health problem. It is common in people over 65 and increases disability, hospitalisations and care needs.

Participants in the trial were followed up for one year.

The researchers found that people who received the service had a 35% reduction in unplanned hospital admissions, leading to an average saving of £586 per person to the NHS over the year of the study.

Lead author, Professor Kate Walters (UCL Epidemiology & Health Care) said: "We developed the new service in partnership with experts, older people and carers, with the hope of helping people with mild frailty to maintain their independence and stay healthy for longer.

"We found that by providing personalised home-based support to those in need, we can significantly reduce emergency hospital admissions and potentially free up hospital resources. Our study demonstrates the impact of tailored interventions on maintaining independence and improving overall well-being."

The researchers found that there were additional benefits to the service, including small improvements in wellbeing, psychological distress and frailty score.

However, the new service didn't improve levels of independence in self-care.

The new research supports Health Secretary Wes Streeting's pledges to cut pressure on hospitals and place more emphasis on community and preventative care.

NIHR Health Technology Assessment (HTA) Programme Director, Andrew Farmer, said: "The HomeHealth intervention can help older adults with mild frailty stay independent, improving quality of life and overall well-being, while reducing hospital and care costs.

"By addressing key factors like strength, nutrition, and social engagement, it can reduce deterioration and the need for intensive support.

"High quality research such as this is an important part of improving future health and care practice."

With the right funding and support, the researchers hope the service could be available to patients across the country within two years.

Professor Walters added: "By investing in preventative measures, the health service may be able to reap benefits of savings elsewhere in the system."

The research was carried out in collaboration with Age UK, who helped deliver the service as part of the trial.