Hospital at Home Programme - virtual capacity: equality impact assessment

Key Findings

The policy allows for greater flexibility for the provision of certain healthcare services for patients of all demographics across Scotland. It is an addition and enhancement to current services and will not replace existing models of care.

The expansion of virtual capacity will see more people receive care in their own homes or in a community setting. This will be particularly beneficial for people living in rural and remote communities who often currently face additional transportation barriers when attending healthcare appointments at hospital sites.

The use of technology within the pathways could create barriers or challenges for some groups particularly older people and disabled people who use technology less. It may also have the potential to exacerbate issues of isolation and loneliness which are more prevalent amongst these groups.

Hospital admissions can pose a particular risk to those who have a disability, are frail or vulnerable. Hospital at Home is likely to be of particular benefit to these groups as a hospital stay is avoided and existing care arrangements can stay in place during the patient’s interaction with the service. Thus these services can promote or maintain an individual’s independence. Additionally, evidence shows that Hospital at Home reduces the chance that an older person will need Nursing Home care for up to a year after treatment, enabling them to live independently for longer.

Unpaid Carers are a group that face difficulty accessing traditional healthcare services therefore the greater flexibility of Hospital at Home will likely be of particular benefit to this group. Nevertheless, consideration must be given on an individual basis as to the suitability of the arrangement and what additional short term support may be required.

There are challenges regarding the requirement of a suitable home environment for some services. The homeless community are particularly likely to face difficulties accessing Hospital at Home services. Reasonable adjustment should always be considered to enable this group to take advantage of the flexibility this service offers wherever possible and inpatient treatment options should remain available to ensure that people who are homeless do not lose access to treatment. Consideration is actively being given to mitigation options, with OPAT services actively engaging with homeless addiction teams and using alternative treatment strategies where required.

Hospital at Home services minimise travel costs to appointments, costs associated with care arrangements and can potentially reduce loss of earnings resulting from protracted engagement with traditional healthcare services. Therefore the services will likely reduce financial barriers which is of distinct benefit to those in low income households.