Information summary - out of hours

All Hospital at Home (H@H) services in Scotland operate in a unique way, while following the key elements laid out in the Guiding Principles document.  

For a better understanding of what this means for the different services, we have pulled together the relevant information about out of hours (OOH). The data are taken from the information sheets that were provided by the services, originally in October 2022.  

The information in this document was accurate at the time of publication but as services evolve, the information will change. This document will be reviewed and updated annually.  

Do you/did you collect data on the impact of H@H on OOH?

Aberdeen City

• OOH would inform H@H regarding any visit undertaken. 
• The information is emailed. 
  

Dundee City

Anecdotal evidence based on discussion with OOHs service is that H@H has had very limited impact on their service. Data is needed to support this.  

Glasgow City

• Notified by OOH of any H@H patient activity. 
• Worked closely with OOH team. 
  
  

Fife

H@H don’t collect specific data on this, anecdotally it has never been cited as a concern, possibly as the team works seven days 08:00-22:00 delivering the service so there is only the overnight that’s not covered.   

Few patients get involved with OOH. The H@H team update ADASTRA so that OOH have the relevant information if needed, and they know the patient is being cared for by the H@H service. 

Forth Valley

We did not collect specific data but linked with OOH. There have been no issues reported.  

Moray and Lothian

No

Perth and Kinross

H@H is in pilot stage so impact has been minimal. Data collection tool is being developed to use in the future.

Western Isles

No, but anecdotally approximately five patients have had to use the OOH service since the service’s inception in 2020. 

How do you engage OOH services?
 

Aberdeen City 

• Email referrals, and 
• Telephone. 
   

Dundee City 

Direct discussion with the Lead GP, and ongoing meetings with OOHs services. 

 
Glasgow City 

• Established OOH pathway and as part of review. 
• Regular discussion with OOH team. 
   

Fife 

Did not involve OOH services at the beginning, but then did lots of engagement with them. Worked with one H@H team initially to do PDSAs and set criteria, agreed that ADASTRA would be used to communicate patient information. 

 
Forth Valley 

As previously mentioned we did not collect specific data but linked with OOH. There have been no issues reported.  
 

Perth and Kinross 

GP Specialist, member of H@H team, engaged with OOH services prior to commencing the pilot and pathways were agreed. SBAR is sent to OOH each day to make them aware of patients on H@H caseload. 

 
Lothian 

Via the Lothian H@H Oversight Group which is a conduit between all services.   

 
Western Isles 

The team do not really engage with the OOH service. 

What arrangements are in place for the hours that the H@H service is not staffed?

Aberdeen City 

Geriatric medics cover.

Dundee City 

OOHs are made aware of the patients on the caseload. Patients and carers are advised to call OOHs or 999 if there is deterioration out of hours. Nursing services via the team are available until 20:00 weekdays and at weekends (but not 24 hours)

Glasgow City 

An escalation process is in place for anticipated or unanticipated issues including links to on call Department medicine for the elderly (DME) support within acute. 

Fife 

After 22:00 patients contact OOH if needed. 
 

Forth Valley  

Patients get an information leaflet with contact information, including for times out with service operating hours. 

Moray  

Joint care model with primary care, so existing primary care arrangements (GMEDS) for people at home. 

Lanarkshire

Patients call OOH service after 6pm, very little impact on OOH Service, no feedback from them. 

Perth and Kinross 

Patients are advised to contact NHS 24 or dial 999 in emergency. 
 

Lothian 

Midlothian and Edinburgh both work 08:00-20:00, West Lothian from 08:00-18:00 and East Lothian 07:00-20:00, all seven days a week. Out with these times we ask patient to contact 111 or 999 if appropriate. Patients and referrers may also leave a message on our answerphone.  

Western Isles

• There is a H@H nurse during the day with a mobile number for patients to use. 
• The same mobile is held by the overnight nurses, the mobile number is staffed 24 hours a day.