Information summary - workforce and staffing

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 workforce and staffing in their services. 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.  

How does your service manage hospital specialist oversight? 

Aberdeen City

The H@H service sits within the frailty pathway so consultant hours are pulled from the main geriatric pool. There is one permanent consultant who is clinically responsible for patients. During Out of Hours (OOH) the geriatric ward and general medicine (GMed) service take responsibility. 

Dundee City

There is consultant cover for each Locality Team, covering two GP clusters. Patients that meet acuity criteria for geriatrician care are under the responsibility of consultants while those who do not, come under the care of their GP. 

Glasgow City

A daily MDT meeting is held and patients are escalated to a consultant as required.

Fife

The consultant is part of the acute team but works with each H@H team for two half day sessions each week. The consultant provides advice and support and is on call during H@H service hours.

Forth Valley

There is a consultant with the team every Monday to Friday.

Moray

The team meets regularly, including twice daily meetings. They use a joint care model with GPs and people in the community. 

Lanarkshire

A daily consultant ward round with consultants seeing every new patient. Consultants will visit other patients as and when required. The consultants are also involved in the team meetings and discussions relating to change, pathways and new documentation. 
 

Perth and Kinross

The service currently has consultant oversight agreed for two sessions per week. 

Lothian

Midlothian 
Consultants cover the service from Monday to Friday. They attend ward rounds twice a week and are available for escalation and discussion about referrals if required.  

Edinburgh  
The service operates a consultant of the day model to support the team. There are consultant led ward rounds twice a week. 

West Lothian 
The team hold a daily consultant led MDT discussion four days per week. A consultant geriatrician is available for advice and escalation from Monday to Friday. A consultant physician is available for OOHs.  

East Lothian 
There is consultant presence at morning hand-overs four times per week and an in-depth ward round once per week. Consultants see patients as required and are available for escalation and advice when required.  

Are all team members in the H@H team or do you draw support from other teams?

Aberdeen City 

• Rotational physiotherapist (PT) from community rehabilitation team. 
• Community nurses come on a three month secondment basis to upskill and increase knowledge of the service.  
• Scottish Ambulance Service (SAS) – currently have a Memorandum of Understanding (MoU). 

 
Dundee City 

The team members are as below. The team is made up of members who are available to support care of patients who fall under geriatrician care. It is anticipated, however, that the majority of patients will remain under the medical responsibility of their GP.  
  
Currently we draw on support from other teams as below:  

• Physiotherapy - involved in weekly MDT   
• Occupational therapy (OT) - involved in weekly MDT   
• Speech and language therapy, and  
• Social care  

Pharmacist attends once weekly for a ward round and are contactable for additional support.  

Fife

The AHPs are part of NHS Fife’s Integrated Community Assessment and Support Services (ICASS). The Hospital at Home teams ask for support from AHPs when required. 

 
Glasgow City 

• Yes, but we have been unable to recruit a physiotherapist. We have therefore changed this to a nursing post but are looking to review staffing in general. There are wider workforce challenges around physiotherapists, as well as other posts.   
• Have had to adapt staffing due to what is available.  
• Links with GP, district nurse (DN) and the Community Rehab Team as necessary. 
   

Forth Valley 

• All staff were employed to support the H@H team.  
• Professional speech and language therapist (S&LT) and dietician also have other remits but are based in the team.  

 
Moray  

We aim to integrate more with the Discharge to Assess Team (D2A) to engage with Allied Health professionals (AHPs). We also link with the Community Therapy Team and Front Door Therapy Team, and are looking to link with Community Response Team.  

We are looking to do matrix working.  

 
Lanarkshire 

We have staff within the team (Band 6 NP) who have an Allied Health Professional (AHP) background but we do not currently have any dedicated AHPs. If required, our team members may carry out assessments and give advice and we would refer on to community teams for onward support and rehab.  

 
Perth and Kinross 

• Clinical leadership and support is drawn from other teams, an example being the Advanced Nurse Practitioners (ANP) provide mentorship and support to our Nurse Practitioners.  
• Professional support is also provided to the AHPs out with the team within the partnership.