Research update: Hospital2Home – a gradual transfer is better
21st July 2016
Most people prefer to die at home. In some circumstances it may be possible to transfer a patient from hospital to home. In one cancer centre at the Royal Marsden NHS Trust a new service called Hospital2Home was set up to facilitate this transfer of care. Researchers from the Cicely Saunders Institute and Royal Marsden NHS Trust interviewed patients and oncologists individually to find out what they thought about the transition from hospital to home.
The research team identified 3 main themes; loss, transition and community care. Patients and clinicians experienced loss from the end of the familiar, safe relationship between the patient and oncologist. Barriers to the transition from hospital-led to community-based care included patient and family acceptance, attachment to the acute-care setting, and concerns about community services. Transition was more accepted if initiated in a gradual manner. Participants found the Hospital2Home service crucial in establishing new trustworthy relationships between community providers and the patient.
Researchers concluded that complex notions of loss are triggered by transfer of care from the acute sector to the community. A gradual transfer of care may improve this if the patient’s condition allows. Introductions to the community team should be timely, and a staggered transfer should be planned. This improves the experience of the patient, carer and clinician.
Smith C, Bosanquet N, Riley J, Koffman J. Loss, transition and trust: perspectives of terminally ill patients and their oncologists when transferring care from the hospital into the community at the end of life. BMJ Support Palliat Care. 2016. doi: 10.1136/bmjspcare-2015-001075