Specialists in out-of-hospital settings: case studies

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Our report on specialists in out-of-hospital settings is based on detailed research with six case studies working in new ways to deliver care outside hospital. Here you can read about the case studies in more detail, and watch interviews with specialists from each of the services.


Haywood rheumatology centre

Haywood rheumatology centre is based at Haywood Hospital, a community hospital which is part of Staffordshire and Stoke-on-Trent Partnership NHS Trust, an integrated health and social care provider.

The centre has a dedicated inpatient ward with 10 beds, a day-case unit providing treatment and rehabilitation for rheumatology patients, physiotherapy and occupational therapy departments, and x-ray, ultrasound and DEXA scanning facilities to diagnose osteoporosis.

Imperial child health general practice hubs

The Imperial child health general practice hubs comprise groups of two or three general practices within Inner North West London, which work with paediatric consultants from St Mary’s Hospital to provide care to practice populations of approximately 4,000 children.

The hubs have three core components: specialist outreach, open access and patient and public engagement.

Leeds interface geriatrician service

The geriatrics team at Leeds Teaching Hospitals NHS Trust works with Leeds Community Healthcare NHS Trust to provide a number of services beyond their core acute work. These aim to keep patients out of hospital and involve geriatricians working across secondary, primary and community care settings.

The service has four main areas: multidisciplinary team-working in the community, a nurse-led primary care telephone service, geriatrician input in A&E and intermediate care.

Portsmouth and South East Hampshire diabetes service

In Portsmouth and the surrounding area, the care of a group of diabetes patients who were previously managed at Portsmouth Hospitals NHS Trust has shifted to general practice.

The service defined six patient groups, known as the ‘super six’, whose care would continue to be managed in hospital. The ongoing care of all other patients with diabetes was discharged to primary care.

Sunderland dermatology and minor surgery service

The Sunderland dermatology and minor surgery service is an intermediate service that diagnoses and manages patients with a range of skin conditions whose treatment does not require a hospital setting.

Services include general dermatology, rapid access and nurse-led clinics, minor skin surgery, and a telephone advice line.

Whittington respiratory service

The respiratory service, based at Whittington Health NHS Trust, provides acute services and community health services to a population of approximately 460,000 people in Haringey and Islington CCGs.

The service comprises a specialist outpatient respiratory clinic based at Whittington Hospital, a 21-bed acute inpatient ward including a 4-bed high-dependency unit, and the Whittington Integrated Community Respiratory (CORE) team, which supports patients in their homes following discharge from hospital or referral from GPs.