Taking a patient approach to improving healthcare

Our nursing academics are helping to reduce hospital admissions and visits to A&E.

Project summary

The Challenge

Tackling the increase in hospital admission waiting lists, particularly for the frail and elderly.

The Approach

University of Hull nursing academics evaluated pioneering new approaches, informing new ways of working.

The Outcome

Our service evaluation led to a reduction in the number of hospital admissions, fewer A&E visits, and a better overall standard of care.

Lead academics

Funded by

Project partners

The Challenge

The NHS is facing more challenges than ever before. Hospitals are inundated and patients are facing increased waiting times. An ageing population living with more long-term health conditions is increasing the pressure on hospital departments.

In the UK, there are nearly 3 million people who can be described as frail – about 4% of the population – and research suggests they require about 40% of all hospital beds and GP resources (Leston et al., 2022).

The Approach

An interdisciplinary team of academics at the University of Hull have reviewed a series of services in our region and evaluated pioneering new approaches which are already informing new ways of working.

The University Service Evaluation Unit evaluated a number of services over a period of three years:

Our evaluation [shows] how unnecessary attendances to the emergency departments and hospital admissions for individuals with frailty can be avoided. We were able to document a series of benefits, including the cost savings that resulted from 878 hospital admissions being avoided during the period.”

Sally-Ann Spencer Grey

Nursing Lecturer

COVID Support Unit Specialist Advice and Guidance Telephone Line: Reviewing the service provided by the COVID Support Unit specialist advice and guidance telephone line during the height of the COVID-19 pandemic between 23rd March and 10th July 2020. Contact with the telephone line resulted in 330 unnecessary hospital admissions being avoided suggesting improved quality of care experience for individuals, enabling more individuals to be cared for in their preferred place of care.

Holderness Integrated Care Centre (HICC) Virtual Frailty Model Pilot: This evaluation showed that the care centre model proved to be effective, efficient, personalised, timely and safe and was acceptable to patients and staff. Patients enjoyed and were highly satisfied with their experience. They felt safe, said it was thorough, they were able to talk about what mattered to them, they felt valued, and appreciated the time and attention given to them. They appreciated not having to travel and attend a hospital-based clinic appointment. Staff also felt it was a valuable service that gave great benefit to patients.

Combined Acute – Community Trust Antibiotic Service:  A review of a Hull University Teaching Hospitals NHS Trust (HUTH) and City Health Care Partnership CIC (CHCP) initiative named OPAT - Outpatient parenteral antimicrobial therapy.  This initiative involves the administration of intravenous antimicrobial therapy on at least two separate days without an intervening hospitalisation. OPAT costs at least 50% less than equivalent inpatient care realising significant financial savings. It avoids hospital admissions, reduces hospital bed days, has patient outcomes commensurate with inpatient care and patient safety equal to or improved (less hospital acquired infection risk) compared to inpatient care.

Beanbag Care Services Pilot: This evaluation, which began in November 2022 and will report in January 2024, aims to provide evidence in achieving specific outcomes of interest to stakeholder groups, information for decision making about replication, upscaling or closing of the activities piloted. The findings can also be used to inform future policy.

The Impact

The Uni evaluations were highlighted in a BBC Panorama programme ‘The NHS Crisis: Can It Be Fixed?' which aired in February 2023.  The programme showed how pioneering approaches and innovations can reduce the number of patients admitted to hospital, prevent unnecessary attendances to A&E and support those who, if medically appropriate, can receive care in specialised healthcare centres, in their own home or care home.

The new clinical model has been adopted at Hull’s Jean Bishop Centre, where patients come in for a full 'MOT' that looks at every aspect of their life and health to see where things can be changed to help them live happily and independently. It could also potentially be replicated in other parts of the country.

The team are now building on this evaluation by again working with the CHCP Frailty Team at the Jean Bishop Centre, evaluating wearable biometric technology for frail patients in a virtual ward as an alternative to admission to hospital. This is funded by the update: 2024 -

The team are now building on this evaluation by again working with the CHCP Frailty Team at the Jean Bishop Centre evaluating wearable biometric technology for frail patients in a virtual ward as an alternative to admission to hospital. This is funded by NHS Humber and North Yorkshire Integrated Care Board.

To see the findings of our evaluations represented in the programme which shone a light on the pioneering healthcare developments in Hull was a highlight for us as experience and expertise in clinical practice, academic roles and in health care commissioning and leadership … it is extremely rewarding for us to see how it is helping to advance healthcare in our region and beyond.”

Jacquie White

Head of School (Nursing and Midwifery), Professor of Nursing