Hospital at home

About this release

This release by Public Health Scotland (PHS) presents the first quarterly management information report on activity across Scotland’s Hospital at Home (H@H) services and related admission‑alternative pathways. It includes data submitted by H@H services operating across NHS boards for the period November 2025 to January 2026, covering both H@H services — where acute hospital‑level care is delivered face to face in the patient’s home — and a wider range of outpatient‑based alternatives designed to prevent an inpatient admission to hospital. Collectively these services are described as H@H+.

The figures summarise the number of patients accepted to and discharged from services, alongside national and board‑level variation. In this early phase of national reporting, the publication focuses primarily on activity-based measures and reflects ongoing development of standardised definitions, data specifications, and submission processes.

Main points

• Activity data from 42 H@H+ services operating across all NHS boards in Scotland were submitted for the period November 2025 to January 2026.
• Almost 7,200 patients were accepted into H@H services during the reporting period.
• The majority of patients (68%) were treated within established Older People's/Acute H@H services where specialist teams deliver acute care at home for older people.

Further information

This work is delivered in response to the Scottish Government’s Operational Improvement Plan (OIP) which sets out Scotland’s commitment to strengthening community-based alternatives to hospital inpatient care and improving flow, with Hospital at Home identified as a key mechanism for delivering care closer to home. The data collection and reporting process is managed by Public Health Scotland (PHS), in partnership with NHS boards and other national organisations.

H@H is an acute clinical service that delivers hospital‑level care face‑to‑face in a patient’s home, a relative’s home, or a nursing home. It provides time‑limited, unscheduled acute care that can act as either an alternative to inpatient admission to hospital or early supported discharge. Care is delivered by specialist physicians and multidisciplinary teams, meeting acute hospital standards and supported by access to diagnostics, therapeutics and observation in the home. This model excludes services that are solely outpatient, chronic disease management, virtual‑only remote monitoring, community nursing, primary home care, or day‑facility treatments.

H@H+ refers to a broader group of related admission‑alternative services that aim to prevent an inpatient admission to hospital. These services provide investigation, treatment and rehabilitation for patients who would otherwise have been admitted, but who can safely receive care through non‑admitted outpatient‑based pathways.

H@H+ includes services such as OPAT (Outpatient Parenteral Antimicrobial Therapy), heart failure clinics, and other specialist outpatient pathways where patients may attend multiple appointments over several months. These services are important in reducing hospital demand but do not always meet the full H@H definition because they do not provide hospital‑level care in the home.

Additional detail — including service definitions, data item descriptions, methodology notes and appendices— is available within the main publication. The report also summarises current limitations in data quality and completeness, including variation in local recording practices, operational models, inclusion criteria and referral pathways, all of which are expected to improve as the national dataset matures and further quality‑assurance work progresses. Comparative interpretation with UK programmes, such as NHS England’s Virtual Ward initiative, should be approached cautiously due to differences in service scope, reporting methods and underlying definitions.

Over time, this publication is expected to evolve as data quality and completeness improve, incorporating information on referral sources, rejected referrals, and length of stay. These measures will offer further insight into service demand, operational pressures, and patient flow.

The next release of this publication will be June 2026.