Parkinson’s Home-Based Care
Home-Based Care is an innovative care pathway for People With Parkinson's that transcends ‘standard’ models of routine outpatient care
Provides remote Parkinson's specialist care and self-management support, using digital monitoring tools and targeted clinical intervention when required
Long routine waiting lists, over-burdened NHS resources, and a lack of specialist information for self-management of long-term conditions
Details
Home-Based Care is an innovative and novel pathway for People With Parkinson's that transcends ‘standard’ models of routine outpatient care
Home-Based Care supports patients to manage their symptoms, and the progression of Parkinson’s Disease, while avoiding the traditional pitfalls of routine waiting lists, annual face-to-face appointments (that are often unnecessary), and the inability to have regular contact with a clinician.
In 2019, supported by Health Foundation Innovation and Parkinson’s UK funding, the Home-Based Care model for Parkinson’s disease was introduced at University Hospitals Plymouth (UHP), co-designed by professional and patient service users.
Home-Based Care is a supported self-management pathway that supports people in their self-care, combined with targeted timely review and digitally enabled remote monitoring. This pathway currently supports 250 people in and around the Plymouth areas with Parkinson’s to be well, informed and at home.
The pathway has been successful in managing patients out of the hospital environment and continues to receive positive support and feedback from patients and stakeholders.
The pathway received ‘Highly Commended’ in the prestigious BMJ Awards for Digital Innovation in 2021.
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Parkinson’s disease is the world’s fasting growing Neurological condition, with prevalence increasing by 2.5% per year and projected to reach 172,000 people in the UK by 2030.
Additionally, there is a growing need to meet rising demand for clinical services to support an ageing population.
The NHS Long-Term plan sets out a clear vision for healthcare provision in the UK by 2030, with a particular focus on enabling digital healthcare technology, reducing face-to-face outpatient appointments by up to a third, and to provide the public with more control over their own care and personalised care when they need it.
The Home-Based Care pathway ticks all the above boxes by providing a remote, patient-initiated follow-up (PIFU) service, utilising digital support tools and with the oversight of a supporting specialist team.
Home Based Care provides people with the self-management tools they need to manage Parkinson’s, and regularly monitors disease progression in a tailored way that support each individual patient when they need it.
Evidence
Initial evaluation of the pathway demonstrated it is acceptable, effective, and safe.
The proportion of patients rating the Parkinson’s Disease service as ‘already good’ increased from 25% to 53% between baseline and 6 months on Home-Based Care.
Patients feel more involved in their care, listened to, and treated as an individual, as well as having improved understanding of their Parkinson’s and when to seek help.
Nine patients and ten carers took part in semi-structured interviews which identified themes of autonomy, empowerment and feeling supported. An audit showed better compliance with national care standards than standard outpatient care.
Home-Based Care staff evaluation using the Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) demonstrated overall improvement in wellbeing, with scores improving by a mean of 5.16 points (9.82%), despite the challenges of COVID-19. Staff felt more valued and supported, with more control over their workload and day-to-day work.
The pathway has resulted in a 50% reduction in consultant time required to deliver the same (or better) quality care. The pathway is responsive, with median wait for triggered consultant review being 8 working days.
There is also some evidence to support this model of care impacting the number of non-elective hospital admissions for this patient group.
