Rapid response: a multiprofessional approach to hospital at home.

The provision of 'hospital at home' is not new to the 21st century but pressure from the reduction in the number of hospital beds, population growth, an ageing population and subsequent extended time living with long-term conditions means such services are increasingly necessary. However, research by the authors found services that already exist do not operate 24 hours a day or provide a single multiprofessional approach. Gloucestershire's rapid response (RR) service provides specialist, coordinated, comprehensive and supportive assessment and treatment 24 hours a day in the patient's own home. Data were collected over a 5-month period detailing the number of patients admitted to the service and its impact on hospital admission avoidance and patient outcome. The cost savings and reduction in length of hospital stay is considerable (to almost a quarter of the cost and number of bed days of an acute hospital admission). The position of the hospital as the main provider of urgent/acute care is shifting. The RR service demonstrates its position as a provider of an innovative service that breaks down the boundaries between acute, primary and social care.