Most people admitted to general hospitals are over 65 years old. Many stay in hospital for a long time. This is bad for them because they can develop new illnesses and lose their independence. It is also bad for the NHS because it increases costs and reduces the number of available beds.
An important cause of long hospital stays is when the patients’ medical illness is complicated by psychiatric and psychological problems such as dementia, depression or anxiety.
In the HOME trial we will compare two approaches to this problem. We will recruit 3,300 patients who have been admitted to acute medical wards in general hospitals. Half of the patients will receive usual care – their doctors and nurses will look after them as usual and will ask a psychiatrist in the hospital to see them if needed. Half of the patients will receive a new care programme called Proactive Liaison Psychiatry (PLP) – they will have a brief consultation with a psychiatrist or psychiatric nurse who will see if there is anything they can do to help them get home more quickly. Patients will be allocated to one of these two approaches by chance (randomisation) and we will follow them up in one month’s time to find out how much time they have spent in hospital and how they are feeling.
This randomised controlled trial is funded by the National Institute for Health Research’s Health Services and Delivery Research Programme.