I completed acute care at home rotation over two months in early 2025. I was both excited and a bit apprehensive about it. I was looking forward to not only sometime away from the sterile hospital environment (both in terms of the location and emotion), but as I have a curious nature, I was interested in observing what the patient’s lives were like at home. Little did I know how much it would impact my career going forward... 

My medical school education and experience of working in secondary care were based around acute care delivered within the hospital, with rapid access to investigations and specialist input. Through my geriatric training and experience working with the Southern Trust’s Acute Care at Home (ACAH) service, I have come to realise the possibility and considerable value of delivering acute care in the community...

During my GPST2 year, I spent six months with the Hospital at Home (H@H) team at University Hospital Wishaw. Before that, I’d completed posts in General Medicine and Paediatrics, so I was really looking forward to seeing how H@H brings acute medical care into the community, allowing patients to receive hospital-level treatment in the comfort of their own homes...

Between February and August 2025, I had the opportunity to work with the Hospital at Home (H@H) service in NHS Lanarkshire — an experience that was invaluable from an Acute Internal Medicine trainee’s perspective.

Hospital at Home delivers hospital-level care to patients in the comfort of their own homes. Coming from a fast-paced Acute Medical Unit, this rotation offered a completely new perspective on how acute medical care can be delivered — one that prioritises person-centred, community-based care while maintaining clinical rigour and safety. ...

In May and June this year I visited Boston to undertake a face to face visit at Ariadne (a joint venture institute between Harvard School of Public Health and Brigham and Women’s Hospital) and the Massachusetts General Brigham Home Hospital. This allowed me insight into the current clinical and organisational development of the MGB Home Hospital through direct observation of its clinical work and meetings with its leadership group. I also involved myself in the academic work of Ariadne through its Home Hospital (HH) stream. 

It is important for Hospital in the Home clinicians, academics and policy analysts to gain a deeper understanding of the US HH system as a way of interpreting the research work that will soon dominate the HH literature. The following discussion paper draws from the major observations of the Fellowship visit. ...