From Hospital to Home - Why High-Tech Homecare Could Become Essential to the Future of NHS Neighbourhood Healthcare

The Government has made no secret of its ambition to shift care out of hospitals and into local communities. At the heart of the newly launched Neighbourhood Health Framework is a vision for a health service that delivers more personalised, preventative and joined-up care closer to where people live.

But while much of the conversation around neighbourhood healthcare has focused on GP services, pharmacies and community hubs, it has not specified what will happen to patients with the most complex conditions.

A new report commissioned by HealthNet, From Hospital to Home: High-Tech Homecare and the Future of Neighbourhood Healthcare for Complex Patients, argues that a blueprint for neighbourhood care for these patients already exists in the form of High-Tech Homecare Medicines Services.

These services allow patients receiving highly specialised therapies, including biologics, enzyme replacement therapies, immunoglobulin treatments, parenteral nutrition and selected cancer therapies, to receive care safely in their own homes or local clinics instead of hospital wards or outpatient departments.

According to the report, this model of care is no longer simply an alternative to hospital treatment, it is becoming a strategic necessity for an NHS under increasing pressure from an ageing population, rising multimorbidity and growing demand for specialist medicines.

The Missing Piece of Neighbourhood Healthcare

The UK population is ageing rapidly and with age comes increasingly complex healthcare needs. Rising rates of cancer, autoimmune disease and chronic illness are increasing demand for treatments that are expensive, clinically intensive and traditionally delivered within hospital settings. High-Tech Homecare Medicines Services are already helping the NHS manage this challenge.

Every year, approximately 640,000 patients across England receive some form of NHS Homecare Medicines Service. While only a minority fall within the High-Tech category, these patients are often among the most clinically complex and resource-intensive in the healthcare system.

The report argues that these services are already delivering many of the goals set out in the Neighbourhood Health Framework by reducing pressure on hospitals, supporting continuity of care and allowing patients to remain safely at home wherever possible.

Kerry Hinton, CEO of HealthNet, believes the role of High-Tech Homecare in future NHS planning should now be formally recognised.

“High-Tech Homecare has the potential to make an exponential contribution to the Neighbourhood Health Framework, reducing pressure on NHS capacity, shifting care closer to home, and improving quality of life for patients and their families alike,” he said. “The NHS was designed for acute care but managing the growing burden of chronic conditions requires a different model, one where trusted partners deliver complex, High-Tech care in local communities, while the NHS retains full visibility and oversight.

“To realise this potential fully, I believe High-Tech Homecare must be formally embedded within the complex care NHS pathway, with consistent national commissioning standards rather than the fragmented local approaches that currently exist. Variation in commissioning is a barrier to scale and that needs to change.”

More Than Convenience

While reducing pressure on hospitals is an important driver behind the growth of homecare, the report stresses that patient experience must remain central to the conversation. For many patients receiving long-term therapies, travelling repeatedly to hospital appointments can be physically exhausting, disruptive and stressful.

Myles Broughton, who receives enzyme replacement therapy at home for the rare genetic disorder Mucopolysaccharidosis Type 1 Hurler-Scheie, described the difference homecare has made to his life.

“The main thing I like is the fact I don’t have to leave my home for treatment and I don’t have to travel,” he said. “I can just sit on my own sofa and watch TV while I’m having treatment.”

His therapy requires weekly six-hour infusions and specialist nursing support due to allergic reactions linked to the treatment. Previously, hospital visits often involved long waits for transport and physically difficult journeys home. Now, he says, the care feels safer, more personal and more responsive.

The report argues that this continuity of care is one of the major strengths of High-Tech Homecare. Unlike busy hospital environments, homecare allows nurses to spend dedicated one-to-one time with patients, building relationships and identifying problems quickly.

HealthNet’s Nursing Director, Victoria Walsh, says that level of personalised care is increasingly important as more patients live with long-term and complex conditions.

“I am proud to say that our patients really do get a gold standard service with High-Tech Homecare because we are held to a higher account as a homecare provider and we have to abide by strict policy, protocols and contracts. This means we take the time and are not rushed.  If we are paid to spend one hour dedicated to a patient then that is what we do. We don’t have several other patients to see in that hour, that time is solely dedicated to that one patient we are being paid to care for,” she said.

The Challenge of Capacity

Despite the clear benefits, the report warns that challenges remain in the High-Tech Homecare market. Unlike Low-Tech or Mid-Tech Homecare pathways, High-Tech services require specialist nursing teams, advanced governance structures, cold-chain logistics and close integration with hospital specialists. These barriers make it difficult for new providers to enter the market. As a result, some therapy areas are currently dominated by only a small number of providers nationally.

The report argues this lack of competition creates risks for the NHS, including reduced resilience, operational bottlenecks and limited patient choice. If providers experience workforce shortages, supply chain disruption or service failures, there are often few realistic alternatives available to Trusts or patients.

To address this, the report calls for greater provider diversity and investment across the High-Tech Homecare sector. It also recommends the development of a nationally consistent commissioning framework to replace what it describes as fragmented regional arrangements that can lead to variation in service quality and patient access.

A Growing Role for Providers

As demand for High-Tech Homecare grows, providers are beginning to scale their operations to meet future NHS needs. HealthNet confirmed within the report that it is expanding further into the High-Tech market following significant investment in specialist nursing, automation and digital infrastructure.

The company has increased its nursing workforce, expanded specialist oncology expertise and invested in automated hub and spoke dispensing technology designed to improve efficiency and patient safety.

However, the report is careful not to position expansion by individual providers as the sole solution. Instead, it argues that the entire Homecare Medicines sector must work more collaboratively if the NHS is to successfully deliver neighbourhood healthcare at scale. This includes greater co-operation around workforce planning, nursing standards, training and service resilience.

“There are more than enough patients to care for and we should all be working together and collaborating to get the best outcome for the patient and ensure there is patient choice,” said Victoria.

The report also calls for homecare nursing to be recognised as a specialist profession in its own right, with transferable competency frameworks and stronger integration with NHS workforce planning.

Moving High-Tech Homecare Into the Mainstream

The central argument running throughout the report is that High-Tech Homecare can no longer be treated as a niche or supplementary service, instead, it should be viewed as essential infrastructure for the future NHS. If neighbourhood healthcare is to succeed, the report argues, it must work not only for lower-acuity patients but also for those with the most complex and resource-intensive conditions. That will require the NHS to think differently about where complex care is delivered and who delivers it.

It concludes that High-Tech Homecare already provides a working model for how advanced care can safely move beyond hospital walls while maintaining high standards of clinical oversight and patient safety.  The challenge now is whether the wider healthcare system is prepared to scale and standardise that model quickly enough to meet rising demand.

Link to Full Report