Full. So what needs to change . I i have been meeting doctors and nurses rethinking healthcare, picking problems up early. We have picking problems up early. Have essentially done 20 consultations in one here. The more peeple consultations in one here. The more people they consultations in one here. The more people they get a chance to come more people they get a chance to come here, the better. And usin to come here, the better. And using new to come here, the better. fific using new technology to come here, the better. fific using new technology to to come here, the better. Eic using new technology to take the hospital into the home. So can the nhs be fixed . Mat can the nhs be fixed . Not replacing can the nhs be fixed . Not replacing the can the nhs be fixed . Iirrt replacing the hospital, it isnt about the death of a hospital. Isnt about the death of a hospital isnt about the death of a hospital. Hello mrs east . 93yearold hospital. Hello mrs east . 93yearold elizabeth hospital. Hello mrs east . | 93yearold Elizabeth East hospital. Hello mrs east . 93yearold Elizabeth East is 93 year old Elizabeth East is being assessed at the John Radcliffe in oxford. Being assessed at the John Radcliffe in oxford. How are ou radcliffe in oxford. How are you doing . Radcliffe in oxford. How are you doing . Like radcliffe in oxford. How are you doing . Like many radcliffe in oxford. How are i you doing . Like many hospitals across the you doing . Like many hospitals across the country, you doing . Like many hospitals across the country, it you doing . Like many hospitals across the country, it has you doing . Like many hospitals across the country, it has been | across the country, it has been pushed to its limits. Pushed to its limits. Good morning pushed to its limits. Good morning. How pushed to its limits. Good morning. How are pushed to its limits. Good morning. How are you pushed to its limits. Good morning. How are you feeling today . Morning. How are you feeling toda . , today . Elizabeth phil at her care home today . Elizabeth phil at her care home and today . Elizabeth phil at her care home and has today . Elizabeth phil at her care home and has a today . Elizabeth phil at her| care home and has a broken today . Elizabeth phil at her care home and has a broken arm. She has already spent nearly five hours in the Emergency Department. Now she is being assessed on a Special Unit Run by doctorjordan bowen. You had a lona by doctorjordan bowen. You had a long night by doctorjordan bowen. You had a long night. You by doctorjordan bowen. You had a long night. You must by doctorjordan bowen. You had a long night. You must be by doctorjordan bowen. You had a long night. You must be very i a long night. You must be very sleepy~ a long night. You must be very slee. ~. A long night. You must be very slee. ,. , a long night. You must be very slee. ~. ,. , sleepy. When admitted to a hosital sleepy. When admitted to a hospital ward, sleepy. When admitted to a hospital ward, frail, sleepy. When admitted to a hospital ward, frail, older l hospital ward, frail, older patients stay for an average of ten days. Patients stay for an average of ten da s. � ,. , patients stay for an average of tenda s. � ten days. Are you feeling cold, are you . Ten days. Are you feeling cold, are you . Yes ten days. Are you feeling cold, are you . Yes. Alright. Ten days. Are you feeling cold, are you . Yes. Alright. And ten days. Are you feeling cold, are you . Yes. Alright. And it l are you . Yes. Alright. And it isnt a good are you . Yes. Alright. And it isnt a good place are you . Yes. Alright. And it isnt a good place for are you . Yes. Alright. And it isnt a good place for a are you . Iezs alright. And it isnt a good place for a person like elizabeth who is also living with dementia. It is living with dementia. It is t in living with dementia. It is trying to living with dementia. It is trying to Normalise Living with dementia. It is trying to normalise her i trying to normalise her environment. Which we simply cant environment. Which we simply cant do environment. Which we simply cant do in environment. Which we simply cant do in a hospital. I intend cant do in a hospital. I intend to do as much as they can within intend to do as much as they can within her home, familiar environment, in her care home. This environment, in her care home. This Assessment Unit aims to get people who arrive as emergencies home the same day. It is important, and what we try to it is important, and what we try to do it is important, and what we try to do is intercept patients who try to do is intercept patients who would otherwise be arriving in the who would otherwise be arriving in the Emergency Department or being in the Emergency Department or being admitted into the hospital and instead offering an alternative to that, when they an alternative to that, when they still an alternative to that, when they still get the same quality of treatment and yet go home. Here of treatment and yet go home. Here they of treatment and yet go home. Here they have been very successful, seeing an average of 70 patients a day. 95 are treated without needing an overnight stay. They are geared up overnight stay. They are geared up to get test results back quickly. Up to get test results back ruickl. � ,. , up to get test results back ruickl. � ,. Up to get test results back quickly. Elizabeth quickly. Are you ok . Elizabeth has problems quickly. Are you ok . Elizabeth has problems with quickly. Are you ok . Elizabeth has problems with her quickly. Are you ok . Elizabeth has problems with her kidneys| has problems with her kidneys so doctor bowen adjusts her medication. 0nce her arm is treated, she can go back to her care home. Staff there will monitor her. Care home. Staff there will monitor her. , monitor her. The biggest thing is t in monitor her. The biggest thing is trying to monitor her. The biggest thing is trying to explain monitor her. The biggest thing is trying to explain to monitor her. The biggest thing | is trying to explain to someone who is is trying to explain to someone who is Feeling Unwell why it is a for who is Feeling Unwell why it is a for them to be at home, feeling a for them to be at home, Feeling Unwell. By keeping people recovering safely in their people recovering safely in their own home, we think that people their own home, we think that people get better quicker, and return people get better quicker, and return back to the things that they return back to the things that they value sooner than being in hospilah they value sooner than being in hospital. It is a massive change hospital. It is a massive change in thinking. With the Health Service change in thinking. With the Health Service under change in thinking. With the Health Service under such i Health Service under such pressure, most hospitals are doing this. But in oxford they have gone further, by also providing high level Hospital Treatment in peoples homes. The hospital is full at the moment. 110 filled. People are in there moment. 110 filled. People are in there for 22 hours, eight hours in there for 22 hours, eight hours waiting. Could we get you to hours waiting. Could we get you lo go hours waiting. Could we get you to go out . Hours waiting. Could we get you to go out . To go out . Professor dan matheson to go out . Professor dan matheson was to go out . Professor dan matheson was one to go out . Professor dan matheson was one of to go out . Professor dan matheson was one of the to go out . Professor dan matheson was one of the first doctors in the country to provide this kind of home based medical care. We provide this kind of homebased medical care medical care. We can assess ou, medical care. We can assess you. Diagnose medical care. We can assess you, diagnose you, medical care. We can assess you, diagnose you, and medical care. We can assess| you, diagnose you, and treat you, diagnose you, and treat you at home, if that is your choice. We are replacing the hospital, it isnt about the death of a hospital but the rebirth of a hospital. Mega rebirth of a hospital. New technology rebirth of a hospital. New Technology Means rebirth of a hospital. New Technology Means he rebirth of a hospital. New Technology Means he is l rebirth of a hospital. New Technology Means he is able to look after much sicker people in their own homes. Professor lasserson is here to see 91 year old ted, who has heart failure, and has been referred to dan by a specialist. Mr; failure, and has been referred to dan by a specialist. My name is dan and to dan by a specialist. My name is dan and l to dan by a specialist. My name is dan and i am to dan by a specialist. My name is dan and i am a to dan by a specialist. My name is dan and i am a doctor to dan by a specialist. My name is dan and i am a doctor from i is dan and i am a doctorfrom the hospital. Hello. I is dan and i am a doctor from the hospital. Hello. The hospital. Hello. Ifeel rotten the hospital. Hello. Ifeel rotten. You the hospital. Hello. Ifeel rotten. You feel the hospital. Hello. Ifeel rotten. You feel rotten . L the hospital. Hello. Ifeel. Rotten. You feel rotten . Are ou rotten. You feel rotten . Are you getting rotten. You feel rotten . Are you getting any rotten. You feel rotten . Are you getting any pain rotten. You feel rotten . Are you getting any pain in rotten. You feel rotten . Are you getting any pain in your| you getting any pain in your chest . , you getting any pain in your chest . All you getting any pain in your chest . Me. All yourtummy . Last chest . No. All your tummy . Last week, ted chest . No. All your tummy . Last week, ted fell chest . No. All yourtummy . Last week, ted fell and paramedics wanted to taken to hospital, but ted by his wife and daughter, didnt want to go. He was daughter, didnt want to go. He was always able to manage his own medication up until about two weeks ago. Own medication up until about two weeks ago own medication up until about two weeks ago. Hospital at home has liven two weeks ago. Hospital at home has given them two weeks ago. Hospital at home has given them choice. Two weeks ago. Hospital at home has given them choice. It two weeks ago. Hospital at home has given them choice. It means| has given them choice. It means a doctor, nurse, or paramedic, will visit him every day. Can a doctor, nurse, or paramedic, will visit him every day. Will visit him every day. Can i undo this . Will visit him every day. Can i undo this . Because will visit him every day. Can i undo this . Because i will visit him every day. Can i undo this . Because i want i will visit him every day. Can i undo this . Because i want to i undo this . Because i want to listen to your heart and lungs and have a scan of you. Usually blood tests. And have a scan of you. Usually blood tests, heart and have a scan of you. Usually blood tests, heart monitoring, | blood tests, heart monitoring, and an Ultrasound Scan would involve separate hospital gp visits. But dan and his team carry this equipment in his bag. Carry this equipment in his baa. Carry this equipment in his ba. ,. ,. ,. ~ carry this equipment in his bag. That black area is fluid. That is outside bag. That black area is fluid. That is outside the bag. That black area is fluid. That is outside the lung bag. That black area is fluid. That is outside the lung and | bag. That black area is fluid. I that is outside the lung and in the chest cavity. That bright thing is the. The chest cavity. That bright thing is the. The chest cavity. That bright thing is the. Within moments the can thing is the. Within moments they can see thing is the. Within moments they can see because thing is the. Within moments they can see because of thing is the. Within moments they can see because of the i they can see because of the breathlessness. His Heart Pumping properly. Bud breathlessness. His Heart Pumping properly. And this isnt squeezing pumping properly. And this isnt squeezing very pumping properly. And this isnt squeezing very well. Pumping properly. And this isnt squeezing very well at| isnt squeezing very well at all. And that is the problem. By all. And that is the problem. By quickly uploading the images to the hospital system, Professor Lasserson can discuss the results would be hard specialist. The results would be hard specialist. Have you had a chance to specialist. Have you had a chance to look specialist. Have you had a chance to look at specialist. Have you had a chance to look at the specialist. Have you had a chance to look at the images . Yes, im looking at the images. What yes, im looking at the images. What do yes, im looking at the images. What do you think . His yes, im looking at the images. What do you think . What do you think . His lp isnt there. What do you think . His lp isnt there they what do you think . His lp isnt there. They will what do you think . His lp isnt there. They will keep there. They will keep monitoring there. They will keep monitoring ted there. They will keep monitoring ted and l there. They will keep i monitoring ted and give there. They will keep monitoring ted and give them there. They will keep monitoring ted and give them a dose of intravenous drugs. Professor lasserson also fits a catheter to help get rid of excess fluid. Catheter to help get rid of excess fluid. ~ ,. , excess fluid. Our key is to get the extra excess fluid. Our key is to get the extra fluid excess fluid. Our key is to get the extra fluid out excess fluid. Our key is to get the extra fluid out of excess fluid. Our key is to get the extra fluid out of the the extra fluid out of the body. The extra fluid out of the bod. , the extra fluid out of the bod. , body. Ted can do very little for himself. Body. Ted can do very little for himself. So body. Ted can do very little for himself. So with body. Ted can do very little for himself. So with him i body. Ted can do very little for himself. So with him at| for himself. So with him at home rather than in hospital, most of his care is down to his family. His daughter, jill, returned from her home in france to help, two months ago. Her mum, grace, was already struggling. I her mum, grace, was already struggling struggling. I am trying to rotect struggling. I am trying to protect him struggling. I am trying to protect him from struggling. I am trying to protect him from going l struggling. I am trying to i protect him from going into hospital. Im trying my best to do that. But it is a strain. Mum has Mobility Problems and balance mum has Mobility Problems and balance issues. So often all the toileting and washing she cant the toileting and washing she cant do the toileting and washing she cant do. Ted needs two or three cant do. Ted needs two or three care cant do. Ted needs two or three care visits a day. They on waiting three care visits a day. They on waiting list three care visits a day. They on waiting list for three care visits a day. They on waiting list for council i on waiting list for Council Support butjill needs to return home next week. And with no help, she is worried about how her mother will cope. Mum needs support how her mother will cope. Mum needs support. She how her mother will cope. Mum needs support. She cant how her mother will cope. Mum needs support. She cant carry l needs support. She cant carry on what she has been doing. Im on what she has been doing. Im frightened on what she has been doing. Im frightened because if he fell, and he frightened because if he fell, and he heard himself badly, i dont and he heard himself badly, i dont think i was down for anybody. Dont think i was down for anybody dont think i was down for an bod. ,. , anybody. How important is it that they anybody. How important is it that they get anybody. How important is it that they get some anybody. How important is it that they get some help anybody. How important is it l that they get some help soon . Is probably the most important thing in a case like this. I think the de our attempt to get rid of the fluid may not work. But what will make more difference to him is support coming into the home very quickly, and that will help them, as a couple, just focused on being with each other. The hosital on being with each other. The Hospital Team on being with each other. The Hospital Team helped ted remain at home for as long as possible. He got some social care, but his family says it wasnt enough. He died a few weeks later, in a hospice. The Hospital At Home to work more widely, families will need support. About half a Million People are waiting for local Authority Care services in england. Authority Care Services in england england. Our busy as it . Phenomenally england. Our busy as it . Phenomenally busy. England. Our busy as it . Phenomenally busy. Stephen chandler runs 0xford to chancey council. 0xford shed council. Oxford shed council council. Oxford shed council. ~. ,. , council. We are looking at new and innovative council. We are looking at new and innovative arrangements l council. We are looking at new| and innovative arrangements to help people. So we have been doing everything we possibly can and yet i would say to you thatis can and yet i would say to you that is still not enough. In that is still not enough. In england this winter, a total of £700 million extra is been put into tackling Hospital Pressures by the government. It includes moving some patients into care homes. For councils, it is a short term fix that doesnt tackle the deeper problems, including 165,000 unfilled carejobs. Brute problems, including 165,000 unfilled care jobs. Problems, including 165,000 unfilled care jobs. Unfilled care obs. We have to do firstl unfilled care jobs. We have to do firstly address unfilled care jobs. We have to do firstly address the do firstly address th