Housebound diagnostics pilot study in Lambeth

The challenge

In the Borough of Lambeth approximately 2,800 patients were recorded as housebound in 2022. It was expected that up to 48 of these patients per year would need to access community cardiology services with no current service provision (2023).

An agreement was set up between South-East London Integrated Care Board and Xyla to provide this cohort of patients with community cardiology services for a 6-month pilot study.

“Launching this service has been exciting and has revealed its importance in the community. Many patients, especially those with mobility issues or who are bed-bound, found it beneficial as they struggled to attend clinical appointments. Feedback, effective communication, and teamwork have been key to the project’s success.”

Magdalen Tandoh, Community Service Manager

The solution

Our lead cardiographer scheduled dedicated housebound appointments on Mondays or Fridays for the following investigations:

• 12-lead ECG
• Ambulatory ECG
• Ambulatory BP monitoring
• Delivery and demonstration of a home blood pressure monitor
• If necessary, an additional appointment was arranged to collect the monitor.

Before the appointment, the lead cardiographer contacted the patient to complete a pre-booking questionnaire and an environmental risk assessment. Patients would be introduced through referrals that would go to the booking team, who would add them to the housebound waiting list. Waiting lists would then be reviewed by the service manager and lead cardiographer, with patients deemed as ‘urgent’ booked as a priority. Following the completion of the pre-booking questionnaire and environmental risk assessment by the lead cardiographer and patient, the lead cardiographer would carry out the booked appointments at the patients residence.

The cardiographer was tracked via the Life360 software on their workphone, with check in protocols adhered to between the service manager and lead cardiographer. This ensured the patient and staff safety throughout the pilot.

The outcomes

A total of 51 patients were seen between January and July 2024 – in which 100% of ECG results within this cohort were not within the ‘normal’ category. A further 50% of patients who received ambulatory blood pressure monitoring were diagnosed with hypertension. These results are indicative of an invaluable service in identifying ECG and blood pressure abnormalities (or excluding them) in a cohort of patients that may ordinarily be missed.

“My experience with the housebound service was truly enthralling. Helping individuals at home made me grateful for the opportunity. Patients, families, and carers provided positive feedback, as leaving home for cardiology assessments was challenging. Being assessed at home was a significant relief, and patients were very thankful. Despite initial obstacles, effective planning with Magdalen and Nicole ensured the service ran smoothly.”

Elias Ahmed, Lead Cardiographer

Get in touch

To find out how we can support you, please contact:

Nicole Fadden, Head of Clinical Operations (Cardiology)

T +44 (0)207 713 2756

nicole.fadden@xylaservices.com