Chris Hornung, managing director of the public sector at TotalMobile, discusses how at-home care must become a central pillar of health policy to ease pressure on the NHS.
When the government announced its long-awaited 10-year health plan this month, the headline focused on GPS, waiting times and labor investment. On paper, the ambition was welcomed. Shifting care from hospitals, treating people faster and moving more services into the community. However, there is one service area that feels still overlooked for those working in the system. Take care at home.
If you want to take real pressure from acute services, you can’t treat home care as an add-on. It should be a central part of how you manage your health.
You need to be at the forefront of why you need to take care of yourself at home
For decades, the NHS has been locked in a reactive model, and once a crisis hits the challenge of treating the disease. However, attention at home reverses that logic. That’s about managing faster conditions. Prevents deterioration. Keep people well enough to avoid needing hospital beds at all.
There is technology to do this well. People can track their blood pressure, oxygen levels, and mobility from home and be warned if something is not right. But this is not about replacing people with machines. It is to create faster and better conditions of care without the need for hospitalization. The NHS is good for planning for the future, but talks about a “close to home” model, but it’s not enough to default home-based care.
Fundraising conversation gaps
What the plan clearly doesn’t address is how this shift will be funded. Yes, we’re talking more about community health. However, in the UK, much of that work is entrusted by local governments rather than by the NHS.
At this point, there are few indications that local governments will get the additional support they need to do this job. Most adult social care is provided by locally commissioned private providers. If you are serious about your care at home, you will need to fund your local government to properly outsource and monitor that care.
Otherwise, we risk creating pipelines from hospitals that people can’t go to. For example, this year, 13,000 beds per day have been occupied by medically suited patients for discharge, slowing down patient flow and bottlenecks are running.
What will it look like by 2035?
A powerful home care model is more than just a device. It is about designing flexible, responsive, and person-centered systems.
Today, many people receive a permanent “package of care” that remains unchanged, even when there is a need. It’s not the fault of the caregivers, but now the system is in place, but it’s not how health works in real life. People have good weeks and bad weeks. They recover, recur, and improve again.
What we should aim for is a real-time care plan. We are working with several local governments to create a system in which caregivers can record someone’s daily condition: how they manage their diet, hygiene and mobility and tailor support accordingly.
If someone is doing well, reduce visits. If they catch a cold or show signs of decline, increase support early before you need a hospital trip. These small, real-time changes can make a huge difference. They are better for patients and are much lower than emergency care.
This approach is also supported by recent clinical trials published in the Lancet, where flexible home care packages result in a 35% reduction in unscheduled hospital visits, leading to an average saving of £586 per person over the year of the study.
The role of technology
Ultimately, technology needs to support the people who provide care rather than complicate their work.
Take continuity. I know it’s important for people to see the same caregiver whenever possible. But that’s not always realistic. Staff have holidays and sick days. The key is that the intervention understands who is visiting.
For example, I recently piloted a tool that condenses a six-month care record into a short, clear summary. Caregivers can read it in two minutes and already know what has changed, what is expected, and how best to help. It gives caregivers confidence, gives peace of mind to those in care and gives flexibility to services.
It’s a small feature, but it shows that thoughtful technology can be done. Removes friction and improves care.
I need to change it now
You should stop splitting your funding split into NHS and local government pots. It does not reflect how people live. People who are recovering from surgery at home don’t care who is funding their physics and diet. They just need it to work together so they can get the support they need.
We should treat health funds as a pot in one country. Decide what you want to spend on hospital, community care, and at home care and assign accordingly. Now, money is flowing through parts of the system, while other parts are still short. It’s not sustainable.
The vision for the NHS 10-Year Plan is correct. But without a real investment in care at home, we are asking hospitals to be too much, too late.
You have the chance to shift the system before it breaks. This means providing people with the support they need and using where they live and technology to make their care smarter, faster and more human.
If we take care of ourselves properly at home, everything else will start to work better.
About the author
Chris is driving change in the sector, enabling public sector organisations to improve the quality and volume of services. Chris brings more than 15 years of experience in the sector and works with some of the UK’s largest NHS social and health care providers, as well as private health and social care organizations.
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