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Inclusion Criteria

  • Participant is willing and able to give informed consent for participation in the study.
  • If the participant lacks capacity to consent they have a relative or friend who is a ‘personal consultee’ or Independent Mental Capacity Advocate who will be invited to advise on whether they believe that participation in the study would be in accordance with the values and interests of the individual.
  • Male or Female, aged >65 years.
  • Patient has been referred to the admission avoidance HAH service with CGA, and would otherwise require hospital admission for an acute medical event. This will include patients presenting with delirium, functional decline, dependence, falls, immobility or a background of dementia presenting with physical disease.
  • In the Investigator's opinion, is able and willing to comply with all trial requirements.
  • Willing to allow his or her General Practitioner and consultant, if appropriate, to be notified of participation in the trial.
  • English speaking

The presence of a carer will not be a requirement for enrolment and will depend on the individual circumstances of the patient; this will be at the discretion of the clinician responsible for the patient, as is current clinical practice in each centre.

Exclusion Criteria

The participant may not enter the study if ANY of the following apply:

  • Patient with acute coronary syndrome, this includes myocardial infarction and unstable angina and is characterised by cardiac chest pain and is associated with ECG changes.  
  • Patients presenting with symptoms which require an acute surgical assessment.
  • Patients presenting with a suspected stroke.
  • Patients who are receiving end of life care as part of a palliative care pathway.
  • Patients who refuse the HAH service.
  • Patients considered by the clinical staff to be too high risk for home based care, for example those who are physiologically unstable, who are at risk to themselves or if the carer reports HAH care would not be acceptable (in keeping with existing clinical practices for HAH).
  • Patients living in a residential setting.