Information summary - diagnostics and transport

All Hospital at Home (H@H) services in Scotland operate in a unique way, while following the key elements laid out in the Guiding Principles document.  

For a better understanding of what this means for the different services, we have pulled together the relevant information about diagnostics. The data are taken from the information sheets that were provided by the services, originally in October 2022.  

The information in this document was accurate at the time of publication but as services evolve, the information will change. This document will be reviewed and updated annually.  

 

What point of care testing do you use in your service?

Aberdeen City

• ECG 
• Bloods, and 
• Bladder scanning 
  

Dundee City

Blood test are analysed within 1-2 hours due to an agreement by the Lead Biochemist with the lab. Point of Care (PoC) would not be justified at the moment as our bloods are prioritised by the labs and in line with inpatient status. This is supported by the Clinical Lead Biochemist.  

PoC used: 

• ECG 
• Bladder scan 
• Blood pressure 
• Saturation probes 
• Urinalysis, and 
• Blood glucose meters 
  
  

Glasgow City

• Bladder scan 
• Oxygen stats – awaiting iStat machine for more detailed information 
• ECG, and 
• Normal observations, for example pulse and blood pressure.
  
  

Fife

• Access to X-Rays, the patient needs to attend hospital for an X-Ray to be carried out.  
• ECGs 
• Bladder scan 
• Blood glucose monitoring, and  
• INRs
  
  

Forth Valley

• Blood glucose 
• ECG 
• Blood pressure 
• Oxygen saturation, and 
• Pulse 

Moray

• ECG 
• Blood pressure 
• Bladder scan 
• Saturation levels, and 
• Temperature

Lanarkshire

• We are in the process of procuring POC analysers – Roche Cobas B101 (CRP) & Abbot iStat Allinity (Sodium, Potassium, Chloride, TCO2, Anion Gap, Ionized Calcium, Glucose, Urea Nitrogen, Creatinine, Haematocrit, Haemoglobin) 
• ECG monitor 
• Bladder scanning 
• Pulse oximeter 
• Blood pressure monitor, and 
• Thermometer 
  
  

Perth and Kinross

• Basic point of caring testing is utilised such as urine dips and blood glucose testing 
• Observations included in the holistic care assessments – blood pressure, pulse, O2Sa, respiratory rate, Temperature, weight and breath and heart sounds 
• Access to ultrasound and ECG 
• Functional testing, and 
• Blood tests and mid-stream urine samples are sent away for analysis
   

Lothian

iSTAT but limited use. 

Western Isles

• Pulse oximeter/BP/oxygen/temperature (kit provided to every patient in the service) 
• Capillary blood glucose (BM)/international normalised ration (INR) as Point of Care Testing, and 
• ECG
  
  

How do you manage patient transport for diagnostics or to access other services?
 

Aberdeen City 

Through ambulance service or family (if suitable and safe to do so). 

 
Dundee City 

We can use patient transport line dedicated for clinicians and have priority when stated that it is a H@H patient. 

 
Glasgow City 

• We have an internal transport system for samples, a board-wide service that is supporting H@H 
• Scottish Ambulance Service (SAS) pathway and agreement for imaging 

 
Fife 

If needed the team can organise transport.

 
Forth Valley 

We have to use the patient transport line which is the same channel as everyone else. This can be problematic as it takes a long time to get through. It would be helpful to have a local agreement or priority. It can take hours to get through. 

Generally we don’t transport patients from home to other services. If we need to get someone from home to hospital would phone either SAS or patient transport. 

 
Moray  

Either hospital transport which may include an ambulance or relatives, dependent on their level of function and stability. 

 
Lanarkshire 

Firstly, ask if there is family who can take the patient. If that is not an option we arrange patient transport by SAS Patient Transport Service. 

 
Perth and Kinross 

• SAS, and  
• Royal Voluntary Service 

 
Lothian 

Midlothian 

Local transport to Midlothian Community Hospital (MCH) encouraged by relatives. Can be done via NHS taxi if required. Transport to Royal Infirmary of Edinburgh (RIE) as above or by SAS Patient transport.  

West Lothian 

Relatives if possible, patient transport if not. 

East Lothian 

NHS Lothian Patient Transport to East Lothian Community Hospital (ELCH) if the patient is unable to make the journey independently (for example due to challenges around mobility). Encouraged to ask family or friends or taxi if possible and if deemed appropriate.

 
Western Isles 

Use existing patient transport system. 

 

How does your team manage travel within the city/in rural areas?

Aberdeen City 

• The service operates in Aberdeen City. 
• Arranged in three clusters: North, Centre and South.  
• Will be using the new acuity tool to look at miles and time taken for travelling. 
  
  

Dundee City 

All staff use their own transport. 

Glasgow City 

• Increasing geography means this is more of a challenge. 
• There is a potential for local bases to be used to mitigate travel requirements. 
• Mixture of staff using own and lease cars. 
• We don’t have pool cars. 
• Equipment is distributed throughout city, this impacts on travel time as we need to collect equipment from other areas. Aiming to increase the availability of equipment to reduce this impact. 

Fife 

• Generally using own cars, pool cars are hard to get hold of.  
• Geography is included when measuring capacity, using a RAG status.
   

Forth Valley  

We have three electric pool cars and have submitted an SBAR to the board to request funding for more. It is financially more viable to have additional cars rather than paying mileage. We are moving to an electric fleet of pool cars to reduce costs and our carbon footprint. A couple of staff members have lease cars. 

We have an agreement for two more pool cars and a van. Dates keep getting pushed back for this as getting parts is a problem.  

Moray  

Currently staff use their own transport. We have regular catch-ups to keep track of logistics. 

Lanarkshire

All staff travel in their own vehicles, either privately owned or leased. We try to minimise unnecessary journeys as much as possible. 

Perth and Kinross 

• Personal vehicles with community parking permits. Urban area only (Perth City). 
• Recent access to pool cars for longer journeys supporting rural locations.  
   

Lothian 

Midlothian 

Our service has two cars and one small van for staff use. An additional four electric vehicles are on order for the team.  

Edinburgh  

• One small electric van seven days a week 
• Three electric vehicles seven days a week 
• One LUCS Doctor’s car Monday to Friday 
• One electric vehicle (used by Day Hospital) available to H@H Saturday and Sunday 
• Three electric vehicles on order, and 

• Staff will use own cars on occasion. 

West Lothian 

Staff use own vehicles. 

East Lothian 

We have full time use of two pool cars, and a third until 16:30. Access to LUCS Doctor’s car Wednesday to Friday 07:00-20:00 and every evening Monday to Friday. Some staff have lease cars which they use in addition to the service’s pool cars.

Western Isles

• The service now has one dedicated H@H vehicle but had been paying for a hire car until recently. 
• Staff use their own vehicles and claim back mileage. 

 

Do you have any agreements with other services for transporting patients? 

Aberdeen City 

No 

Dundee City 

No service specific agreements but there is a local service which can transport patients at a relatively low cost, as well as SAS patient transport services. 

Glasgow City 

Potential for use of third sector provider, there is a contract with the British Red Cross. 
 

Fife 

No agreement, patient transport requested via SAS if required. 

Forth Valley 

No, this would be useful. 

Moray  

No 

Lanarkshire 

No 

Perth and Kinross 

• Informally with Royal Voluntary Service, and 
• Normal booking process used if requiring SAS. 
  
  

Lothian 

No