Key points

  • This briefing presents the findings of the evaluation into the effects of providing enhanced support for older people living in residential and nursing care homes in the Nottingham City CCG’s area from September 2014 until April 2017.
  • The rate of emergency admissions into hospital for Nottingham City care home residents was estimated to be 18% lower compared with the control group – and 27% lower relating to conditions which are ‘potentially avoidable’.
  • These lower admissions were driven by residents of residential care homes: for example, compared with the control group, they experienced 34% fewer emergency admissions and 39% fewer potentially avoidable emergency admissions.
  • There was no discernible difference in the number of A&E attendances between the care home residents and the control group, although residents had 20% fewer A&E attendances that did not result in admissions.

This report from the Improvement Analytics Unit – a partnership between the Health Foundation and NHS England – looks at whether enhanced support had an effect on hospital utilisation for new care home residents who moved into one of 39 care homes in Nottingham City, compared with a matched control group.

Read the full list of key points.

The analysis presented in this briefing evaluated the impact of Nottingham City CCG’s existing enhanced package of care up to April 2017, when, as part of the New Care Models programme, a Clinical Pharmacy intervention and Telemedicine facility were established on top of the existing enhanced package of care.

Not only did the IAU observe overall lower rates of emergency admissions, but they found a notable difference when comparing residents from nursing care homes with residents from residential care homes. This indicates that the lower rate of hospital activity is driven by residents of residential care homes.

Assuming that the care home residents and the control group were comparable, the most likely explanation for these findings is that they reflect higher quality of care being delivered to residents of care homes in Nottingham City. This briefing therefore indicates that there is potential to reduce emergency admissions to hospital and A&E attendances for care home residents, and reduce pressure on NHS hospitals.

Cite this publication

Brine R, Conti S, Wolters A, 'The impact of providing an enhanced package of care for care home residents in Nottingham City: Findings from the Improvement Analytics Unit'. Health Foundation; 2019

Further reading


Emergency admissions to hospital from care homes: how often and what for?

July 2019

Combined learnings from national linked datasets and focused care home evaluations in Rushcliffe,...


Improvement Analytics Unit


An innovative partnership between NHS England and NHS Improvement and the Health Foundation...

You might also like...


The Shuri Network and Health Foundation virtual lunch and learn


Join our lunch and learn session focused on empowering black, Asian and minority ethnic women in...

Journal article

Evidence use as socio-material practice

Journal article

Identifying three socio-material mechanisms through which evidence and context shape each other in...

Newsletter feature

Exploring the potential of AI to help address health inequalities

Newsletter feature

Brhmie Balaram from NHSX and Adam Steventon from the Health Foundation discuss the new £1.5m...

Kjell-bubble-diagramArtboard 101 copy

Get social

People’s health and the economy cannot be viewed independently. As we rebuild the economy and 'level up' UK regio…

Follow us on Twitter
Kjell-bubble-diagramArtboard 101

Work with us

We look for talented and passionate individuals as everyone at the Health Foundation has an important role to play.

View current vacancies
Artboard 101 copy 2

The Q community

Q is an initiative connecting people with improvement expertise across the UK.

Find out more