Nearly 340,000 older people in England live in residential or nursing care homes. Older people living in care homes often have complex health problems which make them more likely to need hospital care in hospital if their health suddenly deteriorates. People living in care homes account for 185,000 emergency admissions to hospital each year and spend over 1.46 million days in hospital beds. Improving care for older patients living in care homes will directly benefit patients while reducing the demand for hospital beds and reduce the risk of hospital overcrowding.

A significant proportion of hospital admissions from care homes are unnecessary and could be avoided if their needs were addressed differently. The hospital environment and can be distressing for some older people living in care homes and the burden of transferring patients from their home to hospital can be significant. These factors have driven a search for alternative ways of providing better care.

This highly granular dataset of 128,000 admissions from care home provides a unique opportunity to understand reasons, pathways and outcomes from acute presentations to hospital.

PIONEER geography: The West Midlands (WM) has a population of 5.9 million & includes a diverse ethnic & socio-economic mix.

Electronic Heath Record. UHB is one of the largest NHS Trusts in England, providing direct acute services & specialist care across four hospital sites, with 2.2 million patient episodes per year, 2750 beds & an expanded 250 ITU bed capacity during COVID. UHB runs a fully electronic healthcare record (EHR) (PICS; Birmingham Systems), a shared primary & secondary care record (Your Care Connected) & a patient portal “My Health”.

Scope: Acute care episodes amongst patients aged over 65 from care homes. Longitudinal & individually linked, so that the preceding & subsequent health journey can be mapped & healthcare utilisation prior to & after admission understood. The dataset includes highly granular patient demographics, co-morbidities taken from ICD-10 & SNOMED-CT codes. Serial, structured data pertaining to process of care (timings, admissions, wards), presenting complaint, physiology readings (heart rate, BMI, blood pressure, respiratory rate, NEWS2 score, oxygen saturations and clinical frailty scale), Charlson comorbidity index, Lab analysis results(e.g. urea, albumin, platelets, white blood cells) microbiology results, procedures, outpatients admissions, oxygen delivery methods, drug administered and all outcomes. Linked images available (radiographs, CT scans, MRI).

Available supplementary data: Matched controls; ambulance, OMOP data, synthetic data.

Available supplementary support: Analytics, Model build, validation & refinement; A.I.; Data partner support for ETL (extract, transform & load) process, Clinical expertise, Patient & end-user access, Purchaser access, Regulatory requirements, Data-driven trials, “fast screen” services.