Community alternatives to acute hospital (CAtCH) assessment services: Design principles and implementation challenges

Area of Science:

• Geriatric Medicine
• Health Services Research
• Public Health Policy

Background:

• Global focus on hospital avoidance for older adults with urgent healthcare needs.
• UK identifies five crisis response service models: Same Day Emergency Care (SDEC), Hospital at Home (HaH), Urgent Community Response (UCR), Acute Frailty Units (AFU), and Virtual Wards (VW).

Purpose of the Study:

• Evaluate the implementation of Community Alternatives to Acute Hospital (CAtCH) assessment services in the UK.
• Develop key design principles for global policymakers in acute community care for older adults.

Main Methods:

• Critical review and narrative synthesis of published literature (2016-2021).
• Systematic searches of OVID Medline, Embase, CINAHL, Google Scholar, and NHS websites.
• Analysis using an evaluation framework based on BGS 2021 report categories.

Main Results:

• Overview of current CAtCH provision and supporting evidence.
• Key implementation principles: timely patient access, rapid assessment and intervention, and public input.
• Identified challenges: rapid scale-up, regional variation, service heterogeneity, and low public awareness.

Conclusions:

• Design principles aim to support policymakers and service providers in commissioning, implementing, and evaluating CAtCH services.
• Highlights significant implementation challenges requiring attention for successful CAtCH service delivery.