Better Care

Glowing tribute to flexible home-based care

Madeleine Holland
"The care provided by rapid response and district nursing was second to none" - Madeleine Holland

With NHS services under severe pressure from growing demand and financial constraints, it is increasingly important that healthcare can be provided rapidly, flexibly and efficiently in people’s homes.

Birmingham Community Healthcare has developed a single system for managing urgent and non-urgent cases that is delivering impressive results – around 200 people each week are receiving urgent care at home as a high quality, personalised alternative to acute hospital admission.

That ‘rapid response’ care delivered in people’s homes is in addition to the 14,000 visits made each week by the Trust’s community and district nurses.

One grateful recipient of this flexible, patient-centred approach is Madeleine Holland, who was cared for by the rapid response and district nursing teams as she recovered from a triple heart bypass operation.

“In January, I was very suddenly admitted to hospital for surgery, which had originally been wrongly diagnosed and treated as a water infection,” said the 71-year-old retired civil servant.

“The operation was successful but, when I was discharged, I was extremely sore – I had 38 stitches in my leg, 28 in my chest and 14 below my bust. I looked like a patchwork quilt!

“I couldn’t get up the stairs at my home in Walsall so I had to go and live in my daughter’s flat in the centre of Birmingham. As I was out of my own GP practice area, I called a locum doctor, and that was when the rapid response team got involved.

“The care provided by rapid response and my district nurse were second-to-none. Talk about going the ‘extra mile’ – they went down the motorway and back! My care was managed with efficiency and sensitivity and I had complete confidence that my rapid response nurse would leave no stone unturned to provide thorough care.”

Madeleine explained that when she had to be quickly admitted to Birmingham City Hospital just a week into her recovery, the rapid response team was on hand to make sure she arrived armed with sufficient medical history that she could get the attention she needed as quickly as possible.

“I just wasn’t coping well with recovering so needed to go back in to hospital for a short period,” she explained. “It was very impressive and very reassuring to see that flexibility in practice – caring for me at home when possible but no messing about when I actually did need to be in hospital.”

“It was all so efficient but provided with great care. Dressing my wounds was a painful experience but my district nurse made this as quick and dignified a process as possible.  Her combination of intelligence, experience and a wonderfully caring approach is rare and I am genuinely thrilled at how good my experience of NHS community care has been.

“The initiative she took and the knowledge, care and confidence she demonstrated in caring for me were quite exceptional. There is a lot of great healthcare being delivered by dedicated, caring NHS professionals in the community which often goes unrecognised – my experience is a shining example of this.”


  • Health and care professionals can make urgent and non-urgent referrals to Birmingham Community Healthcare's single point of access for adult services, incorporating a citywide inpatient bed bureau, by calling 0300 555 1919.