Two out of three hospital patients are over 65

Since last year NHS nurses have been visiting the homes of patients, identifying and treating any problems before they need to go to hospital.

The Evercare programme has been modelled on a scheme used in the US.

At a cost of �5m, it has been run across nine primary care trusts (PCT) monitoring 1,200 people.

The trusts involved are Airedale, Bexley, Bristol North, Bristol South and West, Halton, South Gloucestershire, Walsall and Wandsworth.

NHS pilots

According to the government the scheme has enabled the elderly and vulnerable to stay at home and benefit from care in the community, which Health Minister John Hutton said was preferable.

"Giving nurses increased responsibility has shown that they can deliver a proactive approach to treating older patients, identifying care needs before hospital treatment is required," he said.

There will be real benefits felt by the patients, supported and treated at home when previously they would have gone into hospital Ian Winstanley, Luton Primary Care Trust

Mr Hutton also said early indications have shown that at a cost of �400,000 for each PCT, the specially trained nurses who monitor "at risk" patients, were a "modest expenditure for great benefit".

But he added it was too early to say whether hospital visits had been cut as a result.

New ways of reducing the risk of hospital admissions for the elderly had to be looked at.

United Healthcare, who developed the project, has said that US hospital admissions for the elderly have been cut by 50%.

Patient care

A Department of Health of report had said that many elderly and vulnerable people were part of an "invisible" population.

They had slipped through the net before being admitted to hospital and were given no care or support after they were discharged.

Just one in four were being seen by district nurses and one in three were registered with social services.

The pilots are expected to run until August, but ministers have already indicated that the schemes could be rolled out across the NHS.

'Reducing demands'

Ian Winstanley, director of patient services at Luton Primary Care Trust, said elderly people living in the area have seen improvements.

More than a thousand people have had home visits under the scheme

"By translating the lessons we have learnt from the Evercare programme we will manage our elderly frail population far better than we ever have before.

"Not only will our nurses gain new skills and a fresh personal interest, there will also be real benefits felt by the patients and their families who will be supported and treated at home when previously they would have gone into hospital," he said.

Jonathan Ellis, social care policy manager with the charity Help the Aged, has said that with two-thirds of patients over the age of 65 and hospital admission a traumatic and difficult experience, the pilots were "a welcome move".

"Preventing the often avoidable decline into ill health and dependency must be a priority. However, preventing avoidable admission to hospital is just one part of the equation.