Supporting people at high risk of developing hypertension in pregnancy
We are supporting the rollout across all hospital trusts in the West of England of HOME, an evidence-based, remote monitoring pathway designed to enhance care for people at high risk of developing hypertension during pregnancy, empowering them to stay healthy at home.
Initially developed by Great Western Hospitals NHS Foundation Trust in 2017, HOME (previously known as GoFlo) was the successful innovation selected from our Evidence into Practice call in 2024.
The challenge
Hypertension affects around 8% to 10% of all pregnant women and can be associated with complications for both the mother and baby. People at high risk are recommended to have additional surveillance during pregnancy.
In most trusts, pregnant women are screened at their antenatal appointments and if they are identified as high risk are offered weekly face-to-face appointments to monitor this from 24 weeks. This leads to additional time and travel demands on both expectant parents and healthcare professionals.
The current pathway potentially widens health inequalities. For people living in rural areas or reliant on public transport, these increased hospital visits can present significant barriers, while Black and minority ethnic people are disproportionately affected, as they have an increased risk of high blood pressure in pregnancy.
Additionally, the environmental impact of travel and hospital visits contributes to the overall carbon footprint of the NHS.
Adopting the HOME approach
HOME stands for ‘HOme Monitoring for Expectant (and postnatal) parents’. It offers a remote blood pressure monitoring service using a digital system and home-based monitoring equipment. This enables early detection and intervention, while reducing the need for frequent in-person visits.
Following its success at Great Western Hospitals NHS Foundation Trust, Health Innovation West of England is supporting the rollout of this standardised approach across all acute trusts in the West of England during 2025, including:
- Gloucestershire Hospitals NHS Foundation Trust
- North Bristol NHS Trust
- Royal United Hospitals Bath NHS Foundation Trust
- University Hospitals Bristol and Weston NHS Foundation Trust.
Support from Health Innovation West of England will include clinical and project management leadership to ensure a safe implementation within the agreed timescales.
Benefits of the HOME pathway
Based on evidence from the implementation at Great Western Hospitals NHS Foundation Trust, the HOME monitoring pathway has demonstrated significant benefits for patients, staff and the overall system, including:
- Better care for women and their unborn babies: providing care closer to home and optimising hypertension treatment, reducing inpatient stays and hospital admissions.
- Improved experience and empowerment: giving parents greater choice and control over their health.
- Environmental sustainability: reducing the carbon footprint of face-to-face appointments and both staff and service user travel and transport usage. Modelling of data from 2023 shows that every year Great Western’s outpatient service saves 1,248 face-to-face appointments, 312 clinical hours, and 118 acute unit appointments. The reduced travel requirements result in an annual carbon emissions reduction of over 22,000kg CO2e—the equivalent of four premium economy flights from London to Hong Kong.
- Cost and resource savings: a reduction in face-to-face appointments and hospital admissions and stays reduces the financial and resource costs for the Trust.
It is anticipated we will achieve the same outcomes when this is implemented in all trusts in the West of England, as well as supporting the NHS Net Zero ambitions through a reduction in carbon emissions.
Angela Willis, Midwife and Sustainability Clinical Fellow Alumni 2023/24 at Great Western Hospitals NHS Foundation Trust, said:
“We’ve had such positive feedback from women and birthing people and hospital staff in Swindon and Wiltshire, and can’t wait to see so many more people get the opportunity to benefit from this service. It genuinely puts the patient at the very heart of their care, while also reducing the impact on the environment and helping to make our systems more efficient.”
For further information about the HOME project and its planned rollout across the West of England, please contact Eleanor Powell, Senior Project Manager: eleanor.powell@nhs.net.
