Jess Garrigan, Physiotherapist - Hospital at Home Team, NHS Lanarkshire - 3 September 2026

I have been working in the Hospital at Home team in Lanarkshire for over 11 years, both as a Physiotherapist and more recently as an Advanced Practitioner.

As an Advanced Practitioner, my primary role is to complete a comprehensive medical assessment, formulate a diagnosis and implement a treatment plan, always taking into consideration the wishes of the patient and their family. I can prescribe medication and perform venepuncture when required, as well as ECGs and bladder scans, which helps to make visits more efficient.

Seeing patients in their own homes is a privilege and so informative - you get to know someone much better in their own environment as well as see the exact challenges they face. It's also much easier to find out what is important to them and their families. There is no doubt that assessing people in their own homes is infinitely more comfortable and convenient for them and for most people, enabling them to remain at home for treatment is the best option. However, it does take some getting used to if you are more familiar working in a clinical environment. I remember feeling daunted when faced with keeping a very unwell patient at home for the first time, but it has become the norm for me now.

Underneath my additional skills, I am always aware of my Physiotherapy perspective and that how I 'see' a patient and their environment differs from the perspective of my colleagues. I work alongside Doctors, Advanced Nurse Practitioners, Staff Nurses, Pharmacists and Assistant Practitioners who all have a multitude of experience and essential skills and who bring their own unique viewpoint to each patient. When we bring our different perspectives together as an MDT alongside those of the patient, it allows us to provide truly holistic care.

My assessment starts as soon as I get out of my car, observing the outdoor environment and any access issues before continuing to the home, noticing as much as possible even before I reach the patient I am there to treat. I think about mobility and independence, as well as falls, furniture, obstacles and hazards, room layout, equipment, other people and animals and of course, stairs.

Our team intervention is often quite short, and combined with the patients being seriously unwell, can limit the rehab opportunities available, but we do implement exercise programmes where possible, supply aids when appropriate and always refer on for further input when I think there is a chance of progression.

I continue to learn so much through this job and understand a huge amount more than I did in my previous Physio-specific roles, such as medication management and renal function. When I was starting my career, it was never my intention to work in the community, and now I can't imagine working anywhere else.