Avoiding hospital admission is often a priority for frail older people, and is a focus of health policy as many countries consider investing in out of hospital services such as hospital at home to reduce reliance on hospitals. Encouraged by the rapid set-up of out-of-hospital services during the COVID-19 pandemic, there is a renewed emphasis on providing safe and high quality ‘hospital at home’ that offers an alternative to a hospital admission. This has the dual purpose of increasing bed capacity and providing patients with the option to remain at home. To address uncertainty about the effectiveness, acceptability and cost effectiveness of admission avoidance hospital at home, we designed and conducted a parallel open multi-site randomised trial of admission avoidance hospital at home compared with admission to hospital. Over 1,000 older people across the UK consented to be part of the study and were randomised to hospital at home or hospital admission. This presentation will report a summary of the trial findings.