Well, every little bit helps the budget shortfall and the new Health Secretary. A five-year study of care homes run by NHS Calderdale (Yorkshire) Clinical Commissioning Group (CCG), equipped with sensor-based equipment (telehealth and telecare) plus a multidisciplinary nursing team available to support residents, saved on bed days, hospital admissions, and even GP visits to care homes. Admissions relating to falls decreased by 7.7 percent in the past year, resulting in an annual saving of more than £200,000.
The 383,500 UK care home residents with complex long-term conditions represent just 0.7 percent of the population, yet they account for a disproportionate amount of the NHS budget. The Calderdale study saved 7,000 hospital bed days in its first two years alone and GP visits to care homes reduced by 45 percent. 50 percent of care homes reduced falls by least 10 percent.
The Quest for Quality in Care Homes initiative co-sponsored by Tunstall Healthcare extrapolated from the Calderdale results that the NHS could nationally save £1bn, avoid some 226,000 hospital admissions. and release 2.5 million bed days. Digital Health, Tunstall Healthcare study page
Care for elderly and disabled goes off the tracks again.
A report in the Health Service Journal
(subscription required), covered in an opinion piece in the Guardian
, indicates that thousands of patients who are disabled and also those who require long-term care may be forcibly put into care homes (US=nursing homes) rather than being treated and maintained in home care. According to the HSJ, “Freedom of Information (FOI) requests from campaign group Disability United
found that 37 NHS clinical commissioning groups (CCGs) in England were introducing rules about ongoing care that could force up to 13,000 people with health conditions into care homes.” CCGs due to NHS cuts have been setting limits on financing home care, between 10 and 40 percent above the care home option. In other words, where a care home is cheaper, the CCG will withdraw payment for home care, and unless the individual can self-pay or has an advocate who can organize a care plan, that person may be involuntarily moved.
The word ‘institutionalization’ deservedly strikes fear on both sides of the Atlantic as a recipe for patient decline, physical and verbal abuse, theft and generally bad care. It’s a blunderbuss solution to ‘bed-blocking’ which we discussed here [TTA 7 Sep 16]–the care plan becomes ‘move ’em out’. By going this way in policy, NHS England is going counter-trend, against more personalized care delivered in home settings, and setting an unfortunate trend for other countries like the US.
Outside the scope of the article, but in this Editor’s thoughts, is the knock-on effect it will have on the UK’s developers and providers of telehealth and telecare services/TECS designed to support home care. Many of these technologies are in a transition period to the greater capabilities (and freedom from land line) of digital from analogue care, which was discussed in TTA here. Cutting domestic demand may not only be critical not only to companies’ survival, but also to their expansion in the (now far more open to the UK) US market. Readers’ thoughts?
The BBC Radio 5’s ‘5 live Investigates’ broadcast today (Sunday) their report on failing care homes. Starting with third-party research from the firm LaingBuisson, which found in examining 10,000 care homes that 20 percent failed to meet one or more ‘key quality measure(s)’, the 5 live team further examined 50 sample homes which failed inspection and found in their reports:
Some homes were found to be placing residents in danger because of insufficient or poorly trained staff.
There were cases where the wrong drugs had been given out. Other homes were dirty, unhygienic or smelt of urine.
In one establishment, dementia patients were being washed in cold water, and staff had not had criminal record checks and worked up to 60 hours a week.
The program was broadcast on BBC Radio 5 live Sunday, 8 February at 11:00 GMT. BBC News page. Unfortunately there is no indication of a podcast or rebroadcast. Hat tip to Guy Dewsbury via Twitter.
If you or a family member are due to grow old in the UK after April 2016, you will find a fascinating answer to the question ‘When is a cost cap not a cost cap?’ in a thorough analysis of the current plans for the future funding of stays in care homes that comes in a blog item by BBC Money Box presenter Paul Lewis: Paying For Care – The Coalition Plans. Hat tip to Roy Lilley’s newsletter.