Peter Seldon, Consultus Care, discusses how at-home care for the elderly can help to alleviate pressure on the NHS
As the Coronavirus crisis worsens and the nation continues to be under lockdown, much of the focus is on the number of elderly patients in hospitals. As the primary at risk group, how can they be kept safe from exposure to the virus? The need to keep the elderly and vulnerable safe in their own homes and prevent hospital admission for both virus and non-virus related issues has never been more important than it is today.
The point is that whether in a crisis situation or not, many of these elderly individuals should not be in hospitals. Instead, with the right care in place, they would be happier and healthier within their own home. But all too often, they are transferred to a step down ward or low quality residential care, in many cases leading to rapid readmission to hospital – a model that is financially unsustainable and morally flawed.
With a live-in care package that is tailored to each individual, elderly patients can be discharged to their own homes sooner, enabling them to recover in surroundings they are familiar with and reducing the risk of readmission to hospital. The Coronavirus pandemic has forced a long-overdue assessment of elderly care and as Peter Seldon, CEO, Consultus Care insists – isn’t it time that live-in care becomes the default strategy for when the NHS discharges patients?
Taking action
Bed blocking by elderly patients in hospitals is something that has been compromising the NHS for years. It not only costs the NHS £640,000 each day, but this process of elderly patients staying in hospital for long periods of time means that their wellbeing is significantly affected and can often lead to further complications and the rapid decline of their health. Whereas, it’s well known that if elderly and vulnerable people can return to their own homes instead of staying in hospital, their health can greatly improve.
This is why the live-in care model is so effective. With a professional, qualified carer living in their client’s home 24/7, they are back in familiar surroundings with all the benefits of dedicated, one to one care. In their own home, an elderly person can enjoy home-cooked food, have friends and family visit any time of day and be able to keep their much-loved pets – a fact that has been proven to aid in a person’s recovery and wellbeing.
This can also aid with proactive healthcare, as trained carers can quickly spot potential health issues such as Urinary Tract Infections, allowing for early intervention to reduce the risk of emergency hospital admission. Overall hospital bed availability can be improved as beds can be released quicker as patients are sent home to a live-in carer, and the rate of hospital readmission is dramatically reduced.
Disjointed patient discharge process
It’s clear that the challenge that the NHS Discharge Teams face within a highly pressured environment is intense. Early patient discharge could mean that the likelihood of hospital readmission is high – with the NHS Trust incurring a penalty if that occurs within 30 days under the non-payment for performance (NP4P) policy.
Yet, if the patient is not discharged, this just adds to the bed-blocking crisis. For most NHS Trusts, the practice has been to transfer patients to a residential or nursing home, or a step-down ward in the hospital. While this strategy may appear to be a solution, patients are often discharged too soon, to a care home that is underfunded and not suited to their recovery needs. This, again, is another factor that contributed to the decline of wellbeing, with an unsatisfactory quality of experience for the individual and a high chance of readmission back to hospital – adding to the additional and unnecessary financial burden placed on the NHS.
Home is where the heart is
With live-in care at home people are happier, the outcomes are better and the costs are lower. According to research, 39% of those in residential care and over half (53.3%) in nursing homes never leave their home. This compares to just one in seven (14%) of those with live-in care.
When you consider daily activities that people enjoy, 11% of people in nursing homes say they don’t do anything they enjoy with their time, compared to 97% of those with live-in care who do at least some of the activities they value and enjoy, even though they may be frail or unwell.
While NHS Discharge Teams are hard-pressed to find the time to fully assess each individual for their discharge needs, live-in care providers can work with patients while they are still in hospital to conduct a rigorous care needs assessment before they are due to be transferred. This includes liaising with health care professionals and meeting with the patient and their family to create a tailored health care plan that also covers a risk assessment at the person’s home. With live-in care providers requiring an estimated advance notice for managed live-in care service of no more than three to five working days and no more than 48 hours for live-in nursing, the entire discharge process can be rapidly escalated.
Conclusion
According to an independent review: nearly one in ten beds is taken by someone medically fit to be released. Add to that the current pressures placed on the NHS as a result of the current pandemic, and it’s clear that change needs to happen regarding thoughts and processes around patient discharge, fast. Cost and bed-blocking are no longer the two primary considerations – in the current crisis, we know that we’re all safer at home – especially elderly and individuals. Inadequate discharge processes will only put more lives at risk – the NHS must expedite this change.
