NHS trusts must to opt for home care as the preferred choice for discharging patients, in order to keep vulnerable people safe, a former senior advisor to NHS CEO Sir Simon Stevens has said.
Dr Ben Maruthappu, who is also the CEO of Cera and co-founder of the NHS Innovation Accelerator, said COVID-19 has shown the health sector that discharging people into care homes “doesn’t always work” and that discharge teams need to “get real” and opt for home care more.
“Whilst opting for care homes from hospital may be the easier route, this isn’t necessarily the right route for patients who will be receiving the care, as they immediately become far more vulnerable,” he added.
Dr Maruthappu’s comments came in response to Sir Simon’s recent call for the government to have plans in place to fully resource and reform the social care sector within a year.
A survey by ADASS has also found that the rapid discharge of patients from care homes during the pandemic, has had “tragic consequences”.
The Coronavirus Survey showed that a significant proportion of people leaving hospital in May did not receive an assessment of their needs as part of ‘discharge to access’.
ADASS warned that if there is a shortfall in assessment and reablement and people are discharged to care homes rapidly, this then limits choice and reduces the ability to help people home.
Dr Maruthappu said it was a “national tragedy” that nearly 20,000 have confirmed to have died of coronavirus in care homes since the start of the pandemic, but stressed that this was a broader issue that spans further than the UK.
“Looking at other nations, around 40% of deaths have also occurred in care homes,” he said.
“If you think intuitively, when you put older, vulnerable people in one place who are more susceptible and most likely to pass away, infections inevitably spread rapidly. This is why home care is by far the preferred option to care homes.”
On social care reform, Dr Maruthappu said sharp interverntion from the government was “more than overdue” after decades of austerity.
“The Covid-19 pandemic, because it affects older people so significantly, has shone a spotlight on the elderly care system which, unfortunately, has been underfunded with a poor national strategy and a poor coordination of services,” he said.
“The major problem within the care sector is how we pay for social care and how we do it in a sustainable way, given the UK’s population.
“Secondly, there remains issues with how health and social care services collaborate and so, people will continue to fall between the cracks in the system. If joined up and an active approach to collaboration is taken, people will be looked after in a holistically comprehensive way.”
Dr Maruthappu said another way to implement reform is through modernisation and digitalisation.
“The social sector is said to be 20 years behind the NHS when it comes to technology uptake. The highly fragmented nature of the sector, continuous underfunding and lack of strategic oversight from government has meant that the social care sector has struggled to adapt and evolve operating models; and embrace technology in a meaningful and integrated way,” he explained.
“People can receive a higher quality of care and costs can go down and we can have a better joint up service if this innovation and technology is used effectively.
“Providers need to wake up to this and government need to make bigger investment into tech and embracing technology in the same way that we’ve seen announcements from Matt Hancock about NHS and technology.”