First-class home care could solve major hospital discharge challenges

By Tinga Umera, Managing Director, Nexus Care Services

The Homecare Association (HCA)’s latest report, Expecting the unexpected: Homecare providers’ views of hospital discharge, has painted an intriguing picture of home care at the point of hospital discharge – highlighting the indispensable support of private home care providers.

The report, which surveyed hundreds of major care providers, found that hospital discharge for patients with ongoing care needs is a point of significant contention, particularly when NHS capacity results in early discharge without the right specialist support, medication and mental health services in place.

As care providers, we’re acutely aware of the issues facing the sector, including recruitment and capacity to deliver complex care.

From this report, it seems that these issues are challenging the relationship between commissioning authorities and care providers – with 67 per cent of respondents noting an increase in pressure to accept people discharged from hospital quickly, despite over two thirds having unused capacity.

It also seems apparent that client-centred, tailored private home care is the key to relieving this strained relationship and getting the home care system moving again.

Commissioned care

Much of the report focused on the state of commissioned care – i.e. external care providers contracted to the NHS or local authority which provide packages of care to those leaving NHS hospitals.

Along with the pressure to accept rapidly discharged patients, commissioned providers have also seen stagnating fee rates and a general decline in their ability to communicate directly with patients and loved ones over discharge care plans.

34 per cent of respondents, on the other hand, said that enquiries into private or self-funded care have increased compared to six months ago, more so than within the last year or before the pandemic – indicating the growing popularity of private care for the speed and flexibility which it offers.

What this indicates is that service users are turning to private care as an alternative to local authority provisions, more so than ever before – but also that commissioned providers are unhappy with their current working relationships with commissioning authorities.

In our view, this dissatisfaction for both patients and commissioned care providers can be addressed by helping discharged patients access private home care if they choose.

The need for speed

Of 223 respondents, over a quarter saw delays in assessments as being the leading cause of hospital discharge delays, which then impacted on the capacity of hospitals and the ongoing care of patients.

We are acutely aware that assessment delays are a major challenge facing care clients across the UK and is one of the leading causes of outcome disparity between those who receive care quickly and those who have to wait a long time for an assessment.

To address this issue, we have become champions of rapid care assessments and implementation. Typically, we can assess and offer a care package within a week of first contact with a client, recognising the particular urgency of support post-hospital.

This is a vulnerable time for many clients, who may only need care for a set period after being discharged.  With this need for flexibility in mind, we’re able to provide as little or as much support as needed, with daily living and personal care a major priority.

Enhancing access to this level and type of private home care also has the potential to support the HCA’s calls for hospitals to meet people’s basic needs when they are discharged and include care providers in needs assessments – as well as creating additional capacity for commissioned care providers.

Our assessments are hands-on and centre the individual’s needs, putting us in a position to see the difference this can make to short and long-term outcomes.

Beyond physical health

One of the most concerning trends highlighted by the report is the rising incidence of avoidable readmittance to hospital – noted by 40 per cent of respondents.

In addition to premature discharge, one of the major causes of readmission noted by the report was difficulty in accessing support for other elements of health, including specialist nurses, mental health and physiotherapy.

Private care has the ability to address this in a way that builds community and emphasises independence – as far as possible – and therefore reduce the potential for delays to impact those under local authority or NHS care.

Tailored home care aims to reduce hospital readmittance in a number of ways, including ensuring regular meals, sleep and medication, but also in providing opportunities to socialise and join in with the community, which may have otherwise been impossible.

Nexus Events has been a real boon for our clients in this regard. Working closely with clients led to the development of a service which gets our clients out into the community with people who share their interests – supported by trained carers and an understanding of additional needs.

While not strictly a care requirement, it expands the way we think about care to include social and mental wellbeing which, the HCA’s report suggests, has a real positive impact on reducing hospital readmission.

Ultimately, this is the key to resolving the issues facing commissioned care providers and authorities – by reimagining care as a tailored tool to achieving long-term independence, rather than a one-size-fits-all service.

We’d urge anyone struggling with putting a care package in place after hospital discharge to speak to us and find out how we can help.