One Armed Maverick: Care Homes or Cash Cows?

All this 'Care closer to home' stuff has been the mantra of many successive governments. The prospects for Sustainability and Transformation Partnership Plans (STPs) in shifting substantial amounts of care away from hospitals and long term care relies heavily on the availability of intermediate care services that are tailored to local needs and circumstances.

Well, that's the theory anyway. Certainly, the Labour Peer Lord Carter with his 'review' looks at how private care homes and fees can help home the geriatrics blocking up the beds in the local hospital. Lordy dawdy Carter of Coles bagged his first private care home in 1988 and now has a string of them so he's advocating the elderly + the taxpayer pay him & other care home providers to take in the aged from the hospitals.

But is that really the problem here in Preston and Chorley?

Delayed transfers of Care (DTOC) lead to cancelled procedures and can close a hospitals doors to other patients. If beds are taken up by the elderly who needn't be there then your ambulance could get turned away & redirected elsewhere, as happened 8 days ago at Preston Hospital. The backlog of patients at Preston was so bad one patient (anon) reported..

"My wife and I accompanied an elderly neighbour to Preston A&E and the corridor outside the unit had a long queue of patients on stretchers, by each stretcher there were two paramedics waiting to handover the patients. This meant that several ambulances were out of action. As the queue got longer a senior paramedic told everyone to put "reverse queueing" into action. When I asked what this meant he said that the stretchers would be moved round the corner so the problem didn't look as bad!"

Many elderly patients cannot be discharged from hospital until they've been assessed as being fit to either live alone or in a care home etc. then there's potential rehab and the mobility test and social services need to be involved for financial assessment and to find some sort of suitable care package such as re-ablement.

But even if this problem was to be solved, it wouldn't result in more doctors working in Emergency medicine with the Chorley A&E re-opening. But it would go some way to reduce the trusts financial burden which currently runs at a pre-deficit of £34m and a projected deficit even greater.

Richard Humphries of the social care institute for Excellence (SCIE) says "the evidence is positive. Intermediate care seems to work for most who receive it".

What he means of course is for those who can afford it.

[23rd July 2017]