Independent care homes can be utilised better so 'the need for hospitalisation can be avoided', says Four Seasons chief executive

Yesterday the Labour Party announced an Independent Commission to look into how health and care services can work more effectively together, with shadow health secretary Andy Burnham accusing the Coalition of “taking the NHS down the wrong path”.

Today, Dr Pete Calveley, chief executive of the UK’s largest care home provider, Four Seasons Health Care Group, shares his thoughts with carehome.co.uk on the integration of health and social care and the vital role he sees care homes and the independent sector in particular as being able to play.

Dr Calveley begins: “After making the case, over a number of years, for a more joined up approach to health and social care funding we welcome that there is widespread recognition of the need for a re-think of the way care is delivered. This has been acknowledged by The Health Select Committee and by the Audit Commission.

“The independent sector has the potential to play an increasingly important role in health and social care provision, particularly for the elderly, that is complementary to the NHS. Larger operators have developed capabilities and have capacity in more specialised areas of care such as nursing for frail elderly, step-up and step-down care, dementia care and palliative care.

“I believe the independent sector already has much of the expertise and capacity to deliver clinical care to selected high dependency patients at a fraction of the cost to the NHS and taxpayer, (between 35 per cent – 50 per cent less than NHS tariff rates for hospital care.). This would assist the Department of Health to meet spending targets without a drop in the quality of care and arguably provide a better all-round experience for patients.

“It would also help to free up hospital beds and alleviate the situation where between a quarter and a third of the beds in acute medical wards are occupied by people, most of them elderly, who don’t need to be there for clinical reasons (bed blocking). They are there because of a combination of a widely held misperception amongst some commissioners that there is no suitable alternative and in some cases an ideological resistance to giving the private sector a greater role in the mix of health and social care provision.”

Leader Ed Miliband had been expected to call for NHS services to run care homes, with a vision that NHS and social care services would combine to achieve a ‘Whole Person Care’ approach, which MP Liz Kendall describes as doing “far more to prevent people from having to use more expensive hospital services and residential homes when they don’t need to”.

Although recognising that social care services have an important part to play, Dr Calveley warns against private care homes being overlooked by any plans to reform.

He continues: “A joined up approach to health and social care funding should, hopefully, remove some of the perverse incentives and cost shifting that currently impedes seamless care pathways and joined up service. It should result in greater flexibility for people to make informed choices about their care. For example, the tendency for local authorities to raise the bar for people to qualify for funding for care home places is in part a philosophical belief that it is better to provide care support to enable people to remain in their own homes for as long as possible, but it is also because providing care for people in their own home is widely thought to be a cheaper option.

“However, what is happening is that in many cases rather than costs being reduced they are simply being moved between different public purses. Many elderly being cared for in their own homes can typically receive anything between one to four visits by carers daily. Once costs such as housing and council tax benefits are taken into account and additional eligible DWP benefits such as pension credits and attendance allowance, even a modest care package is likely to cost the taxpayer well in excess of £500 a week.

“For people with higher levels of dependency, residential care in a care home setting will not only often be a more cost efficient option, but more importantly will often better meet the individual’s care and social needs. Moreover, when people who are being cared for in their own home become unwell, they are frequently moved to hospital and remain there for some time occupying beds at great cost to the NHS budget. In many such cases the need for hospitalisation could be avoided if the person was being looked after in a care home setting.

“We believe people should be helped to remain at home for as long as it is their wish and in their best interests but there should be informed choice.”

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