Care chief calls for lessons to be learned after Norfolk 'care hotel' 'mismanaged' public funds

Care England has called for lessons to be learned from a care hotel initiative which cost taxpayers £15,555 per care recipient during the Covid-19 pandemic.

Norfolk and Waveney CCG pursued a three-month pilot scheme in early 2022, to alleviate pressure on the NHS. The solution was to send 36 care recipients for an average of 16 weeks, to a hotel and to transform it into a ‘care hotel.’

Care England says that the ‘care hotel’ initiative represented mismanagement of public funds where vast sums were inappropriately spent and this was “wholly unacceptable”.

Professor Martin Green, chief executive of Care England said: “News that a Norfolk ‘care hotel’ cost £500k to treat just 36 people represents incredible mismanagement of funds.

“It also emphasises the lack of capacity planning across the NHS and social care sectors, local health and social care economies should be ensuring that there is enough community provision to meet demand.”

The pandemic gave rise to an unprecedented set of challenges within the two years bringing the pressures of Covid-19 to breaking point for the NHS, care hotels were made available for people who had been deemed medically fit to return home but were stuck waiting for a care package, as most local authorities and clinical commissioning groups were struggling to source care at the time.

Professor Green added: “Local independent adult social care services have consistently demonstrated that they are able to offer taxpayers value for money. These providers empower those in need of care, and their families, to make meaningful choices so that they receive the right care across a variety of services including care homes, home care and supported living services.

“They had the capabilities and capacity to care for these individuals and had they been utilised it would have saved the public from these significant costs."

'I would like to set the record straight'

However a care provider that ran some 'care hotels' has defended the amount of money spent, saying the NHS would have spent significantly more keeping the patients in hospital.

Abicare Services Salisbury set up and ran a number of care hotels in 2021 and says the cost of £15,555 per care recipient was not only a "significant cost-saving" but also "released 36 hospital beds" for other patients.

Anne-Marie Perry, managing director at Abicare said: “I would like to set the record straight.

“Keeping the 36 patients who filled one of our care hotels at one point in hospital for the same length of time would have cost the NHS £1.6 million or £44,800 per patient. The cost of £15,555 per care recipient was then not only a significant cost saving, it also released 36 hospital beds and freed up hospital staff to care for other patients.

“As was often reported, there was no spare capacity within adult social services, it had all been used up. The only other alternative for these individuals was to keep them in crowded hospitals.

“First and foremost, care hotels were set-up at very short notice to relieve intense pressure on the NHS. Due to the pressures of the pandemic, the NHS was in a truly desperate situation. On one occasion we had an NHS trust phone us on a Friday afternoon just before a bank holiday weekend to see if we could provide any help within the next two hours. That is how urgent the need for support was.

“For the local NHS trusts, care hotels provided a vital safety valve and lifeline. Care hotels freed up hospital beds and staff, at a time when some patients were stuck waiting for treatment in hospital corridors. Hotel care was an instant solution, which crucially did not weaken any local teams or care providers and instead sourced cohorts of carers from outside of the worst-hit areas.

"This was an immediate option to help an overstressed system which had nowhere else to go."

'Our carers were experienced and fully trained'

Ms Perry says patients were given a choice on whether they wanted to leave the hospital and go to a hotel or go home.

Once admitted, the care hotels allowed recuperating patients onto a full activity and rehab programme so they were ready to go home when local providers had capacity.

"Many found [care hotels] a welcome change of environment that gave them more autonomy, more chance to recover, and less chance of acquiring hospital-related dependencies. Of course, hotels are not designed as care establishments, but just as with the provision of in-home care, there were several things we did to create a suitable environment.

"We had full protocol manuals and worked very closely with our NHS partners to provide a safe and quality service. Our carers were experienced and fully trained, and primary care support was available where required.

"The care they received was of the highest quality and the positive response from patients was overwhelming."

'The alternative would have been to leave the patients in a hospital bed'

With regards to cost, Ms Perry says care hotels were never intended as a long-term solution or alternative to local care.

"They were always an urgently needed short-term solution to a critical problem, not a model for the future of care provision. Because there was no slack in the existing local care systems at the time, the alternative would have been to leave the patients in a hospital bed. This hospital bed costs around £400 per day per patient – far more than the cost of a bed in a care hotel.

"Our staff worked immensely hard and sacrificed a lot to ensure that these care hotels were one of the few success stories during incredibly dark and difficult times. It seems that some have forgotten very quickly just how tough conditions were during the pandemic."

'Learning lessons'

Abicare and Care England say lessons should be learned from the last two years.

Ms Perry said: "The pandemic showed us clearly the fragility of the NHS and local care systems, but also their strengths. We need to establish long-term solutions to the challenges faced by our local health and social care systems. We need more coordination, more planning, and more investment.

"To do this, we need to grapple with what really happened and the real conditions we faced. If we can’t accurately appraise the challenges of the last few years, then we stand little chance of meeting the demands of the years to come.”

Professor Green added: "As a means of learning lessons, Care England would ask for assurances from the government that the care sector will be considered and involved in future ICS planning as to avoid expensive and inefficient initiatives.”