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NHS - plan to pay untrained people to care for surgical patients

(102 Posts)
Cold Wed 25-Oct-17 16:04:25

Just saw this new idea that the NHS is considering paying people £100 per night to rent rooms Air BNB- style to post surgical patients to free up beds.
www.theguardian.com/society/2017/oct/25/nhs-to-pilot-airbnb-type-scheme-for-patients-recovering-from-surgery

It seems like a really strange and potentially dangerous idea that people who are not well enough to return home would be left with untrained people.

Primrose65 Sun 29-Oct-17 21:03:40

Ah, well if it's a 24 hour a day job, then it's not allowed under the working time regs or the minimum wage - the 2 day work calculation is just academic as no one would be allowed to work a 24-hour shift without a break.

M0nica Sun 29-Oct-17 21:22:41

The plan put forward was that the host would provide some supervision and help, 3 microwave meals a day and hydration. In which case the patient is probably well enough to be better off at home with carers coming in.

In fact, having looked after DD, in her own home in similar circumstances I can say that looking after an immediate post-operative patient is actually a 24/7 job. On call at any time to deal with everything from minor to quite serious emergencies, so even though the task of the host is meant to be light and hands-off. I think it would be anything but and I priced it accordingly.

Primrose65 Sun 29-Oct-17 21:35:57

I'm sure if the NHS were able to discharge people with carers coming in, they would do that and there would be no point in this scheme.
My interpretation was that local authorities are not always able to arrange carers. So this was widening their options if people were happy to provide that 'carer' level of support in their own homes. I made that assumption because they are looking at people without medical training and offering £50 a day.
Your interpretation is for a far more intensive workload.
That would need more money, more training, more people.
I think we're talking about totally different things.

varian Sun 29-Oct-17 22:02:46

Members of the House of Lords can claim £300 per day for just signing in. They don't have to vote, speak or even listen to a debate to get the money.

I doubt whether many of them will opt to look after a post-op stranger for £50.

M0nica Sun 29-Oct-17 23:04:36

I'm sure if the NHS were able to discharge people with carers coming in, they would do that and there would be no point in this scheme.

Primrose, that is the nub of the matter. These people will need more than just 3 microwave meals a day and hydration.

Having looked at the Care Rooms site, the people they have in mind are elderly 'bed blockers'. People who are likely to have dementia, and be physically very frail. They will need help washing and dressing possibly/probably help with feeding and toiletting. May have difficulty walking and help with every aspect of their lives.

If people are not well enough to go home, they need to be in a therapeutic environment like a convalescent home, not lodging in someone's back bedroom, even if it does have an ensuite shower room.

JessM Mon 30-Oct-17 07:03:50

It's a batty idea that does not end up to any scrutiny at all. The sensible solution is to have temporary NHS care homes (aka convalescent homes) in which people can be rehabilitated. This does not come cheap. However it is probably even more expensive to keep people in acute NHS beds, and it has a knock on effect on the service. We need to pay more tax to cover the rising demand on the NHS due to demographics. There is no getting away from this if we want the NHS to get back to where it was in 2010. Maybe the new version of a convalescent home looks like a Premier Inn with a few extra facilities and every bathroom purpose built for those with mobility problems. Nice lounge. Subsidised canteen with room service. Physio facilities. Rooms not needed could be let out at a commercial rate to those who need temporary care (respite for relatives etc). Staffed by one nurse, nursing assistants and domestic staff to do the beds and cleaning.

Anya Mon 30-Oct-17 07:18:39

If only Jess - though I agree that’s what’s needed.

This running our NHS and care services on a shoe string is a national disgrace. What is more important than caring for our sick and elderly? I’ve witnessed just these last few months how elderly patients are discharged from hospital, unable to walk or care for themselves. They are given an inadequate ‘care package’, which they have to pay for themselves and in between visits are left sitting in their own excretement and without access to food or a hot drink.

This is what we have come to. Yet, because these poor people have no voice or anyone to speak up for them nothing is being done about it.

This government ought to be ashamed of itself.

Lazigirl Mon 30-Oct-17 09:32:45

Ah Anya. To quote our Health Minister As a conservative, I believe that good public services are the moral purpose of a strong capitalist society. As noted by dj from the interview with Hunt on the Andrew Marr show yesterday.

durhamjen Mon 30-Oct-17 13:48:32

www.theguardian.com/commentisfree/2016/jan/26/doctor-nhs-postwar-britain-mental-health

He has a new book out;

www.goodreads.com/book/show/36235634-don-t-let-my-past-be-your-future

An apt message.

Primrose65 Mon 30-Oct-17 13:59:44

Having looked at the Care Rooms site, the people they have in mind are elderly 'bed blockers'.....
I didn't get that impression at all.
"your spare room and bathroom can be safely converted to allow patients to be discharged for a maximum of 2 weeks, for remote carers to look after them and for minimal impact and risk to your daily life. "
"Can I get care experience with you?
There is a specific legal difference between being a host and a carer, our proposition is focused on being a host with external care being provided by CQC (Care Quality Commision) trained and registered carers."

What did you find on the site that makes you think it will be elderly, frail dementia patients that you will need to feed and toilet?

M0nica Mon 30-Oct-17 19:32:21

On the first page there is a sentence with the last word changing every 5 seconds or so. The words that change are: your mother, your father, your auntie your grandmother, your grandfather. They do not include: your daughter, your son, your sister, your brother, your niece, your nephew.

This scheme is devised for those elderly people who have recovered from the problem that took them to hospital, but because of frailty, mental issues etc are not fit enough to go home. Most are waiting for a care home placement because they have dementia, or are very frail and cannot do things like wash or dress themselves. Someone like that often needs help to get to and from a bathroom and help cleaning themselves after the event.

Primrose65 Mon 30-Oct-17 20:03:49

So you've created all this detail in your head because the website graphics don't include the words 'your children' for a scheme aimed at adults?confused

Lazigirl Mon 30-Oct-17 20:11:05

It's clearly an initiative to free up hospital beds from those cruelly described as "bed blockers" ie the frail elderly who have nobody able to care for them at home. I don't believe younger people are usually stuck in hospital. They are quickly despatched after treatment. The discharge ward my mother was in awaiting "despatch" were all old. None of the people on her ward would have been suitable for such a scheme incidentally.

durhamjen Mon 30-Oct-17 22:14:02

If the scheme is aimed at adults and talks about your mother, your father, your aunt, your uncle, your grandmother, your grandfather, then it's definitely for the elderly.
Have you looked at the ad, primrose?
You don't have to read it all, just the moving strapline.

Primrose65 Mon 30-Oct-17 22:36:03

Yes, I've looked at the website. It's better if you read it all, not just a strapline. The strapline was probably written by a 20-something media bod whose 45-year-old mum would probably be an ideal candidate. Not all grandmothers are 'elderly' either - perfectly normal to become a gran in your 50's.
I've read the Guardian article linked by the OP too which says
"Hosts would be asked to welcome patients recovering minor procedures"
It's part of the NHS Clinical Entrepreneur program so will be monitored by the CQC.

Nowhere does it say elderly, frail or dementia patients would be eligible.

It feels that you are arguing about something you have created in your mind! It's a bit ageist to assume all grandparents are elderly and frail!

durhamjen Mon 30-Oct-17 23:38:22

If it says your gran, it is not being aimed at someone with a 50 year old gran, is it?
I was a gran in my 40s, but it wasn't aimed at my granddaughter, was it?
Do try and be a bit logical.

I read the whole article, too. Who do you think would need a room like that, who couldn't be able to go home?

www.theguardian.com/commentisfree/2017/oct/27/carerooms-nhs-staff-beds-airbnb

Primrose65 Tue 31-Oct-17 08:31:15

I think it's aimed, for example, at someone who has had knee surgery, who lives in a first floor flat in a house. They can't get up the stairs. There's no lift. In all other aspects they are fit to discharge. So they bed block.

That fits the profile that they write about on their website.

I'm not illogical. I'm just basing my discussion on what has been written about the scheme, not details I've invented.

durhamjen Tue 31-Oct-17 08:41:33

My brother in law is waiting for a knee operation. He's 62 and can't have it until he's 70, as you can only have it replaaced twice, so 70 is the youngets in their area.

durhamjen Tue 31-Oct-17 08:42:06

Youngets? Youngest.

Blinko Tue 31-Oct-17 16:26:10

An elderly relative of mine was recently recovering in hospital, almost due to go home when she had a fall. After observation, she was placed in a residential care home near where she lived. I understand that a stay in hospital would have cost the nhs around £2k per week, whereas the care home charged £1k per week. She was there about a fortnight before being able to return home. It worked well. It seems that hospitals do make their own local arrangements wherever possible. Perhaps some cannot? A strategic review of options would be helpful, imo.

JessM Wed 01-Nov-17 10:30:44

Nursing homes are full to bursting and many are closing due to financial problems. It would be ideal if there were lots of beds available but they aren't.
A strategic review at any time in the last 7 years would have told Hunt that one way or another the expenditure needs to rise due to inevitable increase in demand due to demographics and unhealthy lifestyles. Instead there was a massive cutting back of the number of beds, about 3-4 years ago.

durhamjen Wed 01-Nov-17 23:17:18

Primrose, do you know any people who have had knee surgery who are under 65, because I don't.
I know two people who were refused it in their 50s and my brother in law who is 62.
I know someone who died before he had his; he should have had it in his fifties or early 60s, because he had had three heart attacks, two in his late forties.
He was using walking sticks and a wheelchair, but still not considered suitable for a knee replacement.
Maybe it's different up north.

Jalima1108 Wed 01-Nov-17 23:23:20

Yes, I do. Someone I know had both knees replaced in her 50s and very successfully too.
And my DB was not quite 63 when he had his knee replacement.

Perhaps it's not a case of age but a case of how bad it is and how incapacitating?

Primrose65 Thu 02-Nov-17 13:25:18

Perhaps it is different up north dj, I don't know.
There was an article in the BMJ (I think, or it could have been The Lancet) about 5 years ago saying more people under 55 were being referred for partial or total knee replacement. I would guess that this means it's being used more extensively to treat osteoarthritis. I don't have a link to share, but it's probably google-able if you're interested in the details.
I think it's better to discuss ideas more generally, rather than become bogged down in local NHS practices or specific treatments.

durhamjen Thu 02-Nov-17 16:55:45

My brother in law lives in Hampshire.