Hospitals and the Care Service

These are the three main reasons:

There are not enough care packages for people who are returning to their own homes, as there is a major recruitment crisis in community care. This is particularly bad in rural areas.

People often don’t think or plan ahead, and if they need admission to a care home it has to be negotiated as many are resistant, understandably. There is often a delay while family chose the right home, which may not have places immediately available.

Some families drag their feet because a lot of homes require top up fees, and hospital care is free.

Provision of care is a total shambles. Nobody wants to pay and to be fair most can’t afford to pay.

Ten years ago we twice had my MiL spending weeks in hospital while she waited for a bed in a rehabilitation centre and eventually another long wait for a place in a council funded care home. I can't imagine that things have got any better since and I'm not convinced that throwing money at it is going to be the answer.

The situation has deteriorated a lot in the last ten years unfortunately Deedaa, as there are more demands due to the increasing number of very elderly people who need care, and there has been a decline in carers and care homes numbers. The majority of local authorities can no longer afford to run residential care homes themselves, so care home provision is virtually all in the private sector. There needs to be a complete redesign of the system.

A result of putting all the funding into the NHS end of care means that a hospital now have the resources to treat and discharge say 15 patients in month 1, another 15 In February and so on, but those of the first 15 discharged to care homes will still be there in February and March so eventually capacity is exhausted. NHS leaders know this very well and strongly urge more spending on social care. But social care is not a vote winner among younger voters. This is why nothing gets done.

But social care is not a vote winner among younger voters
Neither I imagine are pensions, but that seems to work ok.

Our current system of governance is failing us if it can't tackle a problem like this. Shouldn't government be about leadership?

It isn’t just the elderly who need care after a spell in hospital.

When my husband came out after treatment (in his forties) I had to take unpaid leave to provide the support he needed whilst in recovery. There was no further medical treatment that needed to be given in hospital but he could not be left on his own.

What was needed was a kind of halfway recovery place, even daycare only, would have been enough.

I experienced the same need after my sisters heart operation when I had to do the same again.

If I hadn’t, in both cases they would have had to remain in hospital, preventing others from getting treatment. And actually not getting what they needed for a good recovery, like a food they liked, little walks round the garden, a quiet room .

There needs to be an independent study into what is actually cost effective in the long term, not just the short term balancing of this years budget. And then a plan implemented nationally, not subject to the whims of individual trusts.

My MIL had to wait for a rehab place pretty recently 'as there was no space available' and then when space was found at one it was practically empty!

There is a terrible shortage of care staff though. They need paying better

Lathyrus the old cottage hospitals, now called community hospitals used to fill that recovery role. Now they’re mostly used for minor injuries and ‘ptocedures’..
Voters who haven’t used the system are inclined to equate social care with ‘social services’ generally and not rate it highly enough. The funding division between the two is absurd. No one thinks it isn’t but 12 years of Tory kicking it into the long grass are exacerbating it. We haven’t even seen Boris Johnson’s oven-ready plan of 2019 yet.

Yes winterwhite I searched in vain for something like the oldCottage hospitals. Even privately for my sister who had some funds, but there was nothing. The couple of private ones that looked promising turned out to be mostly for people in “rehab” of quite a different sort!

And time is wasted in fighting between Health and SS as to who should pick up the tab for care. If you fulfil stringent criteria you can have you care at home/in a nursing home completely free and un-means-tested via NHS; if you do not, then SS pick up the tab - or as much as they are willing to after you have been means-tested. This all takes time.

They should bring back convalescence homes to bridge the gap between hospital and returning home. I was offered this years ago, in the early 70s, after major surgery, but turned it down as I didn't feel that I needed it, but at least it was on offer. It would probably result in fewer readmissions, too, as people tend to make a better recovery when out of a hospital environment - or so I am led to believe.

Last April all in goof faith we were more than willing to see a rise in NI in order to sort out the social care issue.

Just been scrapped

A mid-way place sounds a good idea, but it will still need funding. Health care is funded from central funds, whilst social care is a local authority function. Is that reasonable?

How about something radical like cancelling Trident, and using the billions of pounds saved to fund central social care?
There are only 8 or 9 nuclear states, so all the others seem to manage without: why can't we.

Squiffy I agree- post hospital care is almost non existent as convalescent/recovery /rehab facilities have all closed.

Squiffy

Thanks for reminder about convalescent homes.I am a retired nurse and can remember them very well in my younger days.
they were run by the NHS if I remember rightly.Our health authority provided about three, and there was one for men only run by a religious order.Also some private firms provided them for their employees who had paid into a fund.WH Smith and the Co-op had them.
They provided an ideal service for people recovering from serious illness or major operations.They were staffed by trained and untrained nurses like hospitals and there were doctors on call.They were very popular with patients and staff, nearly all set in a country district.
They were not permanent though, patients usually stayed up to 2 weeks until considered well enough to go home, or to a place in a local authority care home.
They all became victims of the cuts in the NHS started by the Thatcher government, and sold to private enterprise to become stately homes, wedding and conference centres or hotels.
There ones for children as well, mostly used for what was termed problem families.Babies and children recovering from serious illness whose parents were unable to provide the care they needed until they had fully recovered.
They are a great miss.

Bring back the convalescent homes and cottage hospitals! Seriously though, there is a major staffing crisis, both in the NHS and in Care. Care staff have left in droves as the work is badly paid. Not helped that it is run by private enterprise who have to make a profit. Disgraceful that sick and elderly people are treated so badly.