In recent weeks I have been commissioned to write two features on how the NHS and social care providers can work together more closely. The reason. Winter is coming and with it many hospitals will face their annual challenge to meet demand. November to February is the busiest time of year for NHS, with more than 20% of patients being admitted from A&E last December and January according to NHS figures. And while the number of people entering hospitals soars, the problem is compounded by those who are unable to leave following treatment.
Delayed transfers of care, or its less kind moniker “bed blocking”, remains one of the most serious problems facing the NHS. Initiatives to solve this problem are many, most recently the integrated care vanguards, but few appear to take root strongly enough to be adopted at a national level.
In the eight years I have been writing about social care, I have asked why not many times. The answer, it seems comes down to cultural differences between the NHS and social care. Social care providers, especially for-profit ones, often feel they are being excluded from these initiatives despite providing the largest number of care homes in the UK. They say they are seeing very little of grants such as the Better Care Fund. Those who do successfully manage to engage with the NHS say they are often seen as the junior partner, having to adapt to hospital trust’s way of doing things.
And for a large provider, working with a range of NHS trusts, each with a different way of doing things, this can be incredibly time consuming. As is care home managers having to visit hospitals to assess each potential client to determine if they could take them or not. This can’t be the most efficient way of doing things.
However, some NHS managers lay the blame at the door of social care providers, saying they are having to repeatedly treat patients due to the poor quality of care received in the community. Clearly there are some trust issues on both sides.
There are far-reaching benefits to both care providers and NHS managers coming together to create a smooth pathway to leaving hospital. After all, the cost of a care home bed is dwarfed by its hospital equivalent. Furthermore, a patient transferred to appropriate care is less likely to bounce back into hospital. A good transfer of care, with equal input from both parties, would save the NHS time and money at a period where both are scarce.
As well as the general public, both health and social care sectors are crying out for a solution to this problem. But that can only happen when the latter is given a seat on the top table and an equal voice in how services are provided.