No one wants to stay in the hospital any longer than they need to, but what happens when patients don’t have the care they need to be discharged safely and healthily to continue their recovery at home? Extended hospital stays due to care shortages are detrimental to well-being, especially for elderly patients, but they are also a drain on the NHS’s finances and resources.
Statistics from the NHS show how widespread the issue is. In December 2023, 63% of patients who no longer met the criteria requiring hospital stay faced delayed discharge as they waited for social care arrangements. A total 12,203 patients had unnecessary overnight hospital stays in just one month, costing upwards of £483 per person per night and blocking beds for incoming patients in need of hospital care. It is therefore clearly beneficial for both patients and Trusts to clear hospital beds as soon as patients are medically fit to leave.
However, a major blockage to this is the current system for finding and allocating carers in the UK, which operates on the traditional agency model. Care agencies tend to work on standard business hours, meaning if a patient is discharged on a Friday afternoon but needs to be allocated a carer before they can go home, the best-case scenario is that they will leave the following Monday. Even for midweek discharges, sourcing carers through agencies can be a slow and arduous process, sometimes taking one or two weeks to arrange adequate care. The root cause of these problems is that experienced, well-trained carers have been undervalued for too long in terms of pay and career opportunities, and there is now a critical shortage of skilled workers as carers have left the profession.
So how do hospitals navigate these challenging circumstances? It is of course crucial that everyone has what they need to be safe and healthy at home, but extended stays while care is arranged urgently need to be curbed to alleviate pressure on the NHS. The key here is technology. Online care providers and innovation within the sector are challenging the outdated care agency model that is slow and expensive, while also empowering patients and their families by putting choice and control firmly into their hands.
Challenge the care system
It is estimated that online care providers could triple the number of people able to leave the hospital when deemed well enough. These services sidestep the business hour limitations of care agencies and parts of the NHS and also ensure that carers are thoroughly trained to deliver high-quality care. This means that excellent care can be found in as little as 30 minutes or even in real-time, day and night, seven days a week. By leveraging these platforms and reducing reliance on care agencies, hospitals will be able to connect discharged patients with a suitable carer much faster.
As well as making care more accessible, carers are heavily vetted so hospital staff can fully trust their patients are being transferred to safe hands. In addition, these self-employed carers earn more on average per hour than agency staff, meaning increased retention, while costing less to the NHS or private client due to lower overheads and reduced admin costs.
Empower patients and families to self-manage
When post-hospital care is provided by a care agency, time and staffing constraints mean that there is a ‘get what you’re given’ approach. Patients and their families do not have true choice and control over who comes into their homes and looks after them.
In contrast, online care system platforms enable clients to browse a marketplace of potential carers to find someone who can cater to their specific needs. Often, care agencies will be inconsistent with the carers they provide which can be confusing and detrimental for clients with conditions such as dementia or autism. By self-managing their own care through an online platform, patients and families can ensure consistency and stronger carer-client relationships.
Find the perfect match
The cost of ineffective care doesn’t always end when the patient leaves the hospital if there are special needs. Between 2019-20 and 2021-22, NHS Trusts spent over £113 million on translation services, and this demonstrates a prevalent need and the associated costs for language skills in home care settings too.
Online platforms allow clients to select options and filter carers by languages spoken so they can communicate effectively with their carer without a third-party translator, saving the cost of an extra person. In addition, these filters can be used to find carers with specialist skills and experience, such as catheter care, hoisting and PEG feeding. By finding a carer who has the necessary specialisms from the outset, clients are more likely to stay well at home, preventing readmissions to hospital.
A new approach to the care system for the NHS
The NHS is underfunded and therefore Trusts need to make cost savings where they can, but this needs to happen without compromising care system quality. Reassessing how post-hospital home care is sourced and managed is a prime opportunity to meet both seemingly opposing needs.
Online care platforms allow hospitals to find carers at a lower cost 24 hours a day seven days a week while ensuring that carers are always vetted and trained. Leveraging these services means that NHS Trusts reduce expenditure on care and delayed discharge, while equally being able to rely on quality-assured carers that their patients can depend on.
By Patrick Wallace, co-founder and director of Curam