Dr Sanjeev Kanoria, Founder and Chairman of Advinia Health Care, tells CHP now is the time for fix the crisis in the UK’s care sector
Another clap for the NHS has just passed, the eleventh of what has been an extraordinary year for the health service. Tens of thousands of Britons have recovered from coronavirus, and the NHS and its staff are rightly praised. But while care workers have endured and triumphed to a similar degree, their efforts go largely forgotten.
It was the same before the coronavirus, and if we thought things might change this year, we were caught off-guard last week when senior politicians criticised care operators without appreciating our severe resource constraints. It is not easy to provide care, meals, accommodation and to comply with the highest health standards for, in many cases, just £100 per day. An issue raised countless times by Care England.
In the heat of the crisis, of course, mistakes were made. Homes should have been sealed off even earlier, and agency staff should not have been working in multiple locations.
The government itself should own up to its mistakes as well. They could have moved faster to provide sufficient PPE and testing kits. They were also slow to distribute emergency funding to help contain the spread of infection and to provide it with minimal bureaucracy. Today, most of a £3.2bn pot given to local authorities has yet to be passed on and won’t even cover the huge sums care homes have already spent on PPE and additional staff to cover those who were unwell.
An important shortcoming was also the poor communication between care homes and the NHS. Patients entering care homes from hospitals should have been properly tested so that care homes could have taken appropriate protective action. Getting the relationship right between the social care and health sectors is the government’s responsibility and striking the right balance would significantly reduce pressure on the NHS.
When Mr Johnson said that the most important role of government was to protect the health of the nation, he showed great leadership. Saving lives matters. However, Gandhi said: “The true measure of any society can be found in how it treats its most vulnerable members.” Caring for old and infirm Britons matter too.
If the government wants to ensure our elderly are well looked after, they should not bash the social care sector but recognise its essential role in society and importance in reducing pressure and costs on the NHS by addressing the evident weaknesses in the system.
In the decade of austerity that followed the financial crisis, funding for care homes fell by 35%. The number of old people, meanwhile, has continued to increase rapidly, and today there are 3.2 million UK citizens over the age of 80. They use a significant amount of public health resources and to keep up with demand, NHS budgets have increased every year.
The inequity in the relationship between the funding of health and care is one of the biggest reasons we have such a high death rate in our care homes. Today, some local authorities are paying just £500 per week for a care home place. In Austria, the government pays nearly three times as much. Funding matters. 5.3% of the UK’s care home residents, nearly 20,000 people, were confirmed or suspected to have died from COVID-19. In Austria, it was 0.3%.
We must use this crisis as a time to build a system that is fit for purpose. Care homes must be funded to the extent that they can take pressure off hospitals. The lack of available support and poor communication means too many old people are left languishing in hospital beds, both at great risk of picking up different and often worse infections, and at great cost. Treating an 85-year-old in hospital costs five times as much as a 30-year-old.
The sector urgently requires a long-term, legally binding, and sustainable funding from the government, as it has made with its spending commitment to the NHS. The fees that local authorities pay need to be adjusted to at least £1,000 per week so that people can receive the best possible care, and are living comfortably, independently and out of hospital.
Increased funding would also allow for technological innovation, such as tools that address epidemic of loneliness or remote doctor consultations, which have been one of the great discoveries of the crisis in the acute setting. If we are able to conduct these in care homes, thousands of unnecessary hospital admissions could be prevented.
Government after government has announced it would fix the crisis in Britain’s care homes. Now is the time to get on with it. The government certainly has an appetite for big spending. There are radical plans to upend the way it conducts its business. Let us hope the Prime Minister understands both the opportunity of getting care policy right, and the simplicity of the solution.