Proposal to move on patients isn’t new

I was pleased to read in the Chronicle (February 3, page 13) that a new in-house team would be formed to improve the flow of hospital discharges by helping patients to move on when they no longer require in-patient treatment. I worked for 40 years in local social services in Bath and Wiltshire and we had a similar programme over 20 years ago, so this is hardly “a pioneering scheme”.

Back then it was jointly funded by health and social services, offering free care at home for a short period, or a stay in a nursing home where care and therapies could be provided to prepare frail people to return home.

However, the scale of the challenge is now even greater because of the constant increase in the numbers of elderly and disabled people living longer, often with greater dependency, including dementia, and without a sufficient close support network.

After a decade of corrosive Tory under-funding and privatisation it is encouraging to learn that staff will be directly employed (not outsourced) and that carers will be decently paid and hopefully on proper employment contracts. The pay and conditions for many carers employed by private companies have been scandalous, partly due to the starvation of resources for social care by successive governments. Our present regime would not even provide a proposed Covid bonus of £500 to help with worker retention and thousands have left carer jobs in recent months. By contrast we now hear that the Chancellor intends to write off more than £4 billion in bad Covid loans to companies where no prior checks were undertaken by the Treasury.

It will be interesting to read about details of the new scheme. For example, how long will the service last and will patients have to pay? Local authorities are legally obliged to make financial assessments and charge service users. This has always been a crucial and problematic distinction between the NHS and social services. What is the

quality of the follow-on service? Many frail people are readmitted to hospital within weeks because they collapse again.

Like many former colleagues, I wish all the best for the new scheme and I hope that managers will consult with former practitioners to learn from their experiences and not merely seek to “reinvent the wheel”.

Steve Richards

Bath