Guest article: Therapy staff could monitor patients at home by working closely with local care providers

Proposing steps that can be taken to help to reform health and social care, Max Parmentier, co-founder and CEO of birdie, says by working closely with local care providers, assessment and therapy staff can monitor and support discharged patients in the comfort of their own home.

Right now it’s difficult to feel confident about growing older in the UK. Demand for elderly care has reached a record high, with almost two million requests for support in 2021-22. Yet current health and social care systems can’t meet this call, with the actual number of people receiving long-term care at just 818,000.

The recent Spring Budget crudely underlined that the reform we need isn’t coming from the Government anytime soon. On that point, let’s be clear: the current NHS crisis isn’t just a consequence of a ‘troubled economy’ or the Covid pandemic. Largely it’s down to the fact that, for almost a decade, there’s been a systematic lack of funding.

Continuing to wait for the government to execute the health care reform we desperately need in the UK puts the lives of thousands at risk. Therefore, health and social care reform must come from within. Here are some proposed steps we can all take together.

Increasing communication

The health and social care sectors are inextricably linked. Increased pressure on either side has a knock-on effect on A&E services, care providers and population health. However, the two sectors continue to operate separately – especially with regards to sharing data.

The process for sharing health and social care data isn’t fully standardised. This means when it comes to sharing data, potentially around a patient’s wellbeing or care plan, there isn’t a standard process – making communication fragmented.

One of the aims of the merger between NHS Digital and NHS England, was to smooth communication between the health and social care sectors. NHS England now assumes responsibility for running the national IT systems supporting health and social care and the collection, analysis, and dissemination of data generated by both services to improve outcomes. While it’s still early days, standardisation must be a key priority to ensure effective communication between the two sectors.

Improving communication is a fundamental step in increasing NHS capacity. Not only will it streamline how the two sectors work together – driving crucial efficiencies -, it will enable the NHS to leverage local care capacity to ensure older people receive the right support for them.

Tackling hospital discharges

Currently, around 13,000 people who are fit to be discharged, are occupying hospital beds in England – placing the NHS under more strain and decreasing capacity even further. But unnecessarily long hospital stays also significantly affect the health of our older population.

Long stays in hospital create a vicious circle. In fact, the NHS recognises that long stays in hospital can increase the risk of falling, sleep deprivation, catching infections and sometimes mental and physical deconditioning. For our older population, this can hinder independent living and increase the likelihood of readmission.

As such, it’s vital that the health and social care sectors work together to accelerate the discharge process. Social care providers often lack visibility, meaning discharging people from hospital to social care providers often takes much longer than necessary. By improving communication between the two sectors, and removing silos, the NHS can leverage local home care capacity, enabling older people to recover and recuperate at home.

But there’s more we can do to accelerate the discharge process. The Local Government Association’s ‘Developing a capacity and demand model for out-of-hospital care’ report, shows the value of shifting assessment and therapy staff from hospitals to the community. By working closely with local care providers, assessment and therapy staff can monitor and support discharged patients in the comfort of their own home. Not only will this improve health outcomes for those who’ve been discharged, it will drastically increase NHS capacity.

Looking to virtual wards

For people with complex medical and social needs, virtual wards offer access to community support, as opposed to remaining in hospital. As such, they represent an exciting step towards enabling more older people to age safely in the comfort of their own home, as well as freeing up vital healthcare resources.

Yet, virtual wards were originally intended to only support specific conditions. And the requirement for patients to take their own biomarkers (such as heart rate, blood pressure and temperature) is slowing adoption.

To unlock significant healthcare capacity, integrating the wider social care network will expand the number of conditions that can be treated using virtual wards. There are more social care providers training their staff to provide complex care than ever before. And the ICS must collaborate with these providers to offer a complete “hospital at home” experience.

By increasing the number of qualified care staff in the community, capable of taking biomarkers for patients and offering more complex forms of care, healthcare capacity can increase sustainably.

The crisis facing the NHS is cruel and unprecedented. And there’s no quick fix to ensure our older population can receive the support they deserve. But meaningful change can start with bolstering communication between the health and social care sectors. Then, we can start to truly increase the capacity for care and create a country in which we can all age with confidence.