Patients recovering from surgery could be discharged from hospital to recuperate in private houses nearby as part of an NHS trial that could earn those renting out the rooms up to £1,000 a month.
The scheme, which is being piloted in Essex, aims to tackle bed shortages and save money but has been criticised by medical professionals and social workers who warn it would give too much responsibility to untrained members of the public.
A startup, CareRooms, is working with the NHS and councils in Southend and elsewhere in Essex to pilot the model and finalise how it will work. It says patients would benefit from “a safe, comfortable place to recuperate from hospital” as well as helping the NHS.
Hosts would be asked to welcome patients recovering minor procedures, cook three microwave meals a day and offer conversation, according to CareRooms, in a scheme targeting people who do not have a family able to care for them.
The Save Southend A&E campaign group, whose members include doctors and other clinicians, warned it “opens a huge can of worms for safeguarding, governance and possible financial and emotional abuse of people at their most vulnerable time”.
CareRooms, which is part of NHS England’s clinical entrepreneur programme, said its governance and quality would address such concerns. Hosts would be interviewed and be subject to disclosure checks and food hygiene tests. There will also be barring service checks of police criminal records – used by employers, often to avoid problems of employees working with children and vulnerable adults. They would also need to understand some care law, including the Mental Capacity Act, which aims to protect those who lack the ability to make their own decisions about treatment.
So-called “bedblocking” in the NHS has risen by 40% in the past year and is estimated to result in as many as 8,000 deaths annually. On some days 6,000 patients are taking up beds when they no longer require hospital treatment.
Harry Thirkettle, a part-time emergency registrar in Essex who is the medical director of CareRooms, told Health Service Journal: “Everyone’s immediate concern is, understandably, safeguarding. We are working hard to be better than standard practice.
“We are not going off half-cocked … We are not going to start taking on patients until we have satisfied all these different organisations’ governance procedures and committees [NHS providers, commissioners and councils]. We are really carefully considering this and making sure it is as safe as possible.”
The financial model is still to be finalised. Thirkettle said rooms would be rented out to funders at about £100 a night, with half going to the host. The rest would be used to pay for the care services required and a margin kept by the company as profit. He said the assumption was that it would be jointly funded by the NHS and councils. “We may also look to take self-funding patients who pay us directly.” For patients who are prepared to pay the option would be presented by a hospital’s discharge team alongside existing options such as nursing homes, he said.
The Association of Directors of Adult Social Services said it wanted more details before making a full assessment but that the “model of care, as described, raises questions about whether the safety and wellbeing of the individual have been fully considered”.
A spokesman for Southend council said: “We want to make it clear that, at this early stage, the council has only agreed to continue exploring the viability of the project with other partners. We are awaiting further information on how the project will run and the preparation of a detailed business case before we can make any formal commitment or give support to the project.”
CareRooms has set up a stall in the restaurant at Southend hospital to find potential hosts.
Save Southend A&E said that in addition to its safeguarding questions, it was concerned about the way the company was pitching itself as a money-making venture for hosts, rather than emphasising care quality.
It said the company was handing out flyers in the public canteen at Southend hospital this month, which “headline with a financial opener offering people the chance to earn up to £1,000 a month renting out a spare room to accommodate someone needing to recuperate from hospital.
“We are shocked that an NHS trust is endorsing such a company … It is almost weekly that there are reports of abuse and poor care in registered residential and care homes, therefore the monitoring of such ‘placements’ in private homes would be a huge and risky task.”
The pilot involves Southend University hospital foundation trust; Southend and Castlepoint, and Rayleigh and Rochford clinical commissioning groups; Essex county council and Southend council.
The chair of the Mid and South Essex sustainability and transformation partnership, Mike Bewick, a former deputy medical director of NHS England, is an unpaid adviser to the company.
The Care Quality Commission (CQC) said that its registration team did not have a record of CareRooms and could not say whether such a registration would be required. “The CQC will contact CareRooms to better understand their business model in case they are providing something that would fall within the scope of our regulation,” a spokesman said.
The Department of Health said: “As NHS England have made very clear- this is a locally organised pilot scheme for patients following minor operations, not national policy, and to suggest it is a cheap substitute for social care is simply untrue. Any schemes such as these are subject to the strictest quality controls and regulations.”
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