Missed ‘designated setting’ targets for care homes adding pressure to UK hospitals

The Government’s plan to help relieve pressure on hospitals by designating care homes to accept Covid-19 patients has failed to meet its target, compounded by the increase of infections amongst care staff in recent weeks.

In October, the Department of Health and Social Care stated that up to 500 social care facilities would be earmarked for accepting additional Covid-19 patients by the end of November to help relieve strain on NHS hospitals during the second wave of the virus.

However, latest statistics gathered by the Care Quality Commission (CQC) show that just over a quarter of the target number of “hot home” facilities have so far been set up.

Latest figures show that as of 5 January 2021, only 2,444 care home beds from 129 approved settings had been found eligible to be used for active Covid-19 patients whilst minimising risk of initiating new outbreaks in care home settings.

The lack of designated settings has compounded pressures on hospitals already increasingly stretched as the new, more infectious variant continues to spread across the UK, with latest figures now placing over 30,000 people in hospital with the virus.

NHS Trust leaders continue to call for an emergency approach between the NHS, the UK government and care providers to reach a temporary agreement to allow Covid-19 patients who no longer need complex medical care to be rapidly discharged into care homes.

Chris Hopson, chief executive of NHS Providers said that hospitals and community services were quickly reaching full capacity and needed to utilise additional settings, but that NHS leaders recognised that “the NHS, clinically, and the government, financially, need to support the care sector.”

"The government needs to provide extra financial incentives and support for the care sector to open up any spare capacity they have on the basis that this is now becoming an emergency,” added Hopson.

“This could also mean additional funding for domiciliary care which social care colleagues tell us is key. The NHS needs to consistently provide clinical and therapy support where needed, for example by treating any beds with higher acuity discharged hospital patients as extended community beds.”

Care homes have been increasingly reluctant to accept patients from hospitals due to staff shortages, but also insurers may not cover taking on additional residents who are a potential Covid-19 risk.

One solution could be for those insurance claims to be covered by the Treasury instead.
If there is not a compromise over insurance, care leaders have warned that both the NHS and social care systems could collapse if pressures overwhelm hospital capacity.

Vic Rayner, executive director of the National Care Forum, stressed that social care providers should not be considered subsidiary to the NHS and that a collective approach was needed to ensure the best approach for patients.

“If people cannot be supported to leave hospital, whether that is by moving into a care home or having care at home, then the whole system will fail,” said Rayner.

“[The] NHS saves lives – but so does social care – and it must be properly supported to ensure that it can play its vital role in making the whole system work for communities.”