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A leading acute trust could become a direct provider of care homes in an effort to meet “unmet demand” for social care and free up hospital beds.

Northumbria Healthcare Foundation Trust has outlined plans to offer its own domiciliary care service and is also considering setting up care homes in what is expected to be a UK first.

The North East trust, which had operated some social care services for Northumberland County Council until this partnership was terminated in September, expects to begin its own home care offer within the next three months. Northumbria Healthcare’s direct care home provision could begin later this year.

Sir Jim Mackey, chief executive of the trust, said there is “unmet demand in our communities” for social care, and that the trust wanted to support the regional care sector and also “to allow the region’s hospitals to cope with demand from new patients coming in”.

Recruitment has begun for the first 25 of the 250 staff which could be employed by the new care service, the trust added.

‘Leave or face the law’

Clinicians have been reminded that legal action is an option against patients who refuse to leave hospital beds when step-down care is made available.

NHS England guidance sent to trusts late last year said that where people “with mental capacity” refuse to vacate a bed because they do not accept NHS-funded short-term care offers, the “local discharge choice policy” should be followed, which could involve invoking the law.

The guidance said the process “may include seeking an order for possession of the hospital bed” under civil law, and that “appropriate formal notification of the process must be given to the person and their representatives/carers”.

These legal powers were open to trusts before covid, but the memo from NHSE comes amid increasing pressure on trusts to improve discharge rates, as waits for emergency and elective care continue to soar. Last week, HSJ reported that trusts are failing to hit an NHSE target to reduce delayed discharges.

Also on today

NHS England orders a health-check blitz to stop the mortality gap growing, and the HSJ week is not compete without hearing from our satirical columnist Julian Patterson.