HSJ’s round up of the day’s must read stories and debate

Improvement on the cheap?

Trust leaders with a mind on expansion may not be thanking Sir David Dalton after the CQC found significant improvements have been made at Pennine Acute Hospitals Trust.

The troubled provider, which was effectively taken over by the leadership of Salford Royal FT in 2016, has been upgraded from “inadequate” to “requires improvement” by the regulator.

But the improvement has been made despite the trusts receiving just a “fraction” of the support funding secured for similar takeovers in London and Surrey a few years back.

Earlier this week HSJ reported how NHS Improvement has been lobbying for more funding to be made available for trust mergers and takeovers, which echoes previous calls from Sir David himself.

So, let’s hope the Pennine/Salford success doesn’t leave Treasury officials questioning the need for greater largesse when it comes to sorting out troubled neighbours. They might just feel they can replicate Sir David’s “group” model on the cheap instead.

CareBnB returns

The company developing a controversial “Airbnb for social care” model allowing homeowners to rent spare rooms to recuperating hospital patients  is bidding to launch a new trial in Cambridge, HSJ has revealed.

We also have an exclusive comment piece by the former bagel mogul turned health tech entrepreneur on why he set up CareRooms.

Private startup CareRooms was forced to abort its first pilot, also exclusively revealed by HSJ, with the NHS in Essex in November, after patient groups and social care directors raised safeguarding concerns about care being provided by non-care professionals.

So this time it’s opted to work with local government. It is now establishing a “working group” with Cambridgeshire County Council and has begun advertising for “host” households in the county.

The CareRooms model will most likely live or die on whether it can create a robust enough safeguarding and governance model and - equally importantly - convince its critics that it is indeed as safe as the company claims it is.

The horror story of course would be the death of a frail, older person (or anyone for that matter) left languishing and neglected in the spare room of a chancer with no care experience seduced by the prospect of a nice little earner.

The company insists its vetting and safeguarding systems, 24/7 biometric monitoring, and a range of CQC-regulated services would prevent that.

The experience in other countries with similar schemes, such as Japan (which has a significantly different culture and demographic profile), suggests the “CareBnB” model should not be dismissed without debate.

HSJ would urge that the Care Quality Commission’s role regarding such new models of care is a core part of this discussion.

CareRooms says it won’t be regulated by the CQC because neither the company nor the hosts are providing care (they are effectively a bed and meals service). However, any care provision within the rooms will be carried by CQC-regulated services.

Is that good enough? The CQC certainly does not have the resource to inspect a plethora of spare rooms.

But the idea that such a service could be launched without the CQC oversight feels intuitively wrong.

With patient safety such a crucial issue, the “independent regulator of all health and social care services in England” must play a central role.