Hospital launches social care service to reduce ‘astronomical’ delayed discharges

Harrogate and District Foundation Trust is among the first NHS providers to branch out into direct social care provision, in what the trust says is a “lift and shift” from the model adopted by Northumbria Healthcare FT.

HDFT is now embarking on a six-month pilot of its new social care service. It comes as around 20 of the trust’s 300 beds are occupied by patients waiting for social care packages on a given day. 

Chief operating officer Russell Nightingale told HSJ  delayed discharges are leading to patients who could have returned home with the right support deteriorating in hospital and ending up in care homes. 

Mr Nightingale said providing care in rural areas is increasingly becoming unprofitable for private providers due to the low rates councils pay and the long distances between visits.

He said: “As an acute trust, we don’t have to make profit in the same regard. Our cost is having beds open in the winter, paying a premium to have those beds open.

“We would pay somewhere between £500 to £1000 a day to have an escalation bed open, depending on the level of nursing. It’s just astronomical.”

The service has 10 staff but could expand to 50 over the trial period. One option under consideration is taking on private paying clients as well as council-funded packages.

As well as supporting clients in the Harrogate area, it is hoping to provide services in Leeds and York.

Mr Nightingale said the NHS could offer better terms and conditions and career progression opportunities than other social care providers. The trust is recruiting care workers on band 4 of the NHS Agenda for Change pay scale.

He said: “Obviously for us as trusts, we’ve got Agenda for Change, we’ve got pension contributions, we’ve got fairly favourable annual leave allowances, but also the one thing we do have that private providers don’t have is a route to training and a route to other professions.

“We’ve gone out with a very holistic package to say, ‘come in as a band four, and here’s your route to director of nursing, here’s your route to chief operating officer. This could be you in 10, 15, 20 years’ time.’”