Published: 11/4/2002, Volume II2, No. 5800 Page 26

Having read your recent series of articles on intermediate care, I believe that care and nursing home providers are being given short shrift by many of your correspondents, especially Malcolm Philp (letters, 21 March).

He argues strongly for national quality standard which we in Northern Ireland's Registered Homes Confederation strongly agree with. But Mr Philp also refers to intermediate care as 'nursing homes with knobs on'.

This attitude denigrates much of the good, innovative work undertaken in care and nursing homes throughout the UK. And we would like to undertake more, to develop in a partnership a practical approach to caring for our ageing population.

However, the independent sector of nursing and care homes is not afforded the opportunity to develop solutions, as funding is not made available. Among innovative schemes we have proposed is a step-down approach to post-operative care that integrates acute care, community care and nursing homes to reduce psychological trauma and minimise risk of exposure to hospital acquired infection. While not a new idea, this could cut delayed discharges while benefiting the patient.

Aside from innovative plans, we are told that a fee is a fee is a fee, and expected to deliver enormously varied levels of care within that fee. We want to develop our staff and services.

We want to agree standards for care, training and quality. The independent sector of care and nursing homes provides thousands of bed spaces. If the appropriate level of funding is not available, and our ideas and proposals are ignored, there will be a cost to the NHS - which it cannot afford.

Rosemary Armstrongg Vice-chair Registered Homes Confederation Northern Ireland