Northamptonshire’s hospital trust may start caring for people at home

Chief executive of the county’s hospital trust Simon Weldon has proposed the radical solution after this winter’s Covid crisis has further exposed the huge issues in the care sector

Care workers could be taken on by the NHS hospitals in Northamptonshire in a revolutionary move to try and sort out the broken system which is leaving patients stranded in hospital beds due to a lack of domiciliary home care.

Group chief executive of Northampton and Kettering General Hospitals Simon Weldon put forward the idea as a serious suggestion at the Kettering Board meeting, saying that the organisation needed to decide ‘whether we get on the pitch on some of these problems’.

Currently domiciliary care comes under the remit of adult social services, which is provided by the local unitary councils. The authorities largely contract out domiciliary care to smaller providers, but poor pay and working conditions within the sector means the job is unattractive for many and large numbers of vacancies are going unfilled.

This is having an impact on the wider health care system in Northants as hospital beds are being blocked by well patients who are unable to go back home as there is not an available carer to look after them. This in turn has an impact on how long patients have to wait in accident and emergency and how many patients can be treated by the county’s hospitals.

Simon Weldon suggested that taking on domiciliary care workers within the NHS may be a more attractive offer to carers. The radical move has already been adopted by a healthcare trust in Northumberland.

Giving a speech about the lessons learned from the most recent omicron wave, which saw a major incident declared across Northants, the chief executive said it was clear that there was not enough capacity across the county’s healthcare system and also that there were big workforce problems.

Hospital trust chief executive Simon Weldon

He said:

“What Covid has revealed is that we are simply short of too many people in too many critical service areas across health and care. I was talking to one of our directors of social services recently and he said ‘look we contract with 80 providers of domiciliary care and on one street there may be up to five different providers working with patients.’

“There is virtually no other setting of care that would operate with such a fragmented model to try and provide what is sometimes the difference between someone being in hospital and someone being able to safely go home.

We also know now that not only do we have a very fragmented model of contacting for those types of services, we are simply unable to recruit to them.

That recruitment problem is not going to change - it is not going to go away.

“I think we now need to decide, and I’m opening a conversation here, whether we get on the pitch on some of those problems or if we stay on the side.

And if we get onto that pitch how do we get into that pitch?”

He went on to say that an NHS career was an attractive proposition for many.

“People still want to join the NHS and I think we are now going to have to look for some of those innovative solutions where we maybe attract the staff, we don’t own the bricks and mortar but we work together with other partners to provide services. Because carrying on like we are is a route to another winter like the one we have just faced.”

He continued:

“Do we stay as solely a provider of acute services? I am not sure that is a viable or indeed helpful thing for us to do anymore. I think we are going to have to think more laterally in terms of some of these models of care.

“It is not just that people want to join the NHS they want to be part of something that is integrated. If we think about the way in which people who are working at the front line, in particular some of the care settings, they are in small bespoke providers, often with not great tc and cs (terms and conditions) and I think we need to do something about that too.

“What’s keeping me awake at night is not whether we will get through this wave, it’s more what’s waiting for us eight months down the line in winter if we don’t take action now.”

As part of the Government’s long term health plan all areas of the country are now forming Integrated Care Systems (ICS), which will become established later this summer. Chief executive of the Northamptonshire Clinical Commissioning Group Toby Sanders has been appointed the chair. 

Simon Weldon said the new ICS was a good opportunity to get organisations working together to solve the urgent social care issue.

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We’ve been reporting on the care worker shortage and the plight of the workers for many months. Read this report from January

‘Every time you think it's getting better it gets worse again’

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