John Burn-Murdoch writes that the crises in the NHS are “not caused by a staff shortage, they’re caused by a bed shortage” (“A lack of beds is trapping the NHS in a perma-winter”, Opinion, December 16 ).
One way to ease this crisis is to increase the rate of discharge of patients from hospital into the care system. However local authorities, who are the main source of funding for care home clients and thus have significant market power, pay below the cost of care and with delayed payments have created a vicious cycle of financially unviable, poor care resulting in increased hospital bed blocking.
It is their statutory duty to pay the right fee for care in line with the Care Act. Failure to do so is having a significant impact on the financial viability of care providers who play an important role in reducing bed blocking in hospitals.
As you report (“Multiple maladies leave NHS in critical condition”, January 4) “12,000 to 13,000 patients, representing 10 to 12 per cent of NHS bed space, are medically ready to leave hospital but have to remain there because there is nowhere else for them to go”. In the past year in social care, another 20,000 beds have been lost as a result of a 400 per cent increase in company insolvencies in the sector.
Meanwhile, the full company costs for four hours’ care per day provided by a carer is £60 — or £80 for a nurse.
Annual index-linked fee increases are not sufficient and must reflect real wage inflation and other costs including capex where VAT is not allowed to be claimed by providers.
It is important for providers to have a 10 per cent cash surplus to reinvest in their properties and staff, to maintain viability. Not paying the right fees creates a vicious cycle, reducing capacity in social care, increasing hospital bed blocking and reducing productivity due to delayed healthcare delivery to the working age population.
Dr Sanjeev Kanoria
Chairman, Co-Founder and Group Chief Executive, Advinia Health Care