Headline news this week picked up an initiative in Essex
which adapts the popular Air BnB model – where people essentially utilise part
of their accommodation – to offer an alternative to remaining in hospital. The
suggestion that hospitals might transfer people into the spare room of a local
resident to meet the short term care needs of individuals has been floated via
a trial offering of a service dubbed by the media as ‘Care
BnB’. The trial was offered by a company
called Care Rooms.
In the wake of negative backlash there is a suggestion that
the rise of Care BnB as a viable alternative in Essex may have been shortlived.
I think that what it represents – a critical need to look and think differently
about how discharge is managed, will not and indeed – should not – go away.
From within the care sector there have rightly been vociferous
objections to this approach, with a particular emphasis on how the care in
those settings would be regulated. Although as ever with these stories – the
devil will be in the detail – and there is a clear talk of partnership with
regulated partners. Of course, these and other challenges raise serious
questions for those who are trying to look for an imaginative solution to a major
and escalating problem. However, we know that there are more ‘innovative’
solutions out there, but clearly the wholescale adoption of them has floundered
and needs a fresh look; potentially a fresh feel.
Getting people out of acute settings into a ‘step down’
setting is not new and there are some
excellent examples of this around the country. For example, the work that is
going on through Somerset Care and their partnership with Yeovil District Hospital.
For a great opportunity to see this in action you can watch here.
Outside of residential care provision, there have been some
innovative models developed to look at how sheltered housing can be used to
support people who are ready to leave hospital, but unable yet to manage within
their own homes. For example, work in this sphere has been carried out by
Hanover Housing. Or indeed the development of onsite wards managed by housing
providers, such as the Cedarwood ward, developed by Midland Heart and located
within the Heart of England Trust.
Indeed, the whole idea of supporting people within a home
outside of the family is very much in operation through the notion of Shared
Lives Plus schemes. There is a growing emphasis on supporting older people
as well as the more traditional application of the model to support people with
And let’s look outside of the UK for other alternatives. I
recently visited a number of Care Hotels in the Netherlands, where there is a
clear focus on rapid discharge to Care Hotel settings, enabling people to
embark on a rapid rehabilitation pathway to get people home. We are bringing
highlights of these models to the care sector at the end of November in an open
session on how it could operate in the UK – so please do contact me if you
would like more details.
So whilst the notion of Care BnB as a solution to addressing
hospital discharge may not be broadly welcomed, I do welcome the focus on the
need for a fresh new model. I was taken by one of the responses on twitter
which very loudly advocated – ‘invest the money in social care’ – and I
wholeheartedly agree, but into what in social care is part of the question. We
have a growing older population, a housing strategy that does little to
prioritise older peoples provision, limited numbers of accessible properties
and an ongoing shift towards a predominance of renting over home ownership. All
of this means that however much we tighten up our integrated health, housing and
social care connections, the number who need somewhere to ‘check in’ after they
have checked out of hospital is only going to grow. Whilst Care BnB is unlikely
to be the answer, a scalable resolution which has social care providers in
partnership should not be far from grasp.