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NHS Airbnb
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In the news is the suggestion of the NHS paying up to £50 a night for patients to stay in local people's spare rooms in an Airbnb style approach.
There would appear to have been initial discussions between Carerooms the organisation suggesting this and some NHS hospitals.
While thinking out of the box is to be applauded, it's also necessary to eventually qualify ideas before implementing them and also to consider any unintended consequences.
There has already been a lot of reaction that this is a madcap idea but what do you think? Putting aside any initial emotional reactions is there any merit in it, or parts of it, or does it provoke thoughts of an alternative better idea?
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Given that we're told that one of the major problems within hospitals is bed-blocking, surely any initiative to try to alleviate it should be welcomed.
This particular idea does, on the face of it, does seem a little outlandish but I would be more than happy to see it given a trail run within one or two NHS Trusts to see if it works. If it does, then it could be rolled out more widely. I think that one of the big problems with the NHS is that, because it's called a 'national treasure' (whether it is in reality or not) people are sometimes reluctant to try new solutions in case it changes how the NHS grew to be what it is.
So let's give this idea a try to see how it works out. If it fails it fails but at least it will have been tested.
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Have given this a bit of extra thought. Although as said previously out of the box thinking is to be welcomed it does in my view need qualification and a look at the downsides and potential unintended consequences and any ways of addressing/alleviating these before proceeding to a trial.
Pros
On the positive side this could be a relatively quick fix for the bed blocking problem. Also it would bring into play a currently untapped people resource and facilities resource at a relatively low cost. Some people might like the idea of the company it could give rather than being by themselves in their own home.
Cons
There would seem to be a lot of difficulties to be overcome and potential downside consequences:
The basic CRB checks (or current equivalent) would seem wholly insufficient to entrust one person with the care of a stranger. There would need to be a relatively high degree of scrutiny of the potential provider, perhaps not as much as say a foster parent but more at that end of the safety spectrum.
The regulation involved would be high and costly and there would need to be an inspection and complaints regime established which would also be costly. Inspection of Care Homes is difficult enough for CQC but at least there is public visibility. Inspection of individuals would be far less cost-effective and even less transparent.
Without a high degree of checks and training before licensing individuals and premises there would be a range of human nature motivations to do the wrong thing such as:
Those offering places would have a financial incentive to keep people for as long as possible (to keep their income going) rather than return people to their homes as early as possible. At worst this could encourage negative care in order to delay the person leaving. There is also a potential danger of abuse/exploitation of an individual at a vulnerable time.
On the other side a recuperating patient could find they prefer this environment to their own and deliberately extend their stay on the basis that they hadn't recovered enough. Would the carer be able to say enough was enough?
A third scenario would be that the patient deteriorates and the carer thinks they need to go back to hospital but the NHS doesn't agree or doesn't have a place for them. What then?
Finally there could be collusion between carer and recovering patient to mutually extend the stay to the benefit of both.
There would also be Home Insurance consequences for the carer. Expectations of patient and carer might also be very different and lead to friction especially if the patient felt they were entitled as the NHS was paying. There may also be simple clash of personalities in this 1-1 situation.
Conclusion
It's fair to say that emotionally I don't like this idea. I think the overriding negative is even if it could be made to work, the cost of regulation and complaints management.
However, I believe the company proposing this should be given the opportunity to come up with ways of addressing these concerns. In particular though any cost of additional regulation, complaints management etc. should have to be borne by the company proposing this. I hope the NHS Trusts looking at this wouldn't be naïve enough to let the company take all the financial benefits without accepting the costs of regulation and any downsides, both predictable downsides and any downsides that emerged in practice.
In the medium term I think the proposals in the Care Homes and NHS sections of the Probably42 draft manifesto have more merit to provide both a quality solution and reduce costs. See http://www.probably42.net/documents/2/13/a-manifesto-of-ideas-for-society-in-the-21st-century
This post was edited by Tony Clack at October 30, 2017 3:19 PM GMT