Hospital at home service facing funding cuts, despite its huge success
A ground-breaking ‘hospital at home’ service for vulnerable patients is enjoying huge success across Manchester and Trafford – but funding is to be cut by £600,000.
Trafford’s health scrutiny committee was told the current £4.2m funding for the service for Manchester Foundation Trust, which covers both boroughs, will be reduced to £3.6m from April 1.
Councillors were discussing the best ways to protest over the cut, with one, Coun Simon Lepori, suggesting they should write to the Greater Manchester Integrated Care Board (GMICB), which controls the allocation of funding.
He said: “We should write to GMICB and say ‘we’re Trafford. You’re underfunding us. You’re selling us short. Make sure we’re not going to miss out on the next year or two when funding is going to be tight, and give us what we need.”
Trafford councillors are concerned that funding decisions are continually based on levels of deprivation. Trafford is one of the boroughs with less deprivation than others in the city region.
But Coun Ben Hartley suggested that it should pointed out to health bosses that there still high levels of deprivation in ‘perceived’ well-off areas, such as Altrincham and west.
“They are among the most 10 per cent of deprived areas,” he said.
Trafford’s executive member for health and independent lives Coun Jane Slater said that she was continuously asking for funding for Trafford from Greater Manchester.
“We seem to be the Cinderella of the 10 boroughs and I don’t think that it’s right. It shouldn’t be about deprivation alone even though we have areas that are deprived.
“We have two and three million pound houses in Trafford, but that shouldn’t skew things at all. And I just think that as long as any of us are at Greater Manchester, we should always be saying that we have older residents in Trafford.
“Our population is aging and it’s frail for longer and we need that investment here. I think that some of the stuff that GM is doing around live well – I think this fits quite nicely with that. Whenever we speak to people at GM we need to say ‘we are Cinderella and we do need something extra here’.”
The councillors were speaking after the director of performance and operations at the Manchester Local Care Organisation Mark Edwards had explained how ‘virtual wards’ had been created as a way of supporting patients at home remotely, using video calls, telephone calls and monitoring them in their own homes.
It developed into a ‘hospitals at home’ service which has been delivered to a total of 5,000 patients across Manchester and Trafford during the last 18 months.
The services are run under the supervision consultants based at wythenshawe-hospital>Wythenshawe Hospital, Manchester Royal Infirmary and Trafford General.
Currently, the hospital at home covers 120 beds in the community, but the aim is to increase this to 170. However, the funding cut and the difficulty in recruiting and retaining advanced nurse practitioners may prevent this.
Patients are dependent on advanced nurses, therapists and district nurses.
They are supported in their own home for a maximum of 14 days after which they will then get care from district nurses, therapists, the social care network, or may return to hospital if needed.
Mr Ewards said: “The feedback we get around the care delivered is exceptional. It’s some of the best I’ve ever seen from services provided in health.
“It’s in excess of 98 to 99pc of compliments associated with every episode of care that that we’ve delivered via hospital at home, which is just great.”
He said that patients outside hospital benefit from not getting ‘hospital acquired infections’ and are less susceptible to falls because they can navigate around their own furniture more easily.
Crucially, it’s 50 per cent cheaper to care for the NHS to care for someone in their own home than in hospital.
After hearing his presentation, Coun George Devlin said: “It seems to defy logic to take money out of a successful project.”
And he asked Mr Edwards and deputy place lead for health and integration in Trafford Gareth James if there was anything the committee could do to support them in demonstrating the case for more funding rather than less.
Mr Edwards responded by saying: “I would really welcome that support. I find it hard to understand, when we’re delivering something that patients love and feels like the right thing to do and is in line with national commissioning intentions, that we reduce this budget at all.
“However, I’m not sitting as the arbiter of having to make very difficult decisions across a whole swath of NHS services.”
Vic chair of the committee Coun Sophie Taylor added: “It is disappointing to hear that such an excellent, well-received service has resulted in so many benefits is having its funding threatened. £600,000 is not an insubstantial figure.”
Coun Judith Lloyd added: “It sounds a fantastic service and if there’s any way we can help I think we should because it is far better for patients to be at home than in a hospital.”
The committee resolved to liaise with Mr James over the best way to protest about the funding – either at Trafford Locality Board level or to GMICB.