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Value for money: how can NHS resources work harder when everyone tightens their belt?



Curo's Director of Health, Care & Support, Harriet Bosnell, continues her three-part blog examining the positive impact housing and support organisations like Curo can have on the NHS. In part two Harriet asks: 'how can NHS resources work harder when everyone tightens their belt?'

NHS resources are currently packed into acute settings and fixed into costly hospital beds. In the course of a year, according to the Joseph Rowntree Trust, 29% of bed spaces are occupied by patients whose needs could be better met in a community non-hospital setting.  Curo’s own experience and evidence is that on any one day, our largest local hospital had an average of 16 patients in a bed space who didn’t need it but who had a social need and got stuck in an expensive hospital venue because they couldn’t return home.

 "...these cost less than a third of the price of a hospital bed and save the NHS around £100,000 every 10 weeks"

There are more cost-effective solutions than funding unnecessary hospital beds.  For instance, Curo’s six ‘step-down from hospital’ units are always full; patients much prefer the hotel-like ambience and privacy of an apartment with telecare where their family can stay and they can recover and sleep well. These cost less than a third of the price of a hospital bed and save the NHS around £100,000 every 10 weeks.

Resources spent on these beds, and on acute services, need to be released to spend on demand reduction; outcome-focussed, personalised services delivered by the voluntary and housing association sector.  Value for money is key, so services need to be clustered and coordinated. These will preferably be services delivered in partnership with GPs and others, sited in GP hubs and commissioned for periods of five years. Short term resource release and commissioning annually is no way to run a sustainable cost-effective NHS or community system, or for that matter any model that actively cares about the people it serves.

Clinical Commissioning Groups and hospital leaders will achieve their vision if they are genuinely able to broaden their horizons and embrace the third sector offer. At the moment we are frequently treated with the suspicion reserved for the private sector enemy, rather than the positive embrace of a potential solution-driven partner motivated to deliver excellent customer service. 

The NHS has protected its resources from the outside world by fixing them into hospital beds and this has proven to be an unsustainable solution. By sharing resources and trusting the expertise of others who have proven track records, patient-centred results can be achieved at less than half the cost based on our experience.

Follow Harriet on Twitter @HBosnellCuro. Read part one of Harriet's blog here.

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