Only 9 per cent of organisations include eldercare support in their reward packages, but lessening the strain for staff with caring responsibilities is increasingly crucial, writes NHS adviser Paul Gaudin
State-funded care for older people is being rationed, with councils cutting support by a quarter in recent years, according to a report from The King's Fund and Nuffield Trust. This means that responsibility for caring – and for funding expensive care home places – is falling on the squeezed middle employees; the 30 and 40-somethings who are already likely to be looking after children of their own and holding down middle and senior-level roles. Employees who have to give up work to become full-time carers costs UK employers £1.3bn a year, according to the Carers Trust.
The cuts in eldercare have to be put into context. The NHS system is broken, and the problems start with what does, or doesn’t, happen in terms of care at home. For example, between 2003 and 2012 there was a 100 per cent increase in unnecessary hospital admissions owing to urinary tract infections. This can so easily be reduced by monitoring fluid intake at home.
Another obvious but overlooked example is a hearing test (available free on the high street), which, by identifying hearing loss, can help to prevent depression, dementia and even falls that often lead to hip replacements, long-term disability and a general decline in health.
Avoidable emergencies cause a backlog of ambulances at hospitals that, because of a lack of beds, can’t admit patients into A&E. This results in the ambulance service fining the hospital £200 for waits of more than 30 minutes, and £1,000 for waits of more than 60 minutes. The hospital is then penalised again for not being able to discharge patients. The total number of delayed discharge days in 2015-16 was 42.7 million, resulting in hundreds of millions of pounds of wasted budgets.
There are practical ways that employers can help the ‘squeezed middle’ who are increasingly faced with the challenge of suddenly becoming carers, paired with a bewildering world of worry and frustration in trying to understand how it’s possible to work with such a disconnected model. For many, the answer is to rush to organise a place at a residential care home, which, given the cuts, now costs an average of £30,000 a year. Despite the severity of the issues and potential impact on employees, there is a hole in terms of benefits offerings. Research from think tank IPPR has found that only 9 per cent of employers offer anything around eldercare in their rewards packages.
There’s also a need for specialist financial support and advice on planning – advice that is personal, specific and face-to-face. One basic option is to offer subsidised health insurance for older family members, although this type of insurance can be prohibitively expensive. Telehealth – providing video access to healthcare professionals and health data – is being seen by employers as one way of cutting absence and the time taken by employees over hospital and other routine appointments. But it’s also a useful time-saving approach for staff who don’t have time to sit in traffic and waiting rooms. Employers can help simply by promoting the option, and providing the required IT, as well as a ‘telehealth space’ for private conversations.
Start-up Tutella supports the creation of wider support networks through its free app, which helps to create a private social network that is the basis for rallying and organising family and neighbourly support – who’s going to do what when; how can we help each other? – as well as linking its members with professional advice and knowledge when it’s needed. People in these networks can then access a professional 24/7 video GP support service via their digital devices, as well as expert advice on property and funding, finances, legal issues and patient support. There are other simple apps out there that help employees with caring responsibilities to cope more easily with the demands on their time, such as disease management app my mhealth.
With caring responsibilities of the working-age population only set to grow, and employees’ wellbeing and productivity in the balance, isn’t it time for ‘responsible’ organisations to do more to support staff who are struggling?
Paul Gaudin is an adviser to the NHS on clinical innovation and a mentor on the NHS Clinical Entrepreneurs Programme