London Rental Opportunity of the Week: Fancy Dying in a Stranger’s Home? Well...

What is it? More of a concept than a place: as announced today, the NHS is currently undergoing a trial in collaboration with a start-up called CareRooms, where patients recovering from surgery are shunted to private homes to continue their rehabilitation, with the NHS and local councils paying those private homes and the caregivers who live there up to £1,000 a month for the pleasure. The people in the homes aren't trained medical professionals, per se – I mean they are just people, normal people, and the extent of their caregiving is, according to the website, "to welcome the patient, warm three microwave meals which will be provide[d] and provide drinks for them each day. You may wish to offer conversation where appropriate." – so, uh, yeah. This is an idea that seems: somewhat flawed;
Where is it? Right now the pilot scheme is going on in Essex, with Southend Council taking the lead, but if the core idea is judged to be a success then it could feasibly unfold into the rest of the country some time in the future. One part of me imagines recovering from surgery in a private home in Essex will be some sort of heavenly one-thousand-pillows-on-a-bed-and-Gemma-Collins-cheerfully-bringing-you-milky-tea rehab-fest, while the other half just imagines being left to fester in a stranger's spare room while they occasionally bring a microwave meal to you and slosh out a shit bucket, and drive up and over you in a white Ford Escort, roaring about Brentwood. It's definitely more likely to be one of those options than the other, isn't it;
What is there to do locally? Ah, the format is starting to fray. Let's instead focus on what critics are saying about the scheme: with the pilot going on in Southend, near to where CareRooms company address is registered, the Save Southend A&E campaign group have been most vocal about the possible constraints, saying the physical outsourcing of patient recovery "opens a huge can of worms for safeguarding, governance and possible financial and emotional abuse of people at their most vulnerable time". Like: what do you want when you're recovering from major surgery – a nurse who has trained for years and brings together medical knowledge with a career in care? Or do you want three microwaved meals a day and some light conversation (where appropriate)? Like, mate, I've been sliced open here and stitched back up. I want the person looking after to me to at least know how a drip works;
Alright, how much are they asking? RIP, London Rental Opportunity of the Week format. You gave it a brave go but you collapsed to death at the end.

Reason we've mashed this into the LROTW format is the two ideas – recuperating alone in a stranger's home and paying monthly fealty to a landlord in the vague hope that they remain good-tempered enough to fix the damp problem – sort of operate within the same realm. In that: national-scale problems (housing shortage, bedblocking) are being pushed into private hands in the hope that it will just sort of, I don't know, figure itself out. In the late-90s/early-2000s the buy-to-let mortgage boom led to a generation of private landlords that now hold the vast majority of the market hostage in a way that seems irreversibly broken and mangled. So obviously you can see how I am not filled with hope that palming off a large-scale problem to untrained people who are primarily motivated by money is going to somehow and magically work second time around.

Southend Council have stressed the scheme is only at the pilot stage for now, and the Association of Directors of Adult Social Services told the Guardian they would wait for more information about the scheme before making a full assessment. I spoke via email with doctor turned comedian turned author Adam Kay about the potential of the scheme, though, and he had some… thoughts. "We're not in some Shoreditch start-up's brainstorming session; there is such a thing as a bad idea," he told me. "This is the NHS, people's lives are at stake, and this is – definitively – a fucking terrible idea. When it first appeared on my Facebook I assumed it was from one of those tiresome sub-Onion websites, but no.

"The NHS is under huge pressure and one of the major problems is undeniably a logjam of elderly inpatients unable to be discharged home safely. Note the word safely. Safely doesn't mean a 'caregiver' who's at best enthusiastic but untrained, more likely skint and borderline neglectful, and at worst physically or financially abusive. The vetting process they've come up with only means that the landlord hasn't murdered anyone (previously).

"The underlying issue here is the catastrophic cut in funding to social services in recent years, meaning provision of at-home care is desperately, dangerously low. The solution involves reversing these cuts and adequately looking after the most vulnerable members of society. This gig economy version is like treating skin cancer by putting make-up on it. Make-up that the patient is allergic to. To be honest, I can't quite believe this is a story I'm having to give a comment about."

Another burning question here is: how did a six-man start-up operation in Southend get into bed (a bed in a stranger's house, hired for £50 a day) with the NHS? The links aren't immediately clear: one of the CareRooms' co-founders and CEOs, Paul Gaudin, is an NHS Innovation adviser who also works as a mentor on the NHS Clinical Entrepreneurs programme. Co-founder Dr Harry Thirkettle told the Health Service Journal that CareRooms is "working hard to be better than standard practice", but that they hadn't ruled out patients funding the care themselves ("We may also look to take self-funding patients who pay us directly"). The Companies House records for CareRooms point to the same office and staff as an adult learning company called London Professional College, but when we called them they hadn't heard of CareRooms at all. So that's good.

I can never really tell if everything the incumbent government has done with the NHS over the past eight years of rule is some massive hide-in-plain-sight undermining of the service as a whole with a long-term view of publicly justifying its dismantling in five to ten years, at which point the whole thing will be so wobbly and unviable that nobody will even protest that much when it's scrapped, because would you, really, when it gets to a point when we're recovering in people's houses with microwaved meals for company instead of actual medical care? But then I think: no, no, that's deranged, you are a tinfoil hat maniac, stop thinking like that.

In America, the healthcare model seems designed to stop you seeking medical help at the point of entry unless you've really, really been shot. Ours is now, apparently, going the other way, classifying patient aftercare as some sort of inessential frivolity that can easily enough be covered by private carers rolling their sleeves up and dishing out some sponge baths.

Anyway, my advice for now is never ever get ill or injured ever again, ever, if you can absolutely help it, ever.

UPDATE: Southend Hospital has announced it has "no intention… to support the pilot at this time" and will not support the pilot going forward.

@joelgolby

More from VICE:

The NHS Is Paying for Drugs Twice

A Bewilderingly Long Timeline of Jeremy Hunt Screwing Up