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Barbara: Hospital to Residential Home


Before hospitalisation

Barbara is 94 years old. In the 6 months before the hospital admission that brought her into the study, she was living alone in her own house, looked after by a family carer.

Barbara needed help with activities of daily living and supervision to ensure that she took her 4 medications correctly. Meals were delivered every day by meals on wheels, which Barbara paid for herself.

During the 6 months before admission to hospital Barbara received 2 visits from a Mental Health Nurse, 2 visits from the District Nurse and 2 visits from her GP.

Cost of care (over 6 months):

Continence pads, 21 @ 30p/pad for 26 weeks £163.80
Medications @ £48.80 / month for 6 months £292.80
2 x hospital appointments @ £152/visit £304
2 x Mental Health Nurse visits @ £56/visit £112
2 x District Nurse visits @ £27/visit £54
Meals on Wheels, paid for by Barbara £520.20
Total: £1446.80

Hospital admission

Barbara was admitted to hospital in January, with a suspected stroke. She stayed in hospital for a total of 47 days.

The rates paid to the NHS for a hospital stay is agreed with the Department of Health (DoH) in national tariffs. The tariff is the rate payable and the number of days required for treatment of every condition. If a patient stays longer in hospital than allowed within the tariff, the reimbursement from the DoH to the hospital per day is reduced. In this case, Barbara should have needed 7 days in hospital, but actually stayed for 47. 40 days were charged as NHS excess bed days - i.e. excess to the number of days required by her medical condition, see National Tariff.

Cost of Care:

7 days @ £346 £2,422
40 days @ £255 £10,200
Total: £12,622

After leaving hospital (first six months)

After 47 days Barbara was discharged to a Care Home. The fees were £493 per week, of which Barbara and her daughter, aged 73, agreed to pay a top up of £117 each week.

During the first six months in the Care Home, Barbara was precribed medication to treat depression.


Cost of Care:

Continence pads, 28 @ 30p/pad for 26 weeks £218.40
Medications@ £48.80/ month for 1 months then£26.80 for 5 months £182.80
2 x hospital appointments @ £152 £304
Care home fee (funded), 26 weeks @ £276 £10,218
Podiatry x 3 @ £28/ treatment £84.00


After leaving hospital (six-twelve months)

Twelve months after leaving hospital, Barbara lived in the same Care Home. She was taking another new medication, an anti-psychotic.

She had spent one night in hospital and received 3 visits from the GP.

Cost of Care:

Continence pads, 35 @ 30p/pad for 26 weeks £273.00
Medications @ £29.80/ month for 6 months £178.80
1 x Hospital admission (1 night) @ £346 £346
3 x GP visits @ £120/visit £360
Care Home fee (funded), 26 weeks @ £276 £10,218
Total: £11,375.80