OUR PRELIMINARY RESEARCH
Here is more detail about the preliminary research Hotels for Hospitals have begun to undertake.
ESTABLISHING WHO OUR CLIENT WOULD BE
It seemed obvious at the time that we would not be taking in patients who were in immediate danger or at risk. However, there is clearly a range of different types of patient guests that could be in need, all dependent on the strategy of the NHS and the depth and breadth of the crisis.
As hotels are not experts in clinical care, an example of a typical patient guest could be hospital patients who are out of danger but recovering, unable to return home but clearly at risk. Their ability to leave hospital into a Hotel For Hospital bed would have an immediate effect on freeing beds in hospitals.
An alternative idea would be for the authorities to move people along a chain so moving the elderly out of care homes into the a Hotel For Hospital bed and then for the NHS to take over the well-equipped care homes as emergency hospital space. This could, however, potentially be disruptive for those care home residents who have to be moved.
There are other groups who could benefit from a Hotel For Hospital set up including medical staff who need to isolate from their families. However, housing the two in the same buildings would not be a sensible course of action as it would potentially be open to fatal errors.
THE NEED FOR HOTELS TO BE KEPT FREE OF INFECTION
Taking in patients from hospitals clearly presents some risks of bringing infection into the hotel, so patient guests should be certified free of infection prior to arrival so as not to introduce the virus into an already very vulnerable group.
We think it would also be sensible to additionally treat new guests as if they were infectious and have an isolation period within the hotel, followed by a follow up blood test, prior to easing their living constraints.
Ideally we would want to restrict access only to hotel staff and clinical care, all with PPE. Better still if some staff could reside on site after isolating themselves.
MEDICAL SUPPORT FOR THE HOTELS
Hotels are not hospitals. Whatever we might be able to achieve in providing food and bed spaces, we are not clinicians. Consequently, we would require some degree of medical support depending on the condition of the patient. What form would this take? A doctor and nurse assigned to us at the end of a phone would, in our opinion, be a minimum. But perhaps a weekly inspection would be better and safer for everyone concerned.
If the general situation worsened significantly, further assistance from medical staff could be needed. However, that could either be assessed as it happens or preparations put in place in advance. Questions that might arise include: If the occupancy had to be increased in a hurry, what is the safe distancing of beds? How many people could we take at a push? Can bathrooms be shared? Would we turn dining rooms into dormitories?
DEALING WITH AN INFECTION IN THE HOTEL
What should we do if a guest was diagnosed with Covid19 or the virus took hold in one of the hotels?
WHAT FOOD SHOULD BE PROVIDED?
Hotels are already very familiar with cooking different meals for different tastes and coping with allergies etc. However, the diet of a patient is probably going to be very different to that of a guest. We would need guidance.
At the start of this preliminary research some supermarkets were virtually empty and sourcing food felt like an issue. Ultimately this wasn’t the case. If it did become an issue in the future, would the NHS have preferred status with certain suppliers and would we be able to access it?
WHAT PPE SHOULD BE AVAILABLE?
Wearing PPE would be necessary and so we would need to learn from the NHS about PPE practices and potentially secure PPE supplies from them too.
COMMUNICATIONS BETWEEN PATIENT GUESTS AND THEIR FAMILIES
Procedures would need to be put in place to isolate the patient guests from outside visitors. Therefore, firm guidelines would need to be agreed for the guests to be able to communicate with their family.
HOW WOULD THE HOTELS BE PAID?
The objective is for Hotels for Hospitals to save lives and save the tourism business not for participating hotels to make a profit. The Forum worked out how much they would need to charge for accommodation and food. The latter being based on menus we managed to track down from care homes and friends who had worked in hospital kitchens. This amount was calculated purely at a “survival rate” for the hotel. It would also remove the need for government hand-outs and grants to the hotels to keep them in business.
In effect the charge would be the minimum hotels would need to stay open to the NHS, be able to pay staff, utilities, rates and look after the patient guests. We also worked out a minimum occupancy level. The occupancy level is the minimum amount of rooms that would need to be occupied, at that charge, for the operation to be viable and self-sustaining. The information was collated, an average taken and that figure agreed by the Forum. Importantly, one single charge has been agreed by all participating hotels so that hotels would not be competing with each other. The actual charge we agreed was substantially below care home rates.
We also agreed to ask if all the hotels participating could be filled to their minimum occupancy levels first, rather than filling one hotel completely then another. This was again to ensure co-operation from the group and fulfil the dual objectives of saving lives and saving the industry and not just saving only one or two hotels.
We also felt that spreading guests across a range of places would be beneficial to the NHS as it would reduce the risk of a mass infection.
Hotels have insurance policies against a number of potential threats, however, they are not likely to insured for the scope of Hotels for Hospitals. We would therefore need either a waiver from the NHS for anything that our existing policies might not cover or which we would breach by becoming carers. Or alternatively, we would expect the NHS to make up any financial shortfall if our existing insurers agreed to a change of use.
WHAT RECORD KEEPING WOULD BE REQUIRED?
It is important to know if there would be any processes or records that the NHS needed hotels to keep. These could be anything from cleaning records to records of admittances and discharges, specifics of care, dietary requirements and emergency contact information
It would also be important to work through a ‘what if’ analysis. Scenarios such as a patient wanting to discharge themselves need to be planned for.
WHAT HAPPENS IF THERE ARE CONVERSION COSTS?
There could be some upfront expenditure to ensure that a hotel is fit for purpose. This could be agreed as the result of a simple pre-launch inspection. It might equally be the case that there are damages incurred as a direct result of the change in use. It should be agreed at the outset if these costs are recoverable and how expenditure should it be documented. An alternative would be for the hotelier to be responsible and therefore there should an adjustment made to the daily rate to cover this eventuality.
We felt the latter would be less complicated in the long run as no burden of proof would be required and there would be no issues around payment.
Central to the successful working of Hotels for Hospitals would be the staff’s part in caring for the patient guests. Their willing participation would be vital to make this initiative work and so we would need to be clear with the staff on a number of fronts.
It would be entirely wrong if we tried to force our staff to work in an environment where they feel they might be at risk, especially when this isn’t the profession they signed up for. Staff should not be obliged to work.
In addition, there would be an imperative on the hotel’s management to ensure that the working conditions are as safe as possible, including PPE.
Full consideration would also need to be given to where and who staff live with, just as there would be with staff in care homes and hospitals. If staff members live outside the hotel then temperature checks would probably have to be taken at entry into the buildings.
Lastly, staff who were above a certain age or vulnerable would not be permitted to work.
And so concludes the preliminary summary. These preliminaries are by no means exhaustive and as Hotels for Hospitals progresses more issues be identified and solutions found.
For more information on Hotels for Hospitals please do contact us.