There have been a number of very positive developments around Four Seasons recently, that are covered in more detail in the company developments and news sections of the website, but I would just like briefly to highlight some of them here as I think that together they tell a story of the sort of organisation we are.

A new study of residents in our PEARL specialised dementia care homes has confirmed a reduction, averaging 48 per cent, in the requirement for antipsychotic medication, together with dramatic reductions in usage of a range of other medications and a corresponding improvement in the wellbeing of participants. Reducing the use of antipsychotics is a national priority and in this respect Four Seasons is at the forefront of dementia care. The PEARL dementia care programme has been recognised by national awards and is now studied by healthcare providers internationally.

Our specialist care subsidiary The Huntercombe Group's Frenchay Brain Injury Rehabilitation Unit has won the Independent Specialist Care Award for excellence in the provision of brain injury rehabilitation services.

The company's innovative e-learning initiative has proved so successful that the millionth learning module has just been completed. E-learning enables employees to improve their care skills and gain qualifications by studying at their own pace and when it is convenient for them. The company's approach to learning has been ground breaking and is setting the standard for learning in the sector. Today more than 27,500 Four Seasons employees actively participate in e-learning.

Four Seasons Health Care has acquired Optimum Care, which operates 17 care homes. This is the first significant strategic addition to Four Seasons since it came under the ownership last year of Terra Firma, one of Europe's leading private equity firms. The homes have a reputation for quality and are a good geographically with our portfolio.

Dr. Pete Calveley
CEO

The widespread acknowledgement amongst policy makers and influencers of the need for a re-think of the way care is delivered is a welcome development to me, having made the case over many years for a more joined up approach to health and social care funding. If implemented it should remove some of the perverse incentives and cost shifting that currently impede seamless care pathways and joined up service and it would be more cost efficient for the public purse.

For example, I strongly support the view that people should be supported to remain in their own homes for as long as it is their wish and in their best interests, but it shouldn't become a default option simply because it is thought to be cheaper. Yes, it often is, but in many cases rather than costs being reduced they are simply being moved between different public purses. Many elderly being cared for in their own homes may typically receive anything up to four visits by carers daily. Once costs such as housing and council tax benefits and additional eligible DWP benefits such as pension credits and attendance allowance are taken into account, even a modest home care package is likely to cost the taxpayer well in excess of £500 a week. For people with higher levels of dependency a care home setting will often be a more cost efficient option and better meet the individual's care and social needs.

Moreover, when people who are being cared for in their own home become unwell they are frequently moved to hospital and remain there for some time at great cost to the NHS budget. In many such cases hospitalisation could be avoided if the person was being looked after in a care home. Larger operators have developed capabilities in specialised areas of care such as nursing for frail elderly, step-up and step-down care, dementia care and palliative care. The independent sector already has much of the expertise and capacity to deliver clinical care to selected patients at a fraction of the cost to the NHS and tax payer, (between 35%-50% less than NHS tariff rates for hospital care.) This would help to alleviate the problem of bed blocking, where between a quarter and a third of the beds in acute medical wards are occupied by people, most of them elderly, who don’t need to be there for clinical reasons.

The 75yrs and over segment of the UK population is projected to increase by over 70% to 8.22m by 2031 so the demand for services and pressure the public purse strings is only likely to get greater!