To post here for traffic? Nurse business set up

[Bubblespip]

I’m shamelessly (sort of) posting here due to traffic and I’d love as many opinions on this as possible.

I’m a qualified nurse with over ten years experience, plus additional training in end of life, chronic conditions and neurological conditions (strokes,MS etc)

In recent years I’ve become very disheartened with the role and find that I don’t ever feel like I do enough for patients in my care. I’ve spent a lot of my working life feeling incredibly guilty that I simply can’t be the nurse I want to be. This isn’t going to change within the NHS or even private sector, because it’ll always be not enough nurses and too many patients.

I have been working on a business idea for a long time now and have had some very positive feedback. But I’d like the opinions of a broader range of people if possible.

Basically, my business plan is to provide a single point of contact (me) to act as an advocate, support and caring role for those with chronic conditions, recovery from critical illness or those who will be undergoing treatment/surgery in future.

The health/social care services are confusing to the majority of people and with services stretched to capacity, it’s difficult to access the right (and best care). So that’s where I come in. I assess the individual on a holistic level and then bring in the relevant services for them. I also provide care and respite for family carers etc. I would assist with an individuals every day life as much or as little as required. So I’d have a small caseload at anyone time, with the possibility for expansion.

I would also provide knowledge and support through appointments (eg consultant appointments) that are generally very time limited. To ensure that as much info is gained in each appointment. So many people I know will leave appointments more confused than when they entered.

I’d also offer wound dressing and monitoring of chronic illnesses.

Telephone contact would also be available in office hours (except for terminal patients who would have 24/7 contact) for a small monthly fee.

I am looking to charge £12-£15 ph then £50pm for constant telephone support. So in comparison to agency caters/nurses it’s actuallt a very cheap service.

My whole idea is that you have contact with one nurse, continuity of care, advocacy and a supportive and trusting relationship can be built.

What are your thoughts? Itd just be my ideal role as I want to care...which is forgotten when you have 30+ patients all relying on one nurse

Firstly, if you know someone wiuld come under the remit of SS, would you honestly refer them on, rather than take their money?

Likewise any other services you provide?

Are you going to employ someone? How are you going to give 24/7 care? I've worked in Elderly Care, you will be getting non urgent phone calls throughout the 24 hours.

I just wonder how fulfilled you'll be from this role, tbh. I say that having been an advocate.

I think this is a good idea if its based on service gaps you've identified but I'd want to know how your practice is quality assured.

I should add that I was a CP SW and you are proposing being a SW, Advocate, Counsellor and Nurse all in one.

Which is going to be exhausting. It will also mean increasing your knowledge base and keeping up to date with everything.

Who will you be generally accountable to, who will you off load to, what will you do to destress?

Just have everything covered in your plan.

I've seen good SWs and Nurses go into burn out.

This is a lot of work for one person. It would get overwhelming very fast. Would you be employing a team?

Also 12-15ph is approximately band 5 rate? For what you're planning on doing, I think you'd need to look at a 6 or 7 rate.

Do you have management experience? You're proposing providing a service, and you'll also need to take care of the "business" side of that, managing legality, safety, insurance, CQC registration, ongoing learning and development etc., as well as day to day planning.

I think something like this requires a small team of nurses and HCAs and someone (you?) to delegate and plan, which means you have to employ them, which means you need to charge more.

One person would not be able to manage all of this without burning out very quickly.

I think you are vastly under pricing your qualifications and experience. £12-15 per hour would engage a cleaner or a gardener maybe a handyman round here.

Having worked in community nursing based roles, this sounds a great idea. However I feel it would be a huge task for one person - just the admin CQQ, Safeguarding, mandatory training (CPR, Equality and Diversity, Fire , Health and safety, Infection control, CoSHH) Nursing CPD and revalidation would take a tremendous amount of your time and money before you even get to caring for patients. And you would have costs of landline, mobile, internet, car & fuel, and professional indemnity insurance.
It is a fantastic idea, and I think advocacy , end of life care and care navigation would be very satisfying but I think the admin and costs would outweigh the monetary rewards and job satisfaction .

I would be registered with the CQC so would have to be up to standard, carry out the relevant assessments and keep up to date with essential paperwork.

I would not take payment from someone if they are happy to be under NHS care/social care etc. I would literally only be there to guide them in the right direction, provide support and some continuity of care. I would be a ‘single point of access’ if someone may otherwise be overwhelmed with chasing up referrals etc.

I would begin on my own with a small caseload of 3-5 clients. I’m currently not working as I have a young child, so other than being mum, this would be my sole focus. I am also a qualified bookkeeper so understand the ‘business’ side of things and keeping on top of that. If it takes off and I have enough interest, then I would look to bring more nurses on board, most likely them being self employed also. This would then enable cover for holidays if required, although majority care would go through one nurse only.

I’ve been on the ‘other side’ of things as a patient. Requiring daily visits for wound dressings from community nurses. Even as a qualified person, I became very overwhelmed by differences of opinion/views and how much energy you need to chase everything up. If a nurse doesn’t turn up, then you’re left trying to speak to multiple people until a nurse is finally contacted.

My pricing may be under what it could be, but I’m there to be a good nurse, not just make money. I don’t want to take advantage of vulnerable individuals.

I don’t see who would be your client base.
My husband was terminal and under the care of the hospice and they provided much of what you would be offering for free. I had one number to ring, explain problem ie 3 o’clock in the morning and his catheter was blocked and he was in agony or he was being sick and couldn’t keep down his pain meds and they would take over and get the nurse or doctor to me. Ok it was not the same person all the time as long as I got what my husband needed I didn’t care.
I am sure not everyone can say the the same but his end of life care was excellent, no time restraints on his appointments in fact one took over an hour and a half and the doctor still walked us out to reception and arranged for someone to bring coffee so we could digest all the info given before leaving.

Maybe you are just working in the wrong environment. Have you worked as hospice nurse? As if you just want to care then maybe that would be a way forward. I am sure their case load is not small but I found each and everyone one of them to be so caring and committed to their patients and even the family as a whole.

How would you manage if you are providing end of life care to someone or respite and your phone is constantly going because you provide 24/7 support? I’m struggling to see how that would work?

My Mum has a number of complex problems and she has manage hospital appointments. I’m not sure how you would cope if you say had 3 patients as surely hospital appointments would clash.

but I’m there to be a good nurse, not just make money. I don’t want to take advantage of vulnerable individuals.

But you'll need to fund your business, potentially employ others, and survive on what's left. You need to make money. We all do.

I totally get the frustration of wanting to give the best care possible, but you know this would become your entire life. I've been there and I can honestly say prioritise yourself, not this. You don't want work to become your entire life, you will burn out.

If you really want this, and I completely respect that, it might be worth working a while in teams that already meet some of those needs (palliative care, community neuro rehab, etc) and seeing if that fulfils your needs a little better. If not, you'll gain insight and experience, get to figure out your "niche", so to say.

I'm not saying it isn't possible or good. I've interacted with some private care agencies that have literally melted my heart and floored me with how wonderful they are over the years. It will be a LOT of work, and you will need a lot more than your proposed pricing to make it work well.

Hi Bubblespip. I'm hoping I can give you some practical advice here as I currently run a clinically- lead complex care company and I've 25 years of running Nursing and Care agencies. Firstly you obviously have a fantastic commitment to your patients and I know there will be an ideal role doing what you do in the private sector. Have a look at some of the Case Management companies that do exactly what you offer. I have several clinical assessment and governance roles with small complex caseloads.

You are not being realistic with your pricing. Our hourly charges for a support worker start from £18 per hour.

Also have you thought about the insurances you will need to take out? Professional indemnity, public liability, medical malpractice. These are prohibitively expensive and mandatory. You would also fall under CQC/CIW as a regulated activity and this is an expensive and time consuming process.

You could set up as a limited company and there are cheap packages to help you with the paperwork- plus you'd be VAT exempt. But any Nurses you took on to help would fall foul of last years new IR35 rules and would need to be treated as employees- this would be a major headache for you as a single trader.

Feel free to approach me if you need any advice or signposts to roles that might suit you.

It's a good idea in theory. But just not doable for one person.

Your hourly rate is far too low. Honestly, how can people take your skill set seriously when you charge so little?

You sound like a great nurse, but I'd agree it doesn't sound financially sound.

Registration with the CQC can cost thousands. The people you'd be looking after might be on the phone 24/7 and that would in itself bring difficulties.

The only private practitioners I speak to are doulas and private midwives tho so a bit different.

I've run a nursing business. Feel free to dm me x

My family could have definitely done with someone offering that sort of service during the last 3 months. Whether it's feasible or not, I have no experience in the area so no idea but we definitely would have paid that rate and higher.

Yes I think there is a market with wealthy clients in well off areas, but your rate is far too low: carers with far lower levels of qualification and experience cost £20-£30 per hour round here, I would expect a properly qualified and safe nurse to charge £40/hour or thereabouts.

Could you join an existing company to start with, before going the whole hog and setting up on your own? There are some around, or speak to private-only care agencies locally to see what opportunities there are.