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Homecare: Meeting the challenge. Andrew Heffernan Membership and Marketing Director. Reconciling opposing forces. Cost focused commissioning practices. Increasing quality expectations . “Care is not a commodity”. Published July 2012 739 responses 90% of councils covered
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Homecare: Meeting the challenge Andrew Heffernan Membership and Marketing Director
Reconciling opposing forces Cost focused commissioning practices Increasing quality expectations
“Care is not a commodity” • Published July 2012 • 739 responses • 90% of councils covered • Highlights implications of public spending on homecare services • Is “time and task” homecare dignified or personalised?
Commissioning short visits:73% are 30 minutes or fewer Source: Angel, C (2012) Care is not a commodity
34% providers report dignity and safety at risk during shortest visits
76% providers say their council puts lowest price above quality
Other key findings • 53% of providers reported councilssetting maximum prices in tenders • 77% of providers had prices frozen in2011-12 and 15% reported price decreases • Increasing use of “per minute” billing • Lack of enhancements for short visits, weekends and unsocial hours • Only 24% of providers hold contracts with guaranteed purchase
Impact of short visits Shorthomecare visits bought by local authorities Rushed, undignified care for highly dependent people Dissatisfactionwith homecare services andadverse publicity Workers dissatisfiedwith their ability to provide care High staff turnoverdrains skills & experience and increases costs Travel time increasesas a proportion of total cost Potential non-compliance withNational Minimum Wage
But what can I do with UKHCA’s report? • Understand the current and anticipated trends in council commissioning • Remind yourself how important self-funders are for your business(!) • Killer facts for pricing tenders • Support your arguments with commissioners • A great excuse to meet with your MP • Supply the report to local journalists covering care stories in your area
Why is quality a top agenda item? NHS and hospitals: Social care: Dignity and nutrition reports Meeting needs of people with dementia EHRC report on homecare CQC homecare inspection report • Winterbourne View and Morecambe Bay • Francis Report intoMid Staffordshire • Target-driven culture and failure to act on NHS mortality data • Whistleblowing and use of gagging clauses
CQC Themed Inspection Report - Priority issues in homecare • Missed / late visits • Consider electronic monitoring systems • Resist “call cramming” • Careworker continuity • Inform users of unplanned changes • Training for coordinators • Quality monitoring • Need for QA Systems • Record and act on feedback from users • Staff training • Performance review • Training & development plans
Quality initiatives in progress Openness and information high on the Government’s agenda
Provider Profiles on NHS Choices • Provides a free directory listing: • NHS Choices receives >19 million visits / month • No additional charges to enhance profile: • A text description of the service • Images and videos; biographies of key staff • Types of services offered • Profiles will be extended to offer: • User reviews from 3rd party websites • “Transparency measures” reported by providers • Membership of organisations and quality schemes
Use your quality marks in public • Display your quality marks on your literature and website • Embed CQC’s “widget”on your website • UKHCA’s members benefit from our Code of Practice and logo • Consider signing-up for TLAP’s “Making It Real” programme
Some predictions and challenges • Tough negotiations with councils • Use UKHCA costing model • Use every available opportunity to engage with council • Form links with councillors and MPs • Focus on quality • Sign up for the “Transparency measures” • NHS Choices offers excellent (free) opportunity • Engage with customers and promote quality proposition • Growing interest from the media • How will you respond to positive opportunities to promote homecare and your services? • UKHCA guidance on responding to negative enquiries
For more information • www.ukhca.co.uk