providing homecare in a hostile financial climate duncan white senior policy officer february 2015 1
TRANSCRIPT
Providing Homecare in a Hostile Financial Climate
Duncan White
Senior Policy Officer
February 2015
1
First … what has created the hostile financial climate?
• UK economic situation overall
• Local authority settlements
• Demographic changes
• Commissioning practices
what has contributed to the hostile financial climate?
Demographics: 15% population increase
(Most growth is people >=60 years)
2012 2017 2022 2027 2032 20370
5
10
15
20
25
60-74 years 75-84 years85 years and above
Millions
National Population Projections 2012
Future demand for adult social care for people aged 65 years
33 per cent of men and 15 per cent of women will never need formal care
19 per cent of men and 34 per cent of women will need residential care
48 per cent of men and 51 per cent of women will need domiciliary care
only
so what does this mean in practice?
• the value of Homecare
• risk transfer to Homecare
• the drive for innovation
• the drive for ‘efficiency’
• the quality of commissioning
Why state-funded care is becoming so difficult
• National Audit Office (2014):o Estimated 25% real-terms reduction in total council
budgets since 2010-11 (37% reduction in central funding)
• According to ADASS Budget Survey 2014, state-funded care system will be characterised by:o Increased unmet care needs (eligibility and rationing)o More legal challenges (from providers and users)o Providers in financial difficulty (low rates & HMRC)
• Media create a perception of state-funded care as rushed and undignified
What’s wrong with local authority contracting?
• Continued downward pressure on rates
• Unsustainable maximum tender prices
• Impact of travel time:o 15-minute visits are 14-16% of all purchase
• Polarisation in local markets:o Either: reduced numbers of “approved providers”o Or: Volume fragmented across large framework
agreements
What do we think should be on the next governments agenda?
• Recruitment & Retention:• recruiting values, supply of workers
• Care staff terms & conditions:• National Minimum Wage, Zero-hours contracts
• Regulation:• New inspection methods, Quality Ratings, market oversight
• The costs of regulation: CQC approaching £400 million
• Commissioning & Operating environment:• 400 commissioners nationally !!
• Short visits, “bad news” stories
What do we think should be on the next governments agenda?
take Kent as an example ….
