Embracing the marketplace to deliver personalised care | adam HTT

Those that require care are not faceless; they are real people with real needs. In the same way care providers are also different, delivering varied services. The Care Act talks about personalisation for the individual, ensuring that people receive not only the care they need but the care that they want, to allow them to take control of their own lives. So doesn’t this mean that the approach that many councils take to commissioning doesn’t work?

At the moment it is commonplace for councils to establish framework contracts or lists of preferred providers, allowing only a subset of the local care provider market to supply services. Application processes are difficult, support is limited, and once up and running, there is no transparency or fairness in how packages are distributed amongst providers. Prices are also set up front and take no account of the nuances of individual care packages or individual business conditions. No doubt the favoured providers do well by this approach, but others do not, and the service user’s specific needs aren’t at the centre of the process. This leads to sub-optimal results; often the care package isn’t what’s best for the individual and it is delivered by a provider that is likely capable but not best placed to deliver the care. Surely for people to receive a personalised service, a greater range of providers should be considered and treated as individual businesses? Then the most suitable provider can deliver the service.

Any provider that is suitably qualified should be able to deliver services

That’s why local authorities need to change the way that they commission care services and, indeed, how they support direct payers and self-funders to find the care they need.

Firstly, any provider that is suitably qualified should be able to deliver services. This maximises choice for the council and individual and reduces risk. The process for joining the supply chain should be transparent, simple and the process supported so that it is not a complex form filling exercise but a genuine evaluation of a provider’s suitability to supply services.

Importantly, then, it must be that, when commissioning a package of care, the Council evaluates all providers in the market to find the provider that offers a service best suited to the individual. This not only benefits the individual but also each provider gets considered for care packages, rather than just a favoured few. This could be seen as a manually intensive process but technology can be adopted to make this process easier. Whilst technology should not be used for technology’s sake, if people are better off because all options are considered and providers are better off because all are treated fairly, then everyone wins.

That’s not to say that each provider will be able to meet the needs of every person, because they won’t. People will need different services and providers will have different capabilities. This type of approach means providers can decide whether they have the staffing and resources to meet their needs and then offer a fair price based on those services. If you are a particularly high-quality care provider, this should be recognised by the process. Soon, more providers are involved in the process, with quality and appropriateness winning through.

If councils are going to truly embrace the Care Act, then it needs to be viewed from all sides.

The only way to embrace personalisation is to start with the providers. It’s time for local authorities to offer supply opportunities to more of the provider market and see that a larger supply base actually decreases risk and increases the ability to personalise services, ensuring better quality. Having more suppliers to call on, of all shapes, sizes and capabilities, is better for public service procurement and, ultimately, the people who need those care services.


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