Care England Policy Insight (18.10.2023)
LaingBuisson: Fair Cost of Care Analysis
LaingBuisson was commissioned to undertake an analysis of the results of the Summer 2022 Fair Cost of Care (FCoC) exercise mandated by the Department of Health and Social Care (DHSC) throughout England. The focus was on the costs of care homes for older people and people with dementia, with a remit to use the nationwide FCoC results to build an evidence-based picture of the size and shape of the market and how costs are structured, to explore the relationship between costs and different models of care, to investigate where costs are similar and where they differ, and to describe the impact on costs of a range of factors such as the size and structure of providers, age of home, staffing arrangements, geography and quality of provision.
Perhaps the most important finding from the analysis is the high degree of variance in care home operating costs. This is mainly driven by variance in staffing intensity (staff hours per resident per week), see Figure 2. The high degree of variance cannot be explained by any of the variables at our disposal from the Fair Cost of Care (FCoC) data. By elimination of all other known variables, it is presumed to reflect variability of residents’ needs across different homes. Any such measure was notably absent from the FCoC exercise. The segmentation into ordinary and ‘enhanced’ care built into the FCoC template did not adequately capture variation in residents’ needs, since the cost distribution of ordinary care overlapped substantially with ‘enhanced’ care.
The broad conclusion is that care services cannot be viewed as ‘commodity-like’, and that there is no such thing as a single ‘Fair Cost’ for any of the four modalities of care (nursing/residential, ordinary/enhanced) that applies to most homes in any given geography. Rather, there is substantial, and rarely articulated, variation in costs around the local market medians. This in turn suggests that any ‘Fair Cost’ fee adopted by any given local authority must underpay some individual homes and overpay others, unless mitigated by flexibility around the local market average ‘Fair Cost’.
Professor Martin Green OBE, Chief Executive of Care England, said:
“This publication strengthens our understanding of the social care market in England through a deeper dive into the Fair Cost of Care exercise mandated by the Department of Health and Social Care throughout England. It is clear that there is not a one-size-fits-all commissioning approach to be taken to costs and models of care. There are complex differences between providers, as well as services that operate in the north and the south. Better understanding these differences, and having the advocacy of LaingBuisson’s analysis, only strengthens our position in advocating for a long-term funding settlement to truly close the Fair Cost of Care gap and ensure the future sustainability of the sector as a whole.”
Care England would encourage its members to use the findings of this report in ongoing fee negotiations with local authorities to help evidence the Fair Cost of Care.
To read an executive summary of the report, click here
Public perceptions of health and social care
The Health Foundation has partnered with Ipsos to deliver a 2-year programme of research into public perceptions and expectations of health and social care. Every 6 months, we will poll a representative sample of the UK public using the UK KnowledgePanel – Ipsos’ random probability online panel – building on our previous work on this topic.
The fourth wave of the polling programme showed that public continue to remain negative about the standard of care in the NHS and social care, although they are slightly more optimistic about future standards in the NHS than previously found. Further, The public are generally negative towards social care services, yet there is no clear consensus on what should be prioritised.
Click here to read the full findings from The Health Foundation.
Healthcare education and training tariff: 2023 to 2024
The Department of Health and Social Care have shared updated information on what the Healthcare education and training tariff: 2023 to 2024 cover, how to use the tariffs and in what circumstances the national tariffs may be varied.
This publication was updated in October 2023 with tariff rates being uplifted to reflect pay deals. This supersedes the original guidance published on 31 March 2023.
This document sets out:
the national tariffs for healthcare education and training clinical placements in the financial year 2023 to 2024
how the tariffs will be implemented
in what circumstances the national tariffs may be varied and how to do this
The tariffs cover placements in clinical settings for the following student groups:
clinical students
undergraduate dental students
undergraduate medical (primary care and secondary care) students
postgraduate medical students
Any further information that arises during the year will be published on Health Education England’s website.
Click here to see the updated changes.
Brick by brick
Resources to support mental health hospital-to-home discharge planning for autistic people and people with a learning disability – protocol document and housing needs assessment templates.
The protocol will help practitioners such as social workers, occupational therapists, clinicians, C(E)TR leads, and commissioners working in local health and social care systems to identify housing options for autistic people and people with a learning disability, who are inpatients in mental health hospitals.
The aim is to ensure that housing is planned and sourced much earlier within discharge process, to enable people to be discharged in a timely manner into community-based housing settings.
Leverage the buying power of other care providers and reduce food costs
Three years of inflation have meant food and beverage costs have increased across the board for care homes by 35%. Energy and high freight costs have added fuel to the fire for the movement of food and deliveries. There’s not a commodity which hasn’t been affected.
Care England and Creed are seeking to help care operators manage their costs through multiple channels which require expert support, but where significant reductions are proven to be possible:
Leveraging the buying power of other care providers through joint tendering
Reduction in staffing overheads
Educating catering staff on kitchen best practise
Meeting the challenge of retaining the right skilled staff
Effective product selection
Supplementing from-scratch recipes with semi and pre-prepared more cost-effective items
Product changes without compromising quality
Minimising food waste
Considered and well-planned stock management
Clever preparation of meals
Utilising more of the product through specially designed recipes
Care providers who wish to explore the cost-savings that can be made with the support of Creed Foodservice can find out more by visiting the Care England website where you can also find out how to participate in the food and beverage tender.
NHS delivering fastest ever flu vaccine rollout ahead of winter
The lifesaving NHS winter vaccination programme has delivered more than ten million flu jabs (10,527,579) and over seven million Covid vaccines (7,525,637) to people most at risk across England in just over five weeks, making this the fastest NHS flu vaccine roll out on record.
A record three million people have received their flu and Covid vaccines in the same appointment, as vaccine providers make it as convenient as possible for people to get protected ahead of winter.
On Monday the national booking system opened up for those eligible to book an appointment to have both flu and Covid vaccines given at the same time.
While analysis also shows that this year has seen the fastest ever rollout of Covid-19 vaccines to care homes by NHS teams, with more care homes visited in the first five weeks of this campaign than in previous rollouts.
More than 12,000 care homes have been visited already – over 80% of all care homes in England.
Despite these efforts, millions more eligible people are being urged to get their lifesaving Covid and flu vaccines to reduce the risk of infection.
Section 75 Consultation Response
On the 13th of September, Care England held a webinar with the Department of Health and Social Care regarding the upcoming review of Section 75. Shortly after this event, the DHSC opened a call for evidence on section 75 arrangements.
As a quick reminder, they want views on changes to section 75 of the NHS Act 2006 to increase the use of pooled budgets to support the integration of health and care. The consultation is accepting views on:
whether the scope of section 75 should be widened to include:
additional health-related functions of local authorities and NHS bodies
additional public health functions delegated to local authorities and NHS bodies by the Secretary of State
a wider range of organisations that can enter into arrangements under section 75
any perceived barriers to pooling of budgets and whether the regulations could be simplified to facilitate easier use and reduce the administrative burden on NHS bodies and local authorities
how we could strengthen and/or simplify the governance of section 75 arrangements to further support the commissioning of integrated care services
To inform Care England's response to this consultation, we have put together the following survey, replicating the questions asked in the consultation, to get feedback from members. All submissions will be anonymous. This survey should take no longer than 10 minutes to complete.
Please note. Completing this survey does not mean you have submitted a response to the DHSC. To submit individual responses, please visit the DHSC website.
The survey can be accessed at this link. The Deadline for responses is Friday 20th October.
If you have any questions, contact FRickatson@careengland.org.uk or LHague@careengland.org.uk
Sector Pulse Check 2023: SURVEY EXTENSION – Please respond by Friday 20th October
The deadline to respond to our Sector Pulse Check survey has been extended to Friday, 20th October. The annual report, analysing the adult social care sector’s financial health and workforce, is a leading publication and is foundational in Care England’s efforts to influence Government policy. We need your engagement to ensure it has the desired effect.
Please fill out this year’s survey, accessible here.
Submissions are anonymous and help us present the nature and scale of the issues facing the sector to Government and other key stakeholders. If you have any questions regarding the survey or report, please contact ibishop@careengland.org.uk.
Tenders and contract opportunities for adult social care
The link below lists recent tender and contract opportunities for adult social care providers to consider.
Lichfield District Council - Voluntary and Community Sector (VCS) Funding 2024 - 2027
https://www.publicsector.co.uk/contractalert/503107
Worcestershire County Council - Provision of a Replacement Care Service at Lock Close, Redditch for Adults with a Learning Disability
https://www.publicsector.co.uk/contractalert/503153
London Borough of Lewisham - All-Age Autism Wellbeing Service
https://www.publicsector.co.uk/contractalert/503200
The Royal Borough of Kingston upon Thames - Personal Assistant Brokerage Service
https://www.publicsector.co.uk/contractalert/503321
North Of England Commissioning Support - Health Needs Assessment Provision for North West Health & Justice Services
https://www.publicsector.co.uk/contractalert/503360
Sheffield City Council - Holistic Tier 2 Adult & Family Weight Management
https://www.publicsector.co.uk/contractalert/502729
Knowsley Council - Oral Health Improvement Programmes
https://www.publicsector.co.uk/contractalert/502832
capitalEsourcing - Community Champion Projects
https://www.publicsector.co.uk/contractalert/502842
Gloucestershire County Council - Invitation to tender for a Community Autism Support and Advice Service
https://www.publicsector.co.uk/contractalert/502878
Medway Council - Support to Live at Home Services
https://www.publicsector.co.uk/contractalert/502967
Click here to see tender and contract opportunities.
Care England re-issues gas and electricity tender for care providers
Care providers with energy contracts expiring before 2026, who wish to secure the lowest possible energy price available at their renewal date and to benefit from support and solutions not available to individual organisations on their own, should register their interest here and complete the expression of interest link.